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Autism in Baltimore, 1938–1943

Abstract

This paper examines the genesis of Leo Kanner’s 1943 seminal paper on autism. It shows that describing children as autistic or lacking affective contact with people was not new by this time. But Kanner’s proposal that infantile autism constituted a hitherto unidentified condition that was inborn and different from childhood schizophrenia was new. It also shows that Georg Frankl’s influence on Kanner was important, but Kanner did not misappropriate his ideas or his research. Kanner developed his views on the basis of his observations of several children, his knowledge of the literature on childhood conditions, and his interactions with many scholars.

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Notes

  1. To avoid repetition, quotes from the staff conferences always pertain to the staff conference last referenced, except when otherwise indicated.

  2. The recent literature on Asperger has focused mostly on his connections to Nazi ideology (Czech 2018, 2019; Falk 2019; Sheffer 2018), and hence his relationship to Frankl’s work has only been tangentially addressed.

  3. Kanner started his now famous 1943 paper with: “Since 1938, there have come to our attention a number of children whose condition differs so markedly and uniquely from anything reported so far…” This sentence has led several authors to speculate about the significance of 1938: was Kanner referring to Asperger’s 1938 paper (Lyons & Fitzgerald 2007)? Or to a paper by Despert (Fellowes 2015)? We agree with Olmstead and Blaxill (2016) that Kanner, clearly, referred to Donald’s arrival in Baltimore.

  4. It was not, as Silberman (2015, p. 167) states, “a Johns Hopkins affiliate launched that year [1938] under his supervision.” It was also not directed by Kanner, as often stated.

  5. They deserve further historical study, but it is not accurate to present them as ignored figures. See Manouilenko and Bejerot 2015; Zeldovich 2018.

  6. It seems that Frankl did not get along with the superintendent at the Home, Ms. Mertz. In a letter to Kanner he notes with happiness that “the Mertz storms are over” (Frankl 1942); in another he says: “Occasionally I get worried that I have become too much of a chameleon. On the other hand, I think I could get along now with Miss Barbe and perhaps even with Miss Mertz” (Frankl 1943a).

  7. The minutes of the annual meeting of the Nursery and Child Study Home for 1940 mention that one of the reasons the Home had received fewer children over the last months was that “Displeasure of Dr. Kanner over the dismissal of Dr. Frankl has kept the clinic from sending any children” (Maryland Nursery and Child Study Home 1941).

  8. Eventually, Kanner found out that his mother had died in a concentration camp in Bohemia and that one of his brothers had been shot in Poland (Kanner n.d.).

  9. Silberman claims that at the Phipps Frankl’s observational work managed “to make autism visible to medicine for the second time” (Silberman 2015, p. 169), while Sheffer argues that Kanner based his first case of autism “on Frankl’s research” (Sheffer 2018, p. 60).

  10. He did continue that work in the 1950s, as shown by a copy of an unpublished manuscript (Frankl n.d.) he left at the University of Kansas. Although undated, the paper makes a reference to a roundtable at the American Orthopsychiatric Association meeting of 1953.

  11. Czech (2018, p. 33n7) has found evidence that the JHU Library received the issue of the Wiener Klinische Wochenschrift in which Asperger published his 1938 paper. But this does not show that Kanner actually read it, and made the connection.

  12. Kanner’s own views would change over the years for a series of complex reasons that are beyond the scope of our paper. Vicedo (2021) discusses the changes in Kanner’s views in detail.

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Acknowledgments

We gratefully acknowledge the help received from the following archivists: Marjorie Kehoe and Phoebe Evans Letocha at the The Alan Mason Chesney Medical Archives of The Johns Hopkins Medical Institutions, and Deena Gorland and Gary McMillan at the American Psychiatric Association Foundation, Melvin Sabshin, M.D. Library & Archives, Washington, D.C. Thanks to John Robison, Frederik Boven, and two anonymous reviewers for their helpful comments. Thanks to Mark Solovey for useful feedback on content and form. Marga Vicedo also gratefully acknowledges funding from the Social Science Research Council of Canada Insight Grant’s Program.

Funding

Marga Vicedo: Social Science Research Council of Canada Insight Grant.

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All authors contributed to the study conception and research of this study. All authors wrote drafts and commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Marga Vicedo.

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Approval was obtained from the University of Toronto Human Research Ethics Board (Protocol #30993), and Waiver of Authorization for Research Use or Disclosure of Protected Health Information from the John Hopkins Medical Institutions Privacy Board. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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A code for the children mentioned was developed and deposited at the The Alan Mason Chesney Medical Archives of The Johns Hopkins Medical Institutions.

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Vicedo, M., Ilerbaig, J. Autism in Baltimore, 1938–1943. J Autism Dev Disord 51, 1157–1172 (2021). https://doi.org/10.1007/s10803-020-04602-4

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