You'd think Leo Kanner would be the figure in autism history I'd have the most mixed feelings about, wouldn't you? He was the first doctor to diagnose someone with autism, but he was also the author of the refrigerator mother theory, which has been remarkably destructive. And then he helped to strike one of the most important blows against that theory when he wrote the foreword for Bernard Rimland's 1964 book Infantile Autism: The Syndrome and Its Implications for a Neural Theory of Behavior.
But Rimland's own role in the very odd history of autism is even more complex than Kanner's.
He was autism's first parent researcher, shifting his focus after his son Mark was born. By 1964, Kanner agreed with Rimland that autism had a neurological cause, and his endorsement gave Rimland's book authority.
Rimland continued his advocacy for autistic people and their families until his death in 2006. He co-founded the Autism Society of America in 1965. He was an early and powerful advocate for Applied Behavior Analysis and against Facilitated Communication.
He was the primary technical advisor on the film Rain Man.
Unfortunately, Rimland went too far with the idea of a biological cause for autism, and spread wrong ideas that are still doing harm today. He started the Autism Research Institute in 1967. He popularized the idea that autistic children could be "recovered" through diet and vitamins. He advocated for chelation.
And many, many people have been endangered by his belief that autism is caused by mercury in vaccines.
If Hans Asperger and Leo Kanner are the first heroes of autism history, Bruno Bettelheim is among its first villains. He was one of the most popular child psychologists from the 1960s to the 1980s, and his opinions about autism were especially influential and destructive.
But the term "refrigerator mother" actually comes from Kanner, and he created the theory that autism springs from a lack of parental affection:
In his 1943 paper that first identified autism, Leo Kanner called attention to what appeared to him as a lack of warmth among the fathers and mothers of autistic children In a 1949 paper, Kanner suggested autism may be related to a "genuine lack of maternal warmth", noted that fathers rarely stepped down to indulge in children's play, and observed that children were exposed from "the beginning to parental coldness, obsessiveness, and a mechanical type of attention to material needs only.... They were left neatly in refrigerators which did not defrost. Their withdrawal seems to be an act of turning away from such a situation to seek comfort in solitude." In a 1960 interview, Kanner bluntly described parents of autistic children as "just happening to defrost enough to produce a child."
Bettelheim, however, did the most to popularize the idea that children developed autism because their parents, especially their mothers, did not show them enough love, notably in his 1967 book The Empty Fortress. In the clip above from a 1979 episode of The Dick Cavett Show, he says that parents have the same relationship to their autistic children that Nazi guards had to the prisoners in concentration camps:
In the case of these extremely disturbed children, not only nobody cared, but there was a wish that it would be much better if the child wouldn't live... This autistic child felt that everybody wants him to be dead, as the Nazis indeed wanted all the Jews to be dead...
After Bettelheim killed himself in 1990, it was discovered that he had lied about many things, including his academic credentials. Former patients accused him of abuse.
The "refrigerator mother" theory is still popular in France, as shown in the documentary The Wall.
Although he was not the first person to use the word "autistic" to describe autistic people, Leo Kanner is the person who made autism a recognized diagnosis. In 1943, he published a paper called "Autistic Disturbances of Affective Contact," which began the process of defining autism.
In 2010, Caren Zucker and John Donvan found Donald Triplett, one of the subjects of that paper and the first person ever diagnosed with autism. He turned out fine.
Kanner continued to be one of the most influential figures in autism and the field of child psychiatry through the 1970s. He died in 1981.
Donald Triplett, the first person ever identified as autistic. Photo by Miller Mobley/Redux.
I can think of no better way to end 2010, the most autistic year ever, by going back to Donald Triplett. Caren Zucker and John Donvan found Donald, the first person ever identified as autistic, and published an article in October of this year that describes his long and happy life:
Donald drives his car with a light, percussive rhythm. After pressing on the gas pedal for a second, he lets up briefly, and then presses back down again. Down. Release. Down. Release. The tempo doesn’t vary. It’s late afternoon, and Donald is guiding his coffee-colored 2000 Cadillac, in hardly perceptible surges and glides, south along Mississippi’s Route 80. Though his forward posture and two-fisted grip on the wheel are those of an old man, his face beams like a boy’s. He wears the expression, at once relaxed and resolute, of a man who is doing precisely what he wants to be doing.
The day’s agenda thus far has included morning coffee with friends, a long walk for exercise, a Bonanza rerun on TV, and now, at 4:30, this short drive down Route 80 to get in some golf. “I noticed,” he mentions, “you have a Lafayette County sticker on your car.” He’s broken a long silence with that comment, a reference to the registration decal on the rental we parked in his driveway. His words hang there for a moment, and then he adds: “That means it comes from Lafayette County.” That’s all. Nodding to himself, Donald goes silent again, his focus returning to the road ahead, or tuned to some inner monologue. Given his tendency to close his eyes for long moments when he speaks, this is probably the safest choice.
He parks just short of the front steps of the Forest Country Club, an establishment without pretensions. The one-story red-brick clubhouse fronts onto a well-tended, mostly flat course carved out of the woods. Membership is $100 per family per month, and a round of 18 holes costs $20 on a weekday. On any given day, the roster of players on the fairways includes lawyers and mechanics, bankers and truckers, salesmen and farmers—and Donald. Actually, Donald is there every day, weather permitting. And almost every day, he golfs alone.
Not everyone who plays here realizes that “DT”—as he’s known around the club—has autism. But his quirks are hard to miss as he makes his way to the first tee, well within sight of members who take the shade in armchairs under the club’s columned portico. A small man in khaki shorts and a green knit shirt, with a pink-camouflage bucket hat pulled down tight over his ears, Donald strides to the tee with the distinctive gait that is often a tip-off for autism—his arms out from his sides in the shape of a large capital A, his steps just slightly mechanical, his head and shoulders bobbing left-right-left in the rocking movement of a metronome.