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October 21, 2024 - January 10, 2025
But the secret of Perl’s versatility is that it’s also an expression of the minds of Larry’s far-flung network of collaborators: the global community of Perl “hackers.” The code is designed to encourage programmers to develop their own style and everyone is invited to help improve it; the official motto of this community is “There is more than one way to do it.”
Suddenly, a trim, dark-haired young woman at the next table blurted out, “I’m a special-education teacher. Do you realize what’s going on? There is an epidemic of autism in Silicon Valley. Something terrible is happening to our children.”
Kanner named their condition autism—from the Greek word for self, autos—because they seemed happiest in isolation.
For decades, estimates of the prevalence of autism had remained stable at just four or five children in ten thousand. But that number had started to snowball in the 1980s and 1990s, raising the frightening possibility that a generation of children was in the grips of an epidemic of unknown origin.
Sacks cast light on the challenges that they face in their day-to-day lives while paying tribute to the ways they bring the strengths of their atypical minds to their work. “No two people with autism are the same: its precise form or expression is different in every case,” he wrote.
“If you had 100 kids with autism, you could have 100 different genetic causes.”
a disproportionate number are unemployed and struggling to get by on disability payments.
To Kanner, autism was not merely an eccentric cognitive style or an alternate mind-set. It was a tragic form of childhood psychosis, akin to schizophrenia, caused by inadequate parenting. It was certainly nothing to be proud of.
echolalia (the term of art for the way that autistic people sample the speech they hear around them and repurpose it for their own use).
In his introduction to Seroussi’s book, Rimland proclaimed that she had found “what all parents hope for: a cure for her son.” With his endorsement, the notion that autistic children could be cured by making changes in their diet sent ripples of hope through the parent community at a time when the fear of a worldwide epidemic caused by vaccines was reaching its peak.
The popularity of biomedical treatments for autism mirrored the general rise of interest in so-called complementary and alternative medicine in recent decades. By the first years of the twenty-first century, the trade in high-dose vitamins and supplements had become an economic powerhouse, with annual sales topping $33 billion.
Americans now consult their homeopaths, naturopaths, herbalists, acupuncturists, chiropractors, and Reiki workers more often than they see their primary care physicians.
Gottfried was highly intelligent—but in ways that didn’t register on the clinic’s standardized tests.
Even the most gifted of these kids found it hard to learn basic life skills like dressing, bathing, and behaving politely at the table. They also tended to be clumsy and inept at sports, which singled them out for mockery in a culture that exalted athletic vigor as a sign of spiritual health.
“We will not allow ourselves to be turned into niggers,” Hitler bragged to the editor of a conservative German daily in 1931. “The Nordic blood available in England, northern France and North America will eventually go with us to reorganize the world.”
In July 1933, Reich Minister of the Interior Wilhelm Frick put the Law for the Prevention of Genetically Diseased Offspring into effect. Any German citizen who showed signs of schizophrenia, bipolar disorder, epilepsy, inherited blindness or deafness, Huntington’s disease, or alcoholism could be forcibly sterilized.
The law also mandated the creation of Genetic Health Courts that decided the outcome of individual cases and heard appeals (which were rarely granted). In 1934 alone, 84,600 cases were brought to the court, resulting in 62,400 forced sterilizations. Eventually, more than four hundred thousand men, women, and children were sterilized against their will by the Nazi regime.
In other words, it was a spectrum. Once you knew what to look for, you saw it everywhere.
There, he helped Nazi officials draft a secret plan to rid the world of children like Gottfried, Fritz, and Harro that would become Hitler’s blueprint for the Final Solution against the Jews. This monstrous scheme, which Jekelius and his cohorts carried out with brutal efficiency, began with the murder of a single child who had been declared an idiot by his doctors.
Over the next five years, Jekelius and his successors, Ernst Illing and Heinrich Gross, murdered 789 children at the facility, including 336 from the infants’ ward. Most of these children had been diagnosed with feeblemindedness, epilepsy, or schizophrenia—the three diagnoses that autistic children were most likely to receive in the days before autism was an accepted diagnostic category. Nonverbal patients were favored for extermination because they created extra work for the nurses; eventually children who were “simply annoying” were added to the list.
variety of killing methods, all equally barbaric, were employed by Jekelius’s team and by medical staff in other institutions. Some children were killed with an injection of carbolic acid, and some with an excess of barbiturates; others were simply left outside, exposed to the harsh Austrian winter, until they contracted pneumonia. Parents would typically receive a note in the mail informing them that their son or daughter had died of natural causes. (The lesson of Meltzer’s 1920 survey of parents had not been lost on Hitler.) Often these notes also included a bill for cremation or burial
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All over the world, autism was referred to simply as “Kanner’s syndrome.” The fact that two clinicians, working independently on both sides of the Atlantic, discovered it nearly simultaneously is still considered one of the great coincidences of twentieth-century medicine.
“When the time is ripe,” mused mathematician Farkas Bolyai, “these things appear in different places in the manner of violets coming to light in early spring.”
Frankl stressed that Karl represented only one point on a continuum that stretched from children with profound intellectual disability to “astonishing” child prodigies.
Another community that enabled autistic people to make the most of their natural strengths in the early and mid-twentieth century was amateur radio. By routing around the face-to-face interactions they found so daunting, even people who found it nearly impossible to communicate through speech were able to reach out to kindred spirits, find potential mentors, and gain the skills and confidence they needed to become productive members of society.
Pulp devotees did not invent the word fan (derived from the Latin fanaticus, “possessed by divine madness”), but they established the first fandom in the modern sense, with its own elaborate customs, art forms, specialized jargon, conventions, and absurdly bombastic internecine warfare.
The text-based nature of online interaction eventually provided the foundation for something that Leo Kanner couldn’t have imagined: the birth of the autistic community. But two things had to happen first. Kanner’s notion that autism was a rare form of childhood psychosis would have to be permanently laid to rest. Then, as Asperger’s lost tribe finally emerged from the shadows, autistic people would have to overturn the notion that they were the victims of a global epidemic.
Fittingly, the man who consigned the theory of toxic parenting to the dustbin of history was the loving father of an autistic boy himself: a warm, garrulous, obsessively curious Navy psychologist named Bernard Rimland.
By writing a book called Infantile Autism as a self-taught outsider in the field, he firmly established autism as an inborn condition based in genetics and neurology rather than the complexities of the developing psyche.
“It may not be too far amiss to suggest that some autistic individuals are incipient geniuses whose eccentricities are so severe and incapacitating that all but minimal participation in the ‘normal’ world is precluded.”
you met [the children] now . . . you would never know that anything had been wrong with them,” Lovaas told the New York Times. “I’m positive now that autism need not be chronic.”
He reiterated his belief in a connection between autism and genius, suggesting that children with the syndrome inherit “a double dose of the extreme ability to concentrate—to narrow their attention to a very fine point, like a searchlight, to illuminate with great intensity a very small matter.”
He calculated a prevalence estimate of 4.5 cases of autism in 10,000—that is, thirty-two children in total, a very small number indeed. After being replicated by other researchers using similarly restrictive criteria, this number became the oft-quoted baseline against which all future autism prevalence estimates would be compared in the coming decades.
Ultimately, she adopted the term autism spectrum. She liked the sound of it, which evoked pleasing images of rainbows and other phenomena that attest to the infinitely various creativity of nature. Clinicians readily adopted the phrase, because it helped explain what they’d been seeing in the real world for decades. It was a meme destined to go viral, so to speak—with assistance from a collusion of cultural forces that Lorna could not have foreseen, including a film that would turn Kanner’s formerly obscure disorder into a household word virtually overnight.
Bill, starring Mickey Rooney, with a handsome unknown named Dennis Quaid playing Morrow, aired in 1981—the year of Reds, On Golden Pond, and Chariots of Fire. The film went on to win an Emmy award, a Peabody, and two Golden Globes.
Cliff Robertson won an Academy Award in 1969 for his sensitive portrayal of an intellectually disabled baker in Charly, an adaptation of Daniel Keyes’s heartbreaking novella Flowers for Algernon.
was an open secret that two patients presenting with the same complaints in two psychiatrists’ offices might end up diagnosed with different disorders. This flexibility, so to speak, was built into the system, reflecting the enduring influence of Kanner’s mentor, Adolf Meyer.
It was the psychiatrist’s job to arrive at an understanding of this situation by interpreting symptoms and probing into the patient’s background, using the tools of whatever theoretical school the therapist subscribed to.
In short, while Spitzer’s eccentricities may have fallen short of meeting the criteria for Asperger’s syndrome, the DSM-III was the product of a mind that exhibited many classic qualities of autistic intelligence. These traits enabled Spitzer to get the job done with a minimum of fretting about offending various sectors of the profession.
Autism was framed narrowly in terms of his two cardinal signs: “pervasive lack of responsiveness to other people” coupled with “resistance to change.”
For the mature Temple Grandins of the world, the only diagnosis on offer was “Infantile Autism, Residual State”—an awkward kluge invented to describe people who met the criteria for the full syndrome in infancy and still manifested “oddities of communication and social awkwardness.”
The word infantile was finally gone for good, and Kanner’s syndrome was rechristened “autistic disorder,” which was understood to persist from the cradle (or shortly thereafter) to the grave.
One thing that is immediately obvious is that the new criteria could be applied to a much larger and more diverse population than the criteria in the DSM-III.
Later studies confirmed that the revised criteria were better at picking up cases of autism at every level of ability, including children who would have been diagnosed only with “mental retardation” in previous generations.
Between 1990 and 2000, cases of autism in the Family Fund database went up by an astonishing 22 percent on average each year.
A major change in referral patterns was also under way in England that was guaranteed to produce a spike in autism diagnoses that would never level off again.
“As I explain to parents, the cure for Asperger’s syndrome is very simple—it is not surgery, medication or intensive therapy,” says Tony Attwood, one of the world’s leading authorities on the subject. “It is taking your son or daughter to their bedroom, leaving the bedroom, and closing the door. You cannot have a social deficit when you are alone. You cannot have a communication problem when you are alone. Your repetitive behavior does not annoy anyone when you are alone. All the diagnostic criteria dissolve in solitude. That’s why teenagers with Asperger’s are reluctant to leave their bedroom
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Given a technology that enabled him to communicate with other like-minded young people, he might have encouraged them to feel that their problems originated not in themselves, but in the system that had branded them diseased and inferior.
Few members of Volkmar’s subcommittee could have predicted that the term Aspie would become a badge of honor and defiant pride within a decade, even for those without an official diagnosis.
Spotting the signs of autism—once the arcane skill of the initiated few—became the job of nearly everyone involved in pediatric medicine, psychology, and education.
