Vaccination, Social Violence, and Criminality - TRADUZIDO PORTUGUÊS

VACINAÇÃ
O
SOCIALWHE
NCE m
CRIMINAUTY
O Medical DE ASSALTO
American CÉREBRO
ON
THE
HARRISLCOUL
TER
uummm
*
Vacinação, social violência e
vacinaçãoCriminalidade,
Social Violência e
Criminalidade
O assalto médico noamericano
Cérebro
por Harris L. Coulter
North Atlantic Books Berkeley, California O Centro de Empirical

Medicina Washington, D.C.
O autor deseja agradecer a seguinte permissão para citar as fontes listadas: A
Americana Psiquiátrica
Associação de autorização para citar o Diagnóstico e Estatístico Manual de TranstornosM
entais, Third Edition
e Terceiraedição, revisada, © 1980, 1987 pela American Psychiatric Associação. O Sion Aynesworth.

New citar americano

© de 1989
Conversas Biblioteca, por Stephen uma divisão com G.
ichaud um de
M
Stephen Hugh
assassino do pinguim por e Livros Aynesworth.
G. EUA
Michaud Inc.
, Por e permis
- Hugh
Random House, Inc., Permissão para citarasubclasse por Ken Auletta. © 1982 por Ken Auletta
orker). Jack
(originalmente publicado no The New Y Friedman, Kristina Johnson e Dan Knapp/P eekly
essoas W
©1988TheTime Inc. CoMagazine. Todos os direitos reservados.
Vacinação, The M
edical Assault Violência
s ocial, no a
riminalidade: Brain
mericano e C
ISBN ISBN
© 1990 1-55643-084-1 1-55643
03-1 pela Harris L. (Paperback)
-1
Coulter (pano) Todos os direitos reservados
editores endereços': North Atlantic Books 2800 Woolsey Rua Berkeley,

Califórnia 94705
Center for empírica Medicina 4221 45th S treet, N.W. Washington, D.C. 20016
Capa e projeto do livro por Paula Morrison Typeset b

y Campaigne & Associates Impresso nos Estados
Unidos da América

Estudo dos nativos Artes e
Criminalidade é patrocinado pela Sociedade para o
Vacinação, violências ocial, e
Ciências, uma sem fins lucrativos educacional corporação cujos objetivos

são desenvolver uma ecológica e
intercultural perspectiva que liga vários sociaiscientíficos, e camposartísticas; para nutrir uma holística visão
das a rtes, ciências, das humanidades,

e cura;
mente, corpo, e natureza.
e para publicar e distribuir literatura sobre a relação Biblioteca do Congresso catalogação-em-P
ublicação de dados
Coulter, Hanis L. (Harris Livermore), 1932- 616,8'0471

- c érebro/Hanis 3 . RJ135.C68 Vacina, ISBN Inclui
I. Imunização P
Desenvolvimento 1-55643-1
03-1 : bibliográfico
cm.
20 1990 Coulter. s ocial de crianças
L. dc - deficiências- violência , $35,00
Complicações Etiologia. 2.
referências e a criminalidade ISBN p(. o assalto médica na American 1-5
5643-084- 1): e index.
Conduta Distúrbios e sequelas. Eu. Título.
(pbk.):
US $16,95
em crianças
- Etiologia .
90-7991 CIP
Índice
Introdução: “A maioria imunizados Criança na História!”. . .
Capítulo I: Autism
Alienação Ego Fraqueza Medo e Ansiedade “O Frigorífico Mãe” A Teoria Neurológica do Autismo
Craniano Nervo paralisias A Neurológicas Base para a alienação ea Ego Fraqueza Appetite,
digestivo, e Bowel Distúrbios Dores decabeça, Head-Bater Defining Autismo: S
índrome deRett,
Asperger's Syndrome. . . . 31 Compensando a Ego Fraqueza do: Resistindo à Mudança
Compensando a Ego Fraqueza do: Agressão . . . Compensando a Ego Fraqueza do:
uscando Estrutura: M
Hipersexualidade . B úsica cronológicos paralelos Uma intrigante
característica
Capítulo II: Minimal Brain Damage
espiração e Asma Psicológica ou
Definindo a Síndrome craniano nervo Paralisia do R
Neurológica? Intelectual FragilidadeIncapacidade de adquirir Experiência Ego F
raqueza do,
Egocentrismo A lienação deeEmocional Imaturidade Depressão e Suicídio Compensando a Ego
Fraqueza do: Resistindo à Mudança Compensando a Ego Fraqueza do: Hipersexualidade .
Buscando Estrutura: Música MínimoCerebral Dano e Autismo
1 1 357151824283038404648495159 60

IX
656970777980828385899293
Capítulo III: A Pós-Encefalítica Síndrome . . . .
Encefalite no XX século agudas Reações na encefalite e após a vacinação . . . . 103 Anorexia e
Bulimia Hiperatividade Craniano Nervo p aralisias retardomental, convulsões, paralisiacerebral,
ue deve haver uma aguda reaçãosevera? O “ Hot Lot” Developmental Delay
paralisias, hipotonia q
egoísmo, FraquezaEgo, Alienação A Moral e emocional vazio Intelectual Fragmentação labilidade
e Impulsividade Compensando a do fraquezaego: resistir à mudança Compensando a do
fraquezaego: Hipersexualidade. E ncefalite, autismo, e cerebral mínima danos
Capítulo IV: Vacinação e alergias
Alergias na encefalite, autismo, e Minimal Brain Damage Mielina e desmielinização experimental
encefalomielite alérgica Aumentar alérgica Hipersensibilidade do Modem Homem
Predisposiçãogenética? Dietético Tratamento de Alergias
Capítulo V: A Sociopata Personalidade e o Crime Violento . 1 71
Aumentando a violência eo crime na América criminoso comportamento n o Post-encefalítica
População Criminal Comportamento e Autismo: de Síndrome Asperger. . . . 181 criminoso
comportamento e cerebral lesãomínima: Conduta Transtorno de Personalidade Sociopathic. . . A
Classecriminosa, a subclasse do preto Adolescent violência e Epilepsia
99 100
108 110 111
117 119 124 125 127 130 131 132 133 141 143151
152 155 157 159 160 162
172 179
183 186 194 196 197
Aviolência, retardamentomental, e c raniano nervo paralisias Violência e Minor Neurológicas
Deficiência Personalidade do Sociopath: infantil. o egoísmo . . . A g
angue que nãopodia Pense
ersonalidade do Sociopath: FraquezaEgo, perder o controle. 209 Personalidade do
Hetero P
Sociopath: Depressão e Suicídio. . . . 211 D
efesas e Compensações: Paranóia, Sexuais Defesas e
efesas e Compensações: Álcool e
Compensações: Infantil Abuso . . . . D rogas . Álcool e
D de
drogas a o minimamente cérebro danificado O irresistível impulso: o caso de
buso por autistas e
Ted Bundy Háuma cura?
Capítulo VI: O Hubris Médico e suas Consequências
Apêndice: As Entrevistas
Bibliografia
Índice
200 202 204 207
212 214 216
217 229 239249

265
267
293
Introdução: “A Mais I munizada Criança da História!
”O XX século é a idade de vacinação. Edward JenneremA 1798 de descoberta de que a varíola
bovina inoculação de previne a infecção tardia com varíola foi o início de uma nova ciência.
Agora chamado de “imunologia”, foi adornada por tais históricos nomes como Louis Pasteur,
Robert Koch, Emil von Behring, Jonas Salk, Albert Sabin, e muitos outros menos proeminente.
Depois de varíola bovina veio vacinas contra a raiva (1885), febre tifóide (1911),
tuberculose (1921), a difteria (1925), tétano (1925), yel- baixa febre (1937), influenza (1943),
poliomielite (1954 e 1956), e outros.
A maioria tem sido benéfico, especialmente aqueles contra as grandes epidemias que já
assolaram a ÁsiaÁfrica, e Latina América - pestebubônica, febreamarela, cólera, tifo e
poliomielite. oXIX, século nenhum Europeia ou americano poderia visitar osafricanos ou
N
asiáticos continentessem arriscar um poten- cialmente doençafatal. britânicos, franceses e
portugueses Diplomatas e coloniais administradores morreram em grande número.
Ainda hoje, turismo ou de negócios na maior parte doTerceiro Mundo seria impossível
semvacinas.
Estes triunfos da imunologia são incontestáveis, e nenhum criti- CISM é feito deles nas a
páginasseguir. Atuberculose, por exemplo, mesmo no início do séculoXX, levado milhares a
cadaano; hoje mortes por esta doença têm sido drasticamente reduzido, graças, em parte, à
vacina.
Segundo a Mundial de OrganizaçãoSaúde, a varíola de erradicação da campanha tem
completamente livraro mundo desta vez- epidemiatemida.
No entanto, como tantas vezes acontece nos humanos assuntos, o sucesso levou ao
excesso. Depois de domar estes flagelosancestrais, os médicos procuraram
ix
“A maioria i munizados C aH
riança n istória!
"Novos desafios e, no devido tempo, dirigiu sua aatenção para as comuns doenças da
infância.
O primeiro tal vacina foi para convulsa a tosse ( coqueluche) em 1925. Uma vacina para o
sarampo seguido em 1960, por alemão sarampo ( rubéola) em 1 966, e para a em
caxumba,1967 a vacina contra a galinhavaríola está em preparação hoje-..
édicos, noentanto, deu insuficiente pensamento para a diferença entre o
pesquisadores e m
totalmente crescido adultoe o recém-nascido Mesmo no primeirocaso, a injeção de
tóxicas proteínas carrega. uma medida de risco. injecção do mesmo material empequenos
bebês é muito mais perigoso oimunológico adulto sistema foi temperado e pode suportar o
estresse da vacinação os dois-..mês-velho bebê é inconcebivelmente mais vulneráveis
Mas isso é quando a imunização começa. nos Estados Unidos.*
as conseqüências são descritas nas páginasseguintes. vacinação os programas de
começou em s ério durante e depois da Guerra SegundaMundial. em 1960s persuasão
became obrigação como o aioria dos e
s tiros foram tornados obrigatórios na m stados.
Hoje quase todas as americanas criançasé vacinado contra a tosseconvulsa,
arampocaxumba, e tétano. (EuropaOcidental, ao
sarampoalemão, poliomielite, difteria, s
contrário, requer apenas tétano e de pólio vacinasorais.)
A lista está aberta-terminou, noentanto, como empreendedores os fabricantes preparar mais
e mais substâncias para injecção nos braços e coxas de nossos filhos, como se cada
imaginável doença poderia ser repelido por oportuna administração da apropriadamente
doença proteínapreparado.
As campanhas são difíceis de resistir. As vacinas têm p écadas estiveram na
or d
vanguarda do progressomédico. Que mãe irá não proteger seu bebê de uma bacteriana
ou ameaçaviral? O trabalho dos pais pode pagar o inconveniente de ficar em casa por
dias ou semanas com a
*A regra de que a vacinação deve começar em dois meses- mais cedo nos Estados Unidos
do que e m qualquer o utro país- é p
rojetado principalmente para o con- venience de
pediatras (ver Coulter, H. e Fisher, B., 32).
“
a história! "Xi
A mais i munizada criança d
convalescente aluno?
Não há noites ao do ladoberço. Não perdidas Dias na escola! A conveniência se estende
também para o médico ou pediatra. Não há mais visitasdomiciliares. Nenhum
telefonema à meia-noite, com um distraído ou indignado pai com a outra extremidade a
linhaem vezdisso, um agradável constante f luxo de crianças e mães que vêm para o
escritório para! “bem-de visitasbebê” e os obrigatória “tiros”
e, é claro, um muito-reduzido perigo de crianças morrer ou de sofrer cerebrais danos a
partir do encefalite que às vezes ocorre em mais graves casos de papeirasarampo, ou
convulsa a tosse.
nos ú ltimos anos, uma comum propaganda para vacinas em americanas médicas revistas
já contou com um rosado-cheeked jovem exaltado como “a mais criançaimunizados na
história!”
Ele anuncia que quase todos os criança bom nos Estados Unidos terão sido imunizadas
u oito doenças por anosidade de dois
contra sete o
o fabricante patrocinando essa publicidade é orgulhoso de sua vac-. cines, s eeing eles
como inquestionáveis sucessos d a moderna medicina.
Quase todo mundo vai concordar - os médicos que

osadministram, as médicas
organizações que promovem os para o público e para os legislativosestaduais, ea maioria dos
pais dos finais consumidores d esses produtos.
O consenso é que as infantis vacinações conferem grande benefíciosaúde àa ummínimo
custo.
Rara é a discordante voz neste quase-unânime coro de auto-congratulação.
Naverdade, os benefícios da vacinação infantil são aparentemente tão auto-evidente que
quase ninguém dá pensado para um p ossível ladonegativo.
Ninguém sugeriu, por exemplo, que a ameaça d e encefalite é dificilmente mitigado por uma
vacina que provoca encefalite.
Pouco ou nada foi publicado sobre adversas reações. Mas tais reações são, de fato,
generalizadas.
hot in the Dark

S
Em 1985 Barbara Fisher e eu escrevi DPT: A - primeirocrítico escrutínio
desta mais sagrada vaca do American
aioria imunizados Criança na " AHistória" XII

m
medicina.* Descrevemos o
s típicos colaterais efeitos
da DPT (difteria
-coqueluche-tétano) tiro que quase todos os americano bebés recebe a partir de
dois meses. Foi estimado que 1000 bebês, no mínimo, morrem com esta vacina a cada
ano,enquanto 12,000 estão permanentemente danificadas.
Os nossos números nunca foram desafiados pelo estab médica- belecimento, embora
esses números eram muito mais pessimista do que avaliaçõesanteriores.
E o Congresso concordou com nossas conclusões. Em Dezembro de 1986, a comissão
aprovou a Nacional de Infância vacinação Compensação Lei autorização do pagamento de
danos às crianças lesadas por uma imunização.
vacinas Danos causados por são agora um legítimo tópico de público debate. adversas
ramas e na imprensa. A crescente
As reacções foram discutidas na rádio e t elevisão pro- g
consciência do risco de vacinação tem f eito os pais m ais dispostos a processar de os
produtoresvacinas.
Um fabricante, LederleLaboratories, informou médicos em 1987 que “uma
partesignificativa” do preço das vacinas estava sendo reservados para pagar futuras
indenizações.
Uma nacionais paisde organização foi formada: i nsatisfeitos Os pais Together ( DPT),
com sede em Washington, D.C. Mães que devem tomar d ecisões sobreseus filhosde a saúde
estão se esforçando para tornar-semais beminformados. Mais e mais pessoas estão se
recusando a enviar os seus filhos para os tiros, mesmo quando eles são um pré-requisito para a
entrada naescola.
profissionais médicas Organizações não responderam a estes desenvolvimentos. Em vez de
reconhecer que as vacinas são perigosas e tomar as necessárias medidas para reduzir o risco, a
American Medical A ssociation e da American Academy of Pediatrics ter visto o ajuste para
manter osilêncio, esperando que o t umulto vai morrer para baixo e que a vacinação como de
costume pode continuar.
Não houve nenhuma oficial reação às muito graves acusações cometidos em DPT: A
Shot in t he D
ark.
Quando acusado de participar de uma “conspiração de silêncio,” um
* New York: Harcourt Brace Jovanovich, 1985. Revista, 1991, Avery Publishing Group, Inc., Garden
City Park, Nova Iorque.
“
istória! ”XIII
ah
A mais i munizada criança d
médico proeminente da Divisão de Imunização dos Centros de Doenças Controle de é
respondeu:“Não viável para responder a todos os documentos que lida com vacinas. . -
como se o nosso 439- livropágina, que contém mais de 100 entrevistas com famílias de
vacina-dam- crianças emidade, tinha o estatuto de um artigo no National E
nquirer.
Mas avestruz-como recusa de examinar os dados é não uma apro- c omeu resposta.
Oficiais dos Centros de Controle deDoenças, o Público de ServiçoSaúde, a Food and Drug
Administration, e os Institutos Nacionais de Saúde são eles próprios servidorespúblicos,
que trabalham para os contribuintes que pagam seussalários.Quando uma responsável
crítica da vaccination aparece, eles são obrigados a dar-lhe uma audiênciahonesta.
DPT: Um t iro no e scuro descreveu os efeitos da vacinação em bebês e crianças
stes children na adolescência e idadeadulta.
pequenas. No presente trabalho, siga e
Mostramos que longo-longo prazo efeitos ada vacinação são muito mais comuns do que
nunca foi suspeito. Estas deficiências têm sido atribuídos a outras causas, ea conexão com
a vacinação tem sido sistematicamente ignorado.
AAmericana Psiquiátrica Associação publica um guia para mentais doenças neste país, o
Diagnóstico e Estatístico Man- ual, q ue dedica setenta páginas p ara “Transtornos
Geralmente Primeira evidente na infância, ou a dolescência.”*
Esses distúrbios têm recebido a de denominação“deficiênciasdesenvolvimento.
”Provavelmente, o líder é‘dislexia’, também c hamado c erebral de“lesãomínima. destaque
”Outro é“autismo. ”Mas há muitos outros:‘hiperatividade’,‘transtorno apego reativo d e da
infância’,‘transtorno de o positivo’,‘transtorno i dentidade’,‘enuresefuncional’, e assim por
diante.
Provavelmente, vinte por cento das americanas crianças jovem em cinco- sofre
- um de
uma “” desenvolvimento deficiência de.”Este é um stupefy-
e algum estrangeiro
figuraing. S
inimigo tivesse infligido tal dano em nossa
*Terceira Edição, Revisada, 1987. A segunda em edição,1968, lidou com esses transtornos em
áginasz. A primeiraedição, de1952, não mencioná-los em tudo. “Transtornos Geralmente
apenas V/ p
Primeira evidente na infância, ou adolescência” s
e multiplicam de formaclara.

“A riança da história!
ais imunizada c
m
”Countryxiv, de gostaríamosdeclarar guerra. Mas, como as seguintes páginas demónio- strate,
ersistir nela até hoje.
que infligimos-lo em nósmesmos. E nós p
As seguintes páginas mostram que “desenvolvimento deficiências de” são quase
sempre geradas por encefalite. E a principal causa de encefalite nos Estados Unidos e
outrosindustrializados paísesé o vacinação programa deinfantil.*
Para ser mais específico, uma grande proporção dos milhões de U.S. children e
adultos que sofrem de autismo, convulsões, retardomental, hiperatividade, dislexiae outros brotos e
ramos da hidra- liderada entidade chamado de de “deficiênciasdesenvolvimento”, devem suas
uma ou outra d
distúrbios a as vacinas c ontra doenças dainfância.
O modo-chamado de “personalidadesociopata”, que está na raiz do enorme aumento
da criminalidade das últimas duas décadas, é
também largamente enraizado em danosvacina.
Assim, o vacinação programa de tem servido para minar o americano escola sistema- -
que está em colapso através da incapacidade de
lidar com o um-quinto ou um-quarto dos
estudantes que nunca será capaz tanto para ler ou para executar cálculos aritméticossimples.
E isso tem contribuído para a onda de violentos crimes que está transformando nossas
a vicioso presa sobre os fracos e desprotegidos.
cidades em selvas onde os fortes e
Os efeitos da vacinação alteraram o próprio tom e atmosfera da moderna sociedade.
Porque as mudanças são tão insidiosas e difundidas, e porque nos falta perspectiva, elas foram
amplamente negligenciadas. é Não fácil discernir os contornos do pesadelo que o vacinação
programa de foi solto em cima de nós.
Todos os dias este programa continua, centenas de normais saudáveis bebês são
transformadas em produtosdefeituosos: retardomental, cegos, surdos, autístico, epiléptico, de
aprendizagem-deficientes, emocionalmente instáveis, futuros delinquentesjuvenis, e de
criminososcarreira.
Isto pode parecer um e xagero, mas é uma sóbrio conclusãocom base nas provas
recolhidas n áginasseguir.
as a p
*Encefalite pode surgir em outras maneiras: a partir de trauma nacabeça, de um grave bum ou
de uma doençainfecciosa, mas essas são relativamente ocorrênciasraras.

“A ais imunizada c
m riança d a história! "Xv
Quem duvida que tanto mal podia fluir a partir da p ipodérmica agulha tem
onta de uma h
apenas para ler sobre.
Uma palavra sobre o método depesquisa.
Nós têm atraído principalmente na especializada literatura sobre oautismo, de deficiência
encefalitedesenvolvimento, e vacinação. Quando leia com cuidadosuficiente, estes livros e
artigos provar unex pectedly revelador-.
Fizemos pesado uso de citaçãodireta, em parte por seu interesse intrínseco e em parte
porque as seguintes páginas são não só uma análise dosdevacinação programas
infantil,mas também uma história de médicas visões e opiniões. médicos mudar as suas
mentes, perplexidadeexpressa, se contradizem, por vezes, falar bobagem. estes humanos
aspectos de o médico's persona s ão trazidos p ara fora mais graficamente através de
cotaçãodirecta.
opiosamente nestas páginas é desenhada a partir de
outro corpo de informação citou c
três conjuntos de entrevistas com p ais de neurologicamente criançasdanificados.* Uma
série de 100 casos é composta de pais entramos em contato com ao escrever DPT: A
ark.Seus filhos tinham reagido violentamente para o tiroDPT, e os pais
Shot in theD
culparam suas m ais deficiências, tarde, e egunda e terceira s éries, cerca de
stavacina.A s
sessenta casos no t otal, consistem em famílias entrevistadas p or m
im p ara averiguar se a
neurologicamente danificados criança foi vítima de v acinação. Os três s éries são, portanto
complementar, iluminando a ntre a vacinação e neurológicas a partir d
relação e as duas
extremidades da de cadeiacausalidade. Os pais da primeira série sabia que seu filho
tinha reagido violentamente à vacinação e suspeita ele que seja a causa da
deficiênciasubseqüente. Os pais da segunda e terceira séries examinou a possibilidade de
que seu filho's de outra forma inexplicável neurológico dano foi realmente devido a uma
criança- a vacinaçãocapô.
Aqui também fazem pesado uso de citaçãodireta. Quando os pais discutem seus filhos,
sua linguagem é vívida; eles escolhem a exata palavra para descrever alguma
peculiaridade particular de personalidade ou comportamento;
*Veja o Apêndice.
"A maioria imunizados C

riança em História!" Xvi

sua maneira de expressar se pode dificilmente ser melhorado, e direta citação apenas faz
justiça à profundidade e intensidade de seus sentimentos.
As três séries são não para ser considerado amostras“científicos”. As entrevistas com os
pais servem apenas p rgumento retiradas da especializada literatura sobre
ara ilustrar o a
oautismo, desenvolvimento dis- e

ncefalitehabilidades, e comportamentocriminoso.
As seguintes páginas contêm muito implícita, e alguns explícita, crit- icism da
profissãomédica.Esta é não razoável, uma vez que m ão os própriosmédicos,
ais, se n
deve assumir a responsabilidade pela calamidade visitados s obre este país pelos
programas devacinação?
Isso não significa, é claro, que todo médico é deserv- ing de censura. Os médicos são
humanos como o resto de nós, com as mesmas fraquezas e forças. A maioria entrou
medicina em primeiro lugar com a intenção de ajudar os aflitos. Eles foram apanhados
em um mundo feito por outros e deve respeitar as regras que eles nunca formuladas.
ara manter cada um pessoalmente responsável.
Nesse sentido, não seria justo p
Mas a organizada profissão

- que foi concedido um legal
monopólio sobre de
“cuidadossaúde” em - em

1920s conjunto com grupos como aAmericana Médica
Associaçãoe daAmericana Academia de Pediatria, as principais revistasmédicas, os
professores de Pediat- RICS e imunologia nas do médicas escolaspaís, o amontoado de
édicas sociedadeslocais, e
demedicamentos e fabricantesvacinas, hospitais, estaduais e m
outros appanages e feudos que, juntos, compõem o ‘novo médico- complexoindustrial’
or décadas , tem sufocado vozes dentro e
deve assumir uma grande medida de culpa. P
maiminente catástrofe.
fora da profissão alertando contra u
O isolamento da organizada medicina da pública opinião e da pressão por seus próprios
membros manteve tal conhecimento de tornar-se conhecido e de i nfluenciar políticas.
auseam no
Se catástrofes, como o vacinação programa de devem não ser repetidos ad n
eve sermodificado. Isso
futuro, a legalmente privilegiada posição da médica profissão d
apítulo VI.
é discutido mais adiante no C
I
autismo
s filhosautistas.
As primeiras vítimas do médica assalto sobre oamericanos cérebro eram o
Em um agora-lendária 1943 artigodo mundo's melhor-infantil psiquiatraconhecido, Leo
Kanner, descreveu onze casos de uma nova mental doença em jovens pessoas que ele
chamou de “inato distur autista- bances de contatoafetivo.
“A condição é diferente”, escreveuele, “marcadamente e exclusivamente de qualquer coisa
relatados até agora.
...”Logo veio a ser conhecido infantil como‘autismo precoce’ou
simplesmente“autismo. ”2
inguém na época, ou por muitas décadas depois, observou que os primeiros casos de
N
autismo surgiu nos Estados Unidos no em momentoque a vacinação contra a tosse
convulsa foi se tornando cada vez mais popular e difundido.
”1
Alienação A marcante característica da autista criança era auto-absorvida
alienígena- ção (‘autismo’é a partir do automóvelg ue significa“eu"). Kanner
rego, q
observou que “ a dascrianças incapacidade de relacionar-se na ordinária forma a que as
esde o começo da vida ...
olidãoextremo. D
pessoas começam um e situações autista s
De . . . havia ”3“não sentiu necessidade de comunicação.
mão” aos seus pais quando pegou e não moldar-se para
Essas crianças não “estender a
caber nos dabraçosmãe.
I
autismo 2Eles tocaram por si sem exigir atenção: “ele caminha como
se ele está em uma
sombra, vive em um ser alcançado/'5 Eram‘’mundo próprio e“destacado inacessível.
”Onde ele não pode Eles nãopodiam, ou não, sorrir; recusaramse -a ser tocados, mesmo
ram " nervosamente hostis" com estranhos.
por seus pais, e e
auma síndrome de
Eles sofriam de “embotamentoemocional”, afetiva “isola- ção,» 9
inadequaçãoafetiva. ”6
Lembro-me d ele especialmente sentado d m círculo d
entro de u e brinquedos, como se b
loquear para
o resto do mundo * ou

ção. Ela v igorosa. resposta Ela seria
a l evou olhar-nos
um
parecia sem

sforço f ugaz para

expressão real e
o espaço.
ara p
orrir não ou p
sua passageira, a s
obter e tten- Eu m
ay a
ronunciado p izer à s
e lembro de d
pessoas: “Eleé tão distante!O que um e snobe! ” Mesmo q uando ele era p
equeno\ Eu c ostumava
eu b
“'S m enhum interesse
ebê distanteEle, n
dizer; em pessoas”
outros, a sua sentir solidão o que resultou estavam pensando da incapacidade e
sentimento. de empatia A med britânicos- c om o iCal grupo buscando definir autismo
encontrado bruta e sustentado “impairment

d mocionais relações c om aspessoas. Isto
as e
inclui o mais distanciamentousual e o vazio apego (modo-c hamado simbiose):
tambémanormal comportamentoem relação a outras pessoas como pessoas, tais como
usá-los, ou partes deles, impersonally. Dificuldade em misturar e brincar com outras
crianças é muitas vezes excelente e longa-duração. ”7 Eles são inadequadas s ocial
para‘comportamento a mocional o‘significado de pessoas ou
daptativo,’não r econhecem e
eventos,’e mostrar“falta de preocupação com osoutros. ”Eles não podem julgar outro's
emocional o estado pela f acial GoldsmithJerry, expressão.um 8
dezoito anos-ano-velha perto-Normal autista, é descrita da seguinteforma: “funções 'como
uma máquina', sem emoção, e tem apenasintelectual apreciação de ambiente ...
intelectual, mas emocionalmente vazio consciência de interaçãosocial. ”Quando ele tinha
quatorzeanos, ele foi com sua família para uma mexicana fronteiriça cidade
do inter-
*não atribuídas citações (em itálico) são tomadas a partir autor vistas com as
famílias (ver anexo). Os nomes usados são fictícios (Harvey Jackson, Jr., Tammy Garrett, etc.).
Ego Fraqueza 3 ,
onde, não gostando do cheiro do mercado, ele desapareceu e andava pelas dez milhas de volta
para o motel sem informar seus pais, deixando-os a procurar desesperadamente por ele o
diatodo. “Ele não sob- se que sua afamília pode estar preocupado com seu desaparecimento e
pessoa,portanto, tinha não dito qualquer que ele estava saindo. De todos os seus problemas,
esta falta de simpatia, ilustrado nesta vinheta, pareciaa sersua grande- deficiênciaEST. Ele
simplesmente podia não apreciar como outras pessoas se sentiam, e portanto, podia n ão
responder adequadamente. Naverdade, falta uma empática sensibilidade aos sentimentos dos
ict como eles se comportam e assim parecia sempre
outros, ele poderia não mesmo pré- d
surpreso e intrigado com suasações. Isso tornou a vida dentro de sua família difícil e a vida
fora da família impossível.
”O maior defeito que afetou Jerry durante toda a sua vida (e é um proeminente sintoma em todos
os indivíduosautistas) é um glar- ing falta de empática relação ... Este fundamentais interper- bond
sonal parece ter sempre sido falta, e, assim, o mundo dos humanos, em contraste com a dos
objetosinanimados, sempre pareceu intrigante e assustador. Mesmo como um adulto Jerry aparece,
às vezes, para entender intelectualmente c omo outra pessoa pode sentir, m as ele n ão parece ser
capaz d e automaticamente d etectar em si mesmo um outro's e stadointerior. Ele continuaser aum
isolado, mechan- estariCal, incapazes d e intuir as sociais n uances de comportamento é
e,portanto,forçado a recuar de um mundo que é persistentemente surprising e com falta de
regularidade.9
ego Fraqueza do Kanner e outros foram rápidos em perceber a

adas melhorhipóteses, ele se sentia vulnerável, inepto, e
ego fraqueza doda autista criança. N
inferior aos outros; num extremo caso houve:
aparente d e. . . pessoal i dentidade a um grau INAP- reapropriação à sua idade.

esconhecimento d
Isso pode ser visto emem anormal comportamento relação a si mesmo , como postura ou
exploração e escrutínio de partes de seu corpo.10
Isto parece um paradoxo: como é ego-fraqueza reconciliado com total a

auto-absorção?
A resposta é simples. Sem qualquer senso de si, a autista criançaidentifica c om o
mundointeiro:
4 autismo
le d
Dizem que e alguém c omeça.
oesn't sabe onde ele pára e
Ele acha que o mundo gira em torno dele. E

le se vê como o centro d
ou
niverso.Q
ualquer coisa
que aconteça, ele q le irá a
uersaber como e fetá-lo.
Ronald, um moderadamente adultoautista, afirma:
“Eu realmente não sabia que havia pessoas até 1 tinha sete anos. eu Então de repente percebi
que havia pessoas. Mas não como você f az. Eu ainda tenho que lembrar me q á pessoas.
ue h
”Esta necessidade de lembrar a si mesmo era evidente em suasrelações. Ele iria passarpor uma
pessoa como se ele não existisse, ou desaparecer off enquanto fala comalguém como se a
outra pessoa tivesse simplesmente m
orrido. 11
Mas essa auto-absorção não pode suportar a e

xposição à realidade. O adolescente
Ele sob- significa que o mundo exterior não cooperar e
autista percebe quão diferente ele é.12
e ele n ão pode iden-
hostil. Sua gran- Diose visão de simesmo, o seu ego, encolhe a nada. S
ouco àesquerda. Isto se manifesta em uma série de
tificar com o mundointeiro, ele tem muito p
maneiras. Um deles é incapacidade a de h an- dle c rítica o u mesmo uma palavraafiada.
e discipliná-lo muito
não têm d
logio.
Eles
Ele responde b
em a
oe scola. Todos e
na e les t êm d
e é

fazer elogiá-lo bastante. Ele e uito s atisfeito c onsigo mesmo q
stá m uando e lgo c erto, mas
le faz a
uito s
m
ele é le. Nós nunca
ensível à scríticas e iria chorar i mediatamente s e você disse algo a e
ualquer outra f orma .
tivemos que discipliná- l o de q . . Se outro menino o derrubasse, ele ficaria
simplesmente l á e choraria.
e dizer “ sim"\ concordar com uma oferta ou

A autista criançaé muitas vezes incapaz d
proposta exigiria uma consciência de simesmo, das exis- tência de uma pessoa com uma
cordo é muitas
vontade ou vontade de concordar, e isso está além dos poderes maioria da eles. A
vezes significado , repetindo a questão.
ego Fraqueza pode se manifestar como incapacidade de o lhar pessoas asnos olhos, e as
crianças autistas são famosos por seus de “olharessoslaio. ”Tammy Garrett é“medo de das
olhospessoas. Ela tem medo que ela vai cair em de olhosalguém.”
Lack of ego integration is seen also i n the autistic's inability to use personal pronouns
correctly. In particular, he cannot under-
Fear and A nxiety 5
stand the s ignificance of T he child does not refer to himself vol- untarily in any way, does not
nd does not point.13 Personal pronouns are repeated just as heard, with no
call himself “I, ” a
change to suit the altered situation. “The child, once told by his mother, 'Now I will give you
your milk,' expresses the desire for milk in exactly the same words. Consequently, he
s 'I'.” 14
comes to speak of himself always as 'you,' and of the person addressed a
Ego weakness is also manifested by fear of t aking initiative, lack of spontaneity, even in
conversation.15

He w ould answer questions but never initiate s peech. Y ouldn' t h
ou c c
ave a onversation w ith
him.
“Sometimes I h ear them playing,” says t he mother of t wo daughters, one autistic. “ Fran takes
Beth's part in the conversation. It makes you kind of sad, you know, that she doesn't have a
sister to talk to.” 16
The mother of another autistic boy complained: “The only spontaneous
thing my son has ever done was to introduce himself to someone at a party.” 17

Ego weakness is seen in unawareness of r isk. The autistic child walks out into traffic and
along the edges of roofs, climbs up drain- spouts, tight-rope walks on clotheslines,
nonchalantly dives off the high board, etc.:
Unable to comprehend danger, he showed no change in expression as cars screeched to a
halt in front of him. Heights also cap- tivated him at one time, and we often found him
standing on a second-storey window ledge, staring down at the cement below.'9
Fear and Anxiety Another manifestation of ego weakness is diffuse, u ndirected fear
and anxiety. These children's faces betray “an anxious tenseness, probably because of the
uneasy anticipation of possible interference. . . .” '9 They are afraid of everything: dogs and
other animals, loud noises, guns, the refrigerator, a furnace, flashing lights, a
spot on the wall,
and especially of the dark — “ night terrors. ”
Tony M., a near-normal autistic, w

rote in a short autobiography:
6 Autism
I was living in a world of daydreaming and fear revolving about myself. I had no care about
human feelings or other people. I was afraid of everything! I was terrified to go in the water
swimming, and of loud noises; in the dark I had severe repetitive nightmares and occasionally
hearing electronic noises with nightmares. I would wake up so terrified and disoriented I wasn't
ay out of the room f or a few minutes. It felt like I was being dragged to Hell. I was
able to find my w
afraid of simple t hings such as going into the s hower, getting my nails clipped, soap in my eyes,
rides in the carnival . . . I was horrified the first time I saw my own blood . I also was very
— cut
hard to assureor convince and always
needed reassurance and still do today. I don't or didn't
trust anybody but myself — that still is a problem today. And I was and
still am very
insecure ... and was very nervous about everything, and feared people and social activity
greatly.20

Jerry Goldsmith exhibited “ profound feelings of inadequacy” and pervasive anxiety when
interviewed at age twenty-two:
His childhood experiences could b e summarized as consisting of two p redominant experiential
states: confusion and terror. The recurrent theme that ran through all of Jerry's recollections was
that of living in a frightening world presenting painful stimuli that could not be mastered ...
everything was unpredictable and strange ... Dogs were remembered as eerie and terrifying. As a
child, he believed that they were somehow humanoid (since they moved of their own volition,
etc.) , yet t hey were not really human, a puzzle that mystified him . . . He was also frightened of
other children, fearing that they might hurt him in some way. He could never predict or
understand their behavior. Elementary school was remembered as a horrifying experience. The
class- r oom was total confusion, and he always felt he would “go to pieces.” 21

Leonard, a moderately severe autistic occupied in a menial and highly structured job,
responded t o his father's request that he move up a little in life:
“ I can imagine myself doing it, my mind wanders in the air, and I can imagine doing it —
ar. But it will
riving a c
getting a job, d
be quite some time. You know, last year I had dreams of
going to another city, but nothing like that is possible for me.” When
“
efrigerator M
The R other” 1
asked why he couldn't do what he wished, he would answer:
“I simply couldn't drive. Even the littlest things make me too anxious, too panicked.
Unmistakably, unquestionably, if I t ried to drive, I would just certainly fall apart.* »22
“The Refrigerator Mother” Frustrated by their inability to h elp, or even
luded
to explain autism (no cure has ever been found), psychiatrists and psychoanalysts con- c
that the parents, especially the mother, were to blame for the child's alienation, self-absorption,
ego weakness, and anxiety. Kanner's discovery marked the start of an orgy of speculation which
has not quite run its course even today.
Kanner himself was at first influenced by prevailing theories of psychoanalysis and took
the lead, writing in 1944 that the parents of autistics are rarely “ warmhearted.”
For the most part the parents, grandparents and collaterals are persons strongly preoccupied
ry, or artistic nature and are limited in genuine interest in
with abstractions of a scientific, l iter- a
people. Even
ome of the happiest marriages are rather c old and formal affairs. The question
s
arises whether or to what extent this fact has contributed to the condition of the c hildren. 23

In a 1949 article he described a f amily's visit to the psychiatrist:
As they come up the stairs, the child trails forlornly behind the mother, who does not bother to
look back. The mother accepts the invitation to sit down in the waiting room, while the child sits,
ater, in the
stands, or wanders about at a distance. Neither makes a move toward the other. L
office, when the mother is asked under some pretext to take the child in her lap, she usually does
so in a dutiful, stilted manner, holding the child upright and using her arms solely for the
mechanical purpose of maintaining him in his position. I saw only one mother of an autistic child

who proceeded t o embrace him warmly and bring her face close to his.24
Kanner's views may have been influenced by the public he was dealing with. His early
patients were from the upper and upper-middle classes of Baltimore, Maryland, who are
restrained in their display of emotion. T
o a compassionate East European Jew their reticence
8 Autism
cannot tions tional might led refrigeration have but to be seemed his a highly “ refrigerator
which inordinate pathogenic the mother” children inhibition. element theory experience In
in any of the case, autism— patients from these such the early observa- parents emo
'
“

-
per- s onality development.” 25

When exposed to “ prolonged affective deprivation,” children
display antisocial and psychopathic behavior:
It is difficult to escape the conclusion that this emotional configu- ration in the home plays

a dynamic role in the genesis of autism. 26
The finding that autism affects males four o s females added fuel to
r five times asoften a
the general assault on the American m other who, as it w ere, could rear her
daughterssuccessfully but not her sons.
But Kanner was an observant clinician, and he soon started hedging his theory, writing as
early as 1944 that these children often show symptoms “ from the beginning of blame the
And life,” making it hard to why did autistic children often have
parents' rearing practices.27
normal frigid personalities brothers and reared normal sisters? children Finally, who, “
ith
some far from parents withdraw- w
ing autistically, responded with restless aggressiveness. It is not easy to account for this
difference of reaction.
In 1954 he raised the possibility of a biological abnormality in the children, causing an
” 28
autistic reaction to the “ refrigerator m
other.
” In 1955 he noted that about ten percent of parents did not fit the stereotype.- 0 And in 1971
29
he admitted that the whole theory of t he “ refrigerator” In the or “ psychotoxic” mother had
been a meantime, however, others had taken blunder.'it 1
up. This was the era of Freud's
dominance of the treatment of mental illness. To
psychoanalysts mesmerized by the dynamics of ego, superego, and id, autism presented
a rich field for speculation.
They usually selected o ne aspect of the autistic child's behavior and on it erected an
tripartite theory.The poor ego development of autistic

ideological structure reflecting Freud's
children, in particular, opened

almost limitless vistas. It was usually taken as the initial
cause o f the condition and was, o f course, blamed on the mother.
A generation of American moms w as accused of s ubcon- sciously hating their children and
thus undermining t heir egos:
"
The R efrigerator M other" 9

The fact t hat parents can be sick emotionally without being aware of it and can have their
pathological symptoms brought to light in the setting of parenthood with such tragic
effects on the child is shocking and challenging . . . the negative mother does not truly want
her child. She has little capacity t o devote herself t o him, and this fact comes t o light very
clearly in the way she handles the infant. Her mothering i s a duty and often produces a
negative response i n the baby, who i s made uneasy by her ministrations . . . It seems t o me
that the mother of the child who develops autistic behavior i s an e xtreme case of this
negative woman, and unfortunately t he infant i s the first t o sense her unconscious

hostility.32
A1 949 article about autistic children o pined that the ego, which s erves to defend the
individual against external stimuli, must itself be developed in an orderly fashion. This is the
task of the ego sufficient mother, causing formation

.” a who
stimulus, “substitute” can
Or,
err leading and in ego two

this to to
ways. is be “ delayed almost hastily Either
worse,
erected. and
she possibly fails she But overstimulates
— to this all too-delayed give “
-
premature the
child
ego organization” stimuli” and formation of then a mature provides breaks e
go down —
meanwhile having inhibited the
only organization. a “ weak protective barrier against “
Parents and others con- cerned with the welfare of these children would have to protect
these children thoroughly from intensive stimulation until such timeas the child'sego might
ver this function without strain.
be able t o take o
»»33 This
analysis may well have been based on the psychoanalyst's c orrect observation that
autistic children are often hypersensitive to sensory impressions. surge ment Another in
threatening the first group five the of ego years researchers structure. of life results held
erived) develop-
“In a that desperate in a defective libidinal attempt ego (id-d
to maintain a hold on reality the child relates to its less threatening aspects: objects and
parts, rather than to its more dangerous aspects: persons and wholes. Then the mental
function of symbolization fails to develop.” 34

Autistic children do indeed relate to bits and pieces of their environment and have difficulty
with symbolization, but why “libidinal” ? In any case, this daring conjecture was criticized
on the
10 Autism
begs the question as t o what leads to the original

ground that it “ [ego] defect and
what is its nature.”
A penetrating observation, but the author's own proposal was hardly an
improvement:
This writer would like to postulate that, as we move in our spectrum of schizoid phenomena toward the more
virulent and morbid extreme, autism increases and that at one point of loading it becomes the primary defect.
The writer would place the pathological locus of this manifestation at the level o f the mysterious trans-
lation of “ organic” perceptions (the result of “ m
echanical” stimuli from the i nner and outer physical worlds)
Psychoanalysts
into meaningful and integrated psychic experiences.... [??!]35 could sometimes
make correct observations— such as that autism is associated with ego weakness and
protect it— but these w

the need to ere then inundated by a flood of hypotheses a
bout
psychological causes:
Ego safety is achieved by an active and automatic pattern of self- inhibition and withdrawal which
raises an autistic barrier between himself and others, designed to conceal his vulnerability and
resulting in t he characteristic psychological isolation. By with- drawing from emotional contact with
others, the patient n go safety but also succeeds in frustrating the attempts of
ot only achieves e
others to relate themselves to him and so retaliates in a measure by sabotaging the effectiveness
of the “ influencing” pressures which he resents. His ego safety and his retaliation — both
accomplished by the pattern of withdrawal — are purchased, how-

ever, at the price of
egation of further ego growth . . . etc. etc.36

emotional frustration, loneliness, and the n
Why, i n any case, was the American mom so inattentive or uninterested in her
son?What induced her to block his ego development in this systematic way? J. Louise
Despert, professor of clinical psychiatry at Cornell University Medical College, presented
a case in which the mother supposedly rejected her son through identifying him with an
incident of attempted rape by her cousin when she was four years old. Thus the boy
was
owerfully tabooed and childbirth in a sense illegitimate
involved in a conflict which made sex p
(recall the involved fantasy
“ The Refrigerator M other” 11
he sensuous pleasures associated with infant care, which

regarding sex, rape, and illegitimacy). T
mothers usually reveal in indirect statements in their accounts of the baby's first year, are here for-
bidden ... Although no deep analysis of this mother's sexual conflict was made, the nature of the
conflict, even in its more superficial aspects, is so significant that conclusions regarding its bearing

on the rejection of motherhood are inescapable.37
Of all the fault-finders and critics of the American mother the most pertinacious by far was
Bruno Bettelheim, who had spent several years in an Austrian concentration camp (which he
called the “turning point” in his life) and later interpreted the parent-autistic- child relationship in
terms of camp-guards and inmates. His book, The E ortress, which appeared in 1967,
mpty F
remained influential for a decade or more and delayed a correct understanding of autism for the
same length of time. Assuming a p riori that the parents were guilty, he laid down the rule in his
Orthogenic School at the Univer- sity of Chicago that “the patient is always right.” By extension
arent was always wrong. Even the staff of the Orthogenic School was wrong in any conflict
the p
with an autistic child — - who was seen as willing himself to be sick in revenge for lack of
Thus, if the child was beating on a chair with a stick, the interpretation
attention from his parents.38
was: “ He's symbolically punishing his mother for rejecting him.”
But, as one s uch mother pointed out with a t least equal p
lausi- bility, “Billy could just as
im away f rom his beloved mother for this silly therapy hour.” 39
well be punishing y ou f or taking h
Other parents have described similar experiences:
If assistance was offered, it was on the basis of a correction of causative and contributing factors
in the parents first; then and if this were accepted, treatment of the child followed. The parents went
his attitude among professionals has
from being hostages of the child to hostages of the system. T
ately, we
nfortu- n
not died out completely [1978] in dealing with the families of autistic children. U
see it resurfacing in small communities where the only psychiatrist in town is “ king,” his word is
They never were interested in
law, and you had better hope he is not an admirer of Bettelheim.40
really seeing the child, but they had my husband and I come in forever — really doing the trick
on us.
12 Autism
We both thought we loved each other after that things have never been the fifteen years ago ...
But I never Nobody ever loved anything or anybody same — accepted before like even

we I
though it was
Bettelheim. love went this there, kid. No. but
I would improvement gladly, in at him — a I

moment's notice,
mean that.
give my l ife for the
slightest
doing it every day.41
I'm
the inexplicable Psychiatrists unwillingness and psychoanalysts of mothers criticized to be
treated in the gravest for their terms sup- posed sexual frustrations and blockages so as to
cure their child of autism

.
They reject treatment for themselves; and when it is possible to link them actively to the therapeutic
process, their participation remains o ne of contribution t o the child's
treatment rather than any
involvement in their o wn personal difficulties. They see the problem outside of themselves; they a re
victims of, rather than contributors t o, the misfortune that has befallen them . .. Although it i s reported
that they felt responsible for their child's illness, that sons they
the child, had they scrutinized
there
no their indication were, own

themselves is the background
that kind they
of revealed
emotional and

sexual per
their the handling kind and of of -
drome i t appeared
adjustment they themselves had made.42 — Bettelheim s and Its by
'
Bernard Rimland's 1964 Infantile

Implications thesis had, eural f act,
for i n a N been Theory
Autism
— the Syn-
ehavior.
demolished of B even Rimland before
went through the arguments for the psychoanalytic theory of causation and picked them
apart one by one. There was no evidence that even severe maternal rejection of a child,
or maternal deprivation, could cause a syndrome as severe as autism. Children can
withstand formed never

very severe suggested like “overconscientious treatment

deprivation and still or rejection. gasoline-station come
out At normal. w
orst, attendants.
he child's withdrawal and other phenomena of autism must

the Kanner's mothers data per- T
be seen as symptoms of an underlying condition rather than as part of the causal process.
In any case, as Rimland noted, parents often seemed a little cool to the psychiatrist's
e was blaming them for their child's condition.
suggestions because they sensed h

” 43

The Refrigerator Mother" 13
“
They protested in vain that their attitude resulted f rom their child's illness rather than causing
it. As one mother said, “ It is very hard to keep trying to make a relationship with a child
who doesn't know you exist.
They could never make clear to psychiatrists that aloofness, and even occasional
” 44
hostility, toward an autistic child were the nat- ural outcome of having to spend twenty-four
hours a day, 365 days a year, w
ith an individual who was totally unresponsive, probably
mentally defective, possibly incontinent, often hyperactive, and even violently aggressive.
When asked how these supposedly inadequate p arents could raise other children
successfully, psychiatrists pointed out, “A mother, biogenetically identical for all her children,
may n everthe- less psychogenetically differ widely from one child to another.
” 45 In normal language: she treats different children differently, causing some The to b e
major normal argument and others advanced t o be by autistic. Bettelheim [ !!]
ort their “emotional” thesis (and still advanced today!) was that
and others to sup- p
psychotherapy helps in the treatment of autism. If psychotherapy could cure, they claimed,
the cause must be psychological or “ emotional.” But Kanner disputed this, stating that the
children who receive the most intensive psychiatric care show poorer records of recovery
than those provided little or no professional treatment, while those who have recovered
sufficiently to go to school “are children who have not had anything that is regarded as good
psychotherapy or as psychotherapy at all.
he millions of hours of psychiatric and psychoanalytic
This remains true today. T
” 46
roduced little
counseling of autistics and their parents during the past several decades have p
or no benefit. A small proportion of autistics s
eem to improve marginally with age, but this
* Autistics can
is due to the self-healing capacity of the developing nervous system.47
sometimes be trained but cannot be cured.
The “ refrigerator mother” or “ psychogenetic” theory of autism, and the turmoil it
engendered, these “decades of psychotoxic
*See discussion of demyelination and autism in Chapter IV.
14 Autism
theorizing,” have been described as “a black mark in the history of medicine.” 48
It led to
immeasurable “shame, guilt, inconvenience, financial expense, and m arital discord,” as
Rimland put it. Indeed, it has been estimated that more than half of families with autistic
children end in the divorce courts. Rimland, who himself has an autistic son, wrote:
The damage and torment this practice has w rought upon p arents whose lives and hopes have already
been shattered by their child's illness is not easy t o imagine nor p leasant to contemplate. T
o add a
hame finances, and guilt well-being, to the distress and of people
hopes, heavy social burden life, of s
whose feelings of worth have been all but destroyed seems heartless and inconsiderate in the
extreme. Yet i t is done . . ,49
This was in 1964. Things have gotten a little better t oday, but n
ot much, and attempts to
trivialize autism crop up at regular i nter- vals. Nikolaas Tinbergen, professor of animal
behavior a t Oxford, received the 1973 Nobel Prize in Physiology and Medicine, and used
the platform provided b y his Prize L ecture t o revive this largely discredited hypothesis. He
propounded, or repropounded, the thesis that autism is essentially an “ emotional
disturbance,” an “ a nxiety neurosis which prevents or r etards normal affiliation a nd
subsequent socialization.” It is due n ot to “genetic abnormalities or t o gross b rain damage,
but to early environmental influences. The majority of a ell as t heir parents,
utistics, as w
seem t o be genuine v ictims of e nvironmental stress.” Therapy thus must “aim a t anxiety and
at a restarting of proper socialization.” tioned favorably a therapist in Australia who “
en- o f
considers the Tinbergen reduction the restora- m
tion of initially defective affiliation with the mother as the first goal of the treatment of autism
... She does this by provoking in the mother an increase in maternal, protective behavior. .
. .
A 1980 textbook on “ emotional disorders in children and ado- lescents” reads: “The initial
treatment plan for this [autistic] child focussed on both child and parents. The child was
assigned t o a warm mothering child-care worker on a 1:1 basis, and parents were worked
with as a couple at first t o support them and further delineate t heir problems [emphasis
added], following which they sought individual treatment.” 51

” 50

utism 15
fA
A Neurologic Theory o
s-eye view of this sort of program (1984):

A parent'
Evaluations at the handicapped center were unfortunately carried o

ut by psychologists trained in
the outmoded parental causation theory of autism.Treatment, t herefore, was based on that
premise, and we were made to feel ashamed and guilty. . . We pressed for a specific diagnosis,
only to be told that Brian was a “ very unhappy little oy.” ... In the ensuing months Brian was
b
labelled as “emotionally disturbed,” “ mentally retarded,” “ neurologically impaired,” and as having “
minimal brain dysfunction” . . . Could we possibly have brought on such a reaction in a little child
ent seemed to be twisted
who had been loved and wanted from the beginning? Our every com- m
to fit the Bettelheim mold. . . , 52

Robert C ancro in 1981 levelled a critique at the whole decades- long endeavor to
treat serious mental illness psychiatrically; his words apply a f ortiori to Bettelheim's
management of autism:
As so often happens following a “ hard sell,” the initially convinced customer is left with a
significant level of disappointment, if not rage. Thus it was with psychiatry, which could not deliver
the cornucopia of benefits that were promised and in fact found great difficulty in even reducing the
anguish o f the chronically psychotic. After riding off madly in all directions, psychiatry did

ortal injury t o its credibility.53
grievous if not m
A Neurologic Theory of Autism Rimland's work sparked a

theory had had a
reevaluation of autism and a new departure. The “ refrigerator mother”
long run, doing incalcul-
able harm to autistic children and their families in the process,
but it was largely laid to rest (except a
t the Orthogenic School in Chicago) while
researchers started looking at thedata neurologically.
Physicians and scientists eventually came to appreciate that autistics ordinarily
ental retardation, epilepsy, c erebral
suffer from a multitude of other disorders— m
hich are clearly of neurologic origin. T his strengthened the
nd others— w
palsy, a
long.
arguments of those who had called autism a neurologic disorder all a
The relationship with mental retardation was the first to attract attention. Kanner
had thought that autistic children were of at least
16 Autism
iduals nary that Later .
n “ innate inability to form . . v
normal intelligence but suffered from a
affective contact with possessing “splinter people.” skills” — 54

powerful I ndeed, imitative
abilities, remarkable musical autistics, by and large, were of superior research, however, has
revealed that encounters with indi- three-quarters talent — memories, intellectual

convinced him
extraordi- are ability. men-
tally It retarded, is not always while possible forty percent even have to distinguish an IQ
lower autism than from 50.55
ation. 56 William and Marian DeMyer wrote in 1984: “ No specific cutoff exists
retar- d
between 'mental retardation' and autism. In fact, the rule is that the more retarded the child,
the more 'autistic' features he or she will display.” 57

For that matter, “ mental retardation” itself has no clear definition.58

Just as there is much mental retardation among autistics, so the incidence of “ autism”
among children labelled “ mentally retarded” is three to four times higher than in the general
population.59

Another major finding was the close association between autism and seizure disorders.
Kanner in 1943 mentioned a c ase with a
n abnormal EEG and seizures but did n ot view this
as significant. In 1963 Richard J. S
60
chain and Herman Yannet of the Yale Medical School
Connecticut mental h
investigated fifty autistics from a ospital a
nd found, to their “ distinct
surprise,” that the children suffered disproportionately disorders — “ Our review in of
addition the (twenty-one literature to their dealing cases) autistic with from symptoms. autism
epilepsy gave a nd They no o ther indication o bserved, seizure
of such an association ... Other authors have not commented t o our knowledge o n an
association between a history of seizures and the autistic syndrome.
”61 Some twenty to thirty percent of autistics a re now known t o have a seizure disorder:
convulsions, fits, clonic s
pasms, infantile spasms, hypsarrhythmia, temporal lobe epilepsy,
psychomotor epilepsy, “strange quivering tensing of all muscles in a kind o f pass- ing
paroxysm,” grand mal, petit mal, “ absence seizures” or “ staring spells,” a nd combinations
of all of these.62

Sometimes these develop only in a dolescence. Seizures, furthermore, are almost universal
in autistics with an
eurologic T
AN utism 1
heory of A 7
IQ lower than 50, while rare in those of normal intelligence. In other words, autism, mental
retardation, and seizure disorders tend to cluster in the same child.53
Autistics have problems with muscular control: motor disorders, paralyses, cerebral palsies,
paraplegia ( paralysis of the lower limbs), h emiplegia (paralysis of o ne side o f the body),
hemiparesis (slight paralysis of o ne side of the face o r body), hypotonia (muscular
s muscular d ystrophy, spasticity, etc.
weakness), Duchenne'
Peggy Napear's Brain C hild: A
Mother's D iary i s an account of a cerebral palsy child with
autistic features. 54
Autistics have a sixty-five p

ercent incidence of abnormal EEG r eadings, also a high incidence
of “s oft” neurological signs: too little muscle t one (hypotonia) or t oo much (hypertonia,
hyperreflexia), poor coordination, clumsiness, hyperactive knee jerks, ankle clonus, and
others.55
Kanner had noted in 1943 that “ several of t he children were somewhat c lumsy in gait and
gross m otor performances,” but had n ot thought more of it.
A quite common symptom o f hypotonia in autistics, often noted by parents in the very young
child, is reluctance to use t he hands and arms: the baby will reach for objects with his toes,
not his hands; the child will refuse to throw or catch a ball.
/ did n otice that he w ould n ever s queeze my h s a small b
and, even a ven when l would
aby. E
take his hand to g o somewhere , i t w as tike his hand was just t here. A
t some p oint / noticed
'
that h ed idn t use h ands i n t his normal way.
is h
extremely As they h andsome, get older, almost they cherubic-looking are reluctant to
twenty-one-year shake hands: “ The old a
pproached me slowly and revealed his hand like a
flag furled in a breeze. I shook his hand and t hought that it had little relation to any hand I'd
ever touched. ” 66Others have noted the autistic child's “curious, s lipping handclasp.
Here, however, as in many other aspects o
” 67 f autism, opposites meet. While some autistics
can do nothing with their hands, others have remarkable control. S ome autistic toddlers can
n inch of someone's hand across a large room.
consistently throw a ball within a
68
18 Autism
These children have difficulty crawling when small. Some never crawl but only start to walk,
usually later than normal. Many walk on their toes for years
— indicating a general tension of
the
muscular system.
The sensation of pain may be s everely d
iminished, and even t he sense o f touch may be
absent. “ Objects placed in the hand m ay be a llowed to fall away as if they m ade no tactile
representation. Painful stimuli are often ignored; the children may not notice painful bumps,
bruises, cuts, or injections.” 69
The child plays outdoors in the winter without mittens or jacket, is
impervious to hot or cold water in his bath, or, alternately, is very sensitive to heat and insists only
on lukewarm baths.
The prevalence of left-handedness and ambidexterity in the autistic population (common
also in the epileptic and the mentally retarded) has long excited comment.70

Autistics are prone to a number of sleep disturbances and do not observe the normal
day-night rhythm. Even in the first year the child “ turns night into day and day into night.” But
sometimes the child sleeps normally for the first year or eighteen months and develops irregular

sleeping habits later.71
Sleeping difficulties continue into adolescence, often accompanied by night terrors:
It is not uncommon to hear that parents spell each other during the night when their autistic
child screams unceasingly for several hours. Often it is the mother who stays up or stays in
because Daddy has to go to work in the morning.” 72
the basement with the child “
These children may grind their teeth while asleep, and sometimes during the day as

well.75
Cranial Nerve Palsies Finally, the neurologic interpretation w

as able
to account for that hallmark of autism child's alienation from his surroundings. It was
— the “ ”
now seen to reflect impairment of the cranial nerves, which run from the eyes, ears, nose, vocal
cords, mouth, and muscles of the face, over t he skull to the “ brainstem,” at the back of the neck,
between the spinal cord and the brain.
alsies 1
erve P
Cranial N 9
These nerves convey information to the brain and help effect control by the brain over the
respective sensory organs and muscles.
In the autistic child the sensory organ itself is sometimes defective, but more often there
is impairment (palsy) of one or more of the cranial nerves. The sensory organ itself functions
but for some reason c annot transmit information to the brain.
When this happens, the individual is to that extent isolated from his surroundings.
To survive and prosper we must absorb and process information from the environment.
Data are perceived through the sensory organs and processed in the brain. Making sense of
information in this way enables us to function in life, and when we cannot gather this information,
we are ipso facto d iminished as human beings.
Autistic children suffer from a large r ange of cranial nerve disorders.
Take, for instance, the vision. There may be pathology of the eyeball itself, or of the muscles
which regulate its movements. Blindness is not uncommon. The eyes may be crossed
(strabismus). The normal visual reflexes may be diminished (known as decrease or absence of
postrotatory nystagmus), or the cornea may be deformed (keratoconus). Kanner reported a case
of “ conjugate deviation of the eyes to the right.” 74
There may be problems with spatial perception.
These c hildren tend to look to the s ide of t he object regarded, or beyond it, and refuse t o make eye
contact; o n the other h
and, they sometimes stare so intently as to raise a question of a bsence
seizures. They may be unable to control the movement of their eyes — the “ lazy eye
syndrome.”
Others have better than perfect sight. Harvey Jackson, Jr., had the “ vision o
f a hawk.”
Often the eyeball is intact, but information is not processed from t he eyes to the brain, as
in autistics who are dyslexic.

omprehension.75
A related disorder is hyperlexia: the child reads fluently but without any c
'
He reads anything you p im . H
ut in f ront of h e doesn t u
nderstand it but he reads it .
20 Autism
The same variety of disorders is found with the hearing, ranging from total deafness to
various degrees of impairment.
edia and other ear infections; these are likely to be
Autistics suffer frequently from otitis m
more serious in the more seriously a
utistic child, less pronounced in the mildly autistic.76

Otitis, of course, may be partially responsible for the hearing loss.It may be difficult,
however, to determine if the hearing defect is in the eardrum or somewhere in the brain. As
already noted with the eyes, the eardrum itself may be normal and function normally part of
the time, but then “ switch off'; for instance, the child has normal hearing when tested through
the audiometer b ut cannot comprehend words.
In 1951 Isaac Karlin called attention t o a phenomenon which he called “congenital word
deafness,” describing, for example, a boy with an apparent ninety-eight percent hearing loss
who could still distinguish the sounds identifying certain preferred toys; he had learned to
speak in simple sentences, even though this should have been impossible with a
ninety-eight percent hearing loss.
Other children are seemingly deaf to some sounds, such as the mother's voice or a door
slamming right behind them, but can hear others, such as a cellophane candy-bar wrapper
being removed, a vending machine delivering chewing gum, or a favorite TV commercial.
77
He can hear t he higher pitch, the higher ranges, b an' t p

ut he c ro- cess the l ow voice ranges,
such as my voice .
essing defect, central
“ Word deafness” can be called by such names as peripheral pro- c
processing toextract meaning, to make defect in the processing of any sense, sort of defect,
of what coded, is etc. h

eard — m eaningful, It signifies inability i .e. a “ central or tem-
,
porally patterned stimuli.

Other autistics have hyperacute hearing (hyperacusis) and may be pathologically reactive to
sounds which normal persons do not notice at all: the slamming of a door, the buzz of a
hairdryer, or the noise of a crowd.

” 78
Cranial N erve Palsies 2 1
He i s t erribly s ensitive to loud n oises a nd will put h is hands over his e ars. Once a t a

basketball g ame he sat with his hands o is ears because of the c
ver h rowd n
oises.
This is due to the child's inability to f ilter useful information out of background n oise. All their
channels are open, and they are ent confused structure. Music, by however, extraneous The
great is majority inputs.
different, of presumably autistics are because entranced of by its music, inher-
and often display amazing abilities.
Some memorize TV jingles and popular songs, reciting them back faultlessly after hearing
them once or twice. Some have perfect pitch. One legendary case could sing scales “
with extraordinary accuracy of pitch” at fourteen months, at seventeen months spon-
taneously his parents repeated sing it once, in full and an aria by age from three Don could
Giovanni sing after entire hearing symphonies by Mozart and Haydn, songs by Schubert
and Brahms, selections

from Carmen, a Tchaikovsky piano concerto, as well as “diversified
well-known songs.” 79

More often, however, the voice and speech are impaired, due to delayed or nonexistent
development of the nerves governing the mouth, throat, and vocal cords. The baby starts to
burble, gurgle, and chatter, and then, usually before age two, loses this ability and lapses into
muteness. About half of autistics remain c ompletely mute throughout life ( if t he IQ is high
enough, they may learn s ign language). Or t hey develop speech l ate and progress only t o a
certain level, well b
elow their chronological age.
Sometimes the child can speak but prefers not to (elective mutism). Or he uses an almost
inaudible whisper:
ould not speak in a tone of voice louder than a con- v ersational one. “This is going to
Leonard ... c
“ but I just can't talk any louder. I have to talk the way I
sound really foolish to you,” he said , am now.
” H0
Or she will shout for help in an emergency but otherwise remain mute: “ When one patient
was receiving an injection, she clearly said that she wanted to go home, virtually her first
sentence.
” 8 !
22 Autism
Or he will have severe speech difficulties: “ Paul, ten, seems to be trying hard to speak,
without success so far except for a few unin- telligible sounds and a clear 'Mommie'
recorded recently on tape. The moderately autistic child may have a t errible stutter.
On the other hand, he may b
e capable o
f speech and chatter nonstop, b
ut without making
any sense (hyperlalia), or may l imit tions himself will be (delayed rote to parrotlike
enumerations echolalia) — repetition stereotyped even

(
with
of phrases
the
utterances )
precise intonation; or there

heard in of other rhymes, conversa- lists of names, and other
“semantically useless exercises” (as Kanner called them).83

Thus, even when the child c an speak, he will not use language for communication. He may
have a fairly large vocabulary but be unable to convey meaning. Some autistics c
an mimic
ne remarkable child spoke French,
another's voice or some other sound to perfection. O
Spanish, Japanese, Arabic, Hebrew, and several other languages but could not say an
original sentence in any o f them.84 Truly spontaneous a nd unconstrained conversation is
essentially impossible f or an a utistic; there is flat intonation with no vari- ation of tone or
pitch, little or no use o
f gesture, n oc ommunication through facial expression, no interaction
with others.
The tone of the voice may b e unnaturally high, described as a “ screech” or “ high-pitched”
(palsy o f the twelfth cranial nerve).83
In t hese speech disorders autism overlaps w ith what is called “developmental aphasia” or
“dysphasia,” defined as “ disorder of speech due to a brain lesion” in a child. Researchers
have asked whether these two groups r eally are different or, alternatively, part of the same
continuum.
Such comparisons stand or fall on the definition of “ autism” selected. is the understood

post-encephalitic Existing
to be definitions a one-sided syndrome are
exacerbation
discussed artificially
below restrictive
. of a larger in Chapter Once
condition — autism
III — this latter syndrome becomes t he principal object of investigation. Aphasia
,
dysphasia, autism itself, and many other syndromes and conditions will take their places as
parts of the post-encephalitic syndrome.
'
> 82
3
erve Palsies 2
Cranial N
The salivary glands are regulated by derivatives of the cranial nerves and are thus affected
by the same palsies. The tendency of autistics to salivate, drool, and spit indicates damage
to these nerves.
Another set of cranial nerves governs the facial muscles. When these nerves are impaired,
the face takes on an unnaturally rigid look (known as “ rigid facies” or “ Moebius Syndrome”
).
These failures of sensory communication may be compensated by apparent
over-development of the senses of taste and smell. Autistic children often smell, lick, and
mouth objects and people — to extract at least some meaning from their environment. They
extraordinarily sensitive to smells and extremely fussy about their food."
can be
6
One theory holds that taste and smell are preserved unimpaired in autistics because these
cranial nerves, unlike the others, are not myelinated. If, as we suspect, autism is related to
demyelination of the cranial nerves, those which are not myelinated in the first place might
be relatively immune.
Another important cranial nerve is the vagus or pneumogastric, providing the regular neural
impulse to the lungs that stimulates the breathing process. Future autistics have sometimes
been noted to suffer from “ asthma” in infancy, but this relationship has been insufficiently
stressed.
Many kinds of breathing difficulties are common in autism. Called “ stereotyped respiratory
maneuvers” or “compulsive respiratory stereotypies,” these include breath-holding attacks,
hyperventi- lation, deep inspiration followed by a grunting exhalation, “ Valsalva Maneuver”
(trying t o exhale while keeping the mouth and nose closed), exhalation without inhalin g
(causing a fainting fit); and the like. Often these are confused with seizures and may, in fact,
have a seizure c omponent." 7
Harvey Jackson, Jr., is a classic case. According to his father's diary, at age three months
his breathing stopped altogether -six hours after hissecond DPTshot.The father
— thirty
describes thisoccurrence:

I'm hot r ecord n
looking at t he s ow, a
nd it s tates t hat on January 13 , 1
972 , Harvey w iven a
as g
DPT s hot . I then l ooked at m iary,
yd
utism
24 A
“
since this i s a
ne vent you can never f orget . Saturday morning, J 5 , 1972, 1
anuary 1 wrote: A
nd frightening day. Harvey had been wheezing loudly since the m
difficult a orning , a nd by
one to two P.M . h

e was so s everely t ried in his b ecame terribly alarmed. H
reathing t hat l b e
had t o b eld upright so he could b

eh reathe . O
nce , possibly twice, a held h
s1 im, he s
topped
breathing , only to s
tart again a y shoulder and hit on the back. W
fter being thrown over m e
octor —
then saw a d t he b octor for t he r egular pediatrician— who said to t ake h
ackup d im
hildren' s H
to C ospital . H as admitted a t 5: 1
ew 5 P. M
. , and w
e anxiously a fh
waited news o im.
By the next d as much better, a
e w
ay h as b
nd his color w as b
ack t o pink . He w orn i n
October, so h
ew
as three m
onths a ld.”
nd a f ew days o
Harvey, Sr., believes that Harvey, Jr., narrowly escaped “ sudden infant death.” The boy
grew up t o be moderately autistic.
Thus autism and SIDS appear to be generated in the same way — by an encephalitis
most c ommonly caused by vaccination. Breathing difficulties of various kinds ensue, and during
one such “ breath-holding attack” the infant simply expires. The child who would have grown up
autistic dies instead of “sudden infant death s yndrome” (SIDS).
A Neurologic Basis for Alienation a
nd Ego Weakness The emerging
neurologic theory of autism was reinforced by Stella Chess's 1971 observation that children with
uently displayed classic autistic features. These c hildren suffered, in
“congenital rubella” fre- q
particular, from “ multiple sensory disabilities,” and it gradually became clear that the autistic's
—
characteristic alienation, withdrawal, and ego weakness — initially seen as causal
were actually the

effects of disorders of sense percerception. The autistic child lacks the
— that would
instruments — roper running order
the five senses in p
enable him to extract
meaning from the external world. Unable to extract meaning, he is lost in the swirl of events. M.
Rutter and L. Bartak suggested very accurately i n 1971, ”... a central deficit in processing of
symbolic or sequence information is likely to prove the basic defect . . . in infantile autism.” H !I
Once we have received information through the senses, we extract meaning and organize
it in the form of concepts or i deas.
asis for A
A Neurologic B lienation and Ego W 5
eakness 2
These are stored in the memory and recalled when necessary. In this way sense-perception
and memory help us acquire experience.
This the autistic cannot do. He cannot receive sensory information in an orderly fashion.
He cannot distinguish impulses, sensa- tions, and other mental contents which originate
He cannot generate order out of himself
inside from those which originate outside the self.89
and impose it on his surroundings. One investigator wrote: “Severely autistic children exhibit
a preoccupation with the sensory impressions stemming from the world about them, but
seem unable t o organize perceptions into f unctional patterns.
Weakness of memory adds t o their problems. Rimland has written:
” 90
The child with e arly infantile a rossly i mpaired in af unction b
utism is g asic to a ognition: the
ll c
ability t o r elate new stimuli to remembered e xperience. The vital connections between
sensation and memory can be made only with difficulty. New sensation can be related only
to sharply limited fragments of m irtually divested of the means for
emory. The child i s thus v
deriving m eaning from his experience .
yi Observers have been fooled by the startling capacities man - ifested by these “sharply
limited fragments of memory” (already noted in connection with the musical abilities of
autistics). One mother interviewed claimed that her autistic son could remember events
occurring when he was six months old!!
But these mnemonic talents, however striking, are nonetheless fragmentary. In the broader
sense the autistic has a weak memory. He cannot recall, compare, and process a broad
range of information. Sensory experience reaches the child's mind as if phrased in a
of
cally, the to found with foreign abstract — symbols. concreteness

Furthermore immature ,
located
of in the animals. language During frontal
development of the Researchers sense
in the frontal
whose and evolution process temporal perception words and of the have

and temporal 92
maturing and organization lobes.human into
found s yntax
lobes
—
the brain involves
autism world he of acquired will
the of to moving never brain,
abstraction — be
which
associated a capacity
master.
beyond
is not
specifi-
Hence the autistic cannot create and manipulate the symbols which normal people use to
represent and act upon external reality.
26 Autism
Neurologic testing of autistics has disclosed evidence of damage to the brainstem and
cranial nerves. Student and Sohmer in 1978 investigated

the brainstem and auditory nerve
utistic children, finding organic lesions seemingly related to “ im-
in a group of fifteen a
maturity in the development of certain brainstem m echanisms. Rosenblum results, nation of
concluding these and nerves.*coworkers that 94
the Tanguay immaturity repeated and
ame
Edwards these was due tests in to 1982 defective with agreed the myeli- s
that autistic children have a “ generalized lower brainstem dysfunction”:
Brain development involves differentiation of systems or parts of systems that mature at very
different rates. . . In the human it would appear that the period between approximately ten
and t wenty months of age is a particularly critical period in development, where the neural
organization responsible for internal cog- nitive operations is reaching a functional state.95
This neurological research demonstrates that the “developmental delay” or “ maturational
delay” associated with autism reflects an actual biological delay in maturation of the brain and
nervous system. Other phenomena such as “failure to develop abstract reasoning and
concepts,” “ absent or limited symbolic capacities,” or “ relative inability to process
symbolic information,” are the consequences.96
Hence autistics do poorly on IQ tests “demanding symbolic or abstract thought and
sequential logic.
In spite of his i nterest in reading, [Ronald] could neither formu- late his t houghts in
language nor p xtended oral report of h
rovide an e is daily activities; nor c
ould he write in
anything more than a low manner . . . In a
laborious s characteristic incident o f that period
[age fifteen], Ronald b ecame panicked in a theater when he realized that he could not follow
the lines b eing spoken by the a ctors . On another occasion, he recognized how he became
blank and incomprehending when asked t he directions i n a city that he could easily
navigate using guide books.98
” 9 }

” 97
*The myelination of the brain and nervous system during the first year or two of life, and the
impact of v accination on this process, are discussed below in Chapter IV.
AN asis for Alienation and E
eurologic B go Weakness 2 7
By the same token the autistic has trouble with comparisons. A s Kanner noted, “Though he
could speak of things as big or pretty, he was utterly incapable of making comparisons
('Which is the bigger line? Prettier face?' etc.).
” since lay, like speech, is a largely sym-

p
He is unable to “ play,
” 99 bolic activity.
He can read atlases and encyclopedias but cannot
He has little or no sense of humor.100
understand fiction. He is “ restricted, literal, and concrete in his thinking.
rote:
! Kanner w
” 10
His father said something about the pictures they have at home on the wall . This disturbed
“ We have them near the wall” ( “ on
”
e corrected his father.
John somewhat. H apparently
above” ).
meaning to him “ or “ on top”
102 nifying indicating Unwillingness ego abstract weakness — assent, to use also

the is
word
reflects
“ yes”
— inability nalyzed to
a
a concept the autistic
abstract. above as “
Yes,” sig-
may take years to acquire. Normally he indicates “ yes” by repeating the question. One child
learned to say “ yes” when his father rewarded him by putting him on his shoulders.
Thereafter the word meant only the desire to be put on his father's shoulders, and it took
months before he could detach it f rom this specific situation. This b ances of combination
timuli, and concep-
perception, of inability and lack of to ability cope with to abstract new s
distur-
ith others and even with themselves, making them
tualize s everely r estricts their r elations w
aware that they are both different from o thers and less worthy.
They live in the world w ithout acquiring experience o orld; their awareness of being
f the w
cut off in this way, of being alienated f rom the world, deprives them of self-confidence and
ego s trength.
103
This generates their pervasive fear and anxiety

— which at
length deteriorate into paranoia
and depression.104
In the hospital and to others he reported, “ I'm no good” and “ I don't know what's the matter
with me.” He t hought about commit- ting suicide. 105

28 Autism
At the age of thirteen years he believed that other children in his class were talking about
him and trying to influence his thoughts. He was agitated and belligerent with those he
believed were per- secuting him.
106
Jerry Goldsmith exhibited some incipient paranoid distortions; for example, if he found any
of his possessions missing he would automatically assume that one of the other children
had stolen them.
107
ones — “emotional lack i n actual Thus o f inability

”

a neurologic sense research
to symbolize
symptoms of humor, since deficiencies.
of the and autism late paranoia— memory

— and
1960s the has alienation,
weakness
— are all rooted
as shown well that the typical ego-weakness, as the “ mental”
Appetite, Digestive, and Bowel Disturbances With the progress of research in
autism, other constellations of symptoms became associated with this condition. While
usually labelled “emotional” at t heir first appearance, these symptoms are recognized
today a s neurologic.
Autistics have many abdominal pains and appetite disturbances a ften described
nd are o
as “feeding problems first bottle, eleven changing c ases formulas, had serious and the
,
difficulties like.Take with John nursing, F., for instance:
taking the
ain thing that w
The m orries me is the difficulty
The father said: ' in feeding . That is the
essential thing, and secondly his slowness in development. During the first days of life he
ot take the breast satisfactorily. After fifteen days he was changed from breast to
did n
bottle but did n ot take the bottle satisfactorily. There is a long story of trying to get food
down. We have tried everything u nder the sun . . . There were frequent hospitalizations
because of his feeding problem.
One three-year old would eat nothing but baby foods; another, at the age of one year, “
began third “first suspected a problem t o at age starve five himself'; months because the
f a
mother of chok- o
ing and gagging with feeding.
»
IOH Six of Kanner's » ioy
»110
igestive, and Bowel Disturbances 29

Appetite, D
tg et at. She
her to e was real skinny a
nd
ne y ear I couldna
At o ntirely on '
lmost e nursing. She didn' t
existed
eight, but she didn't k eep p
lose w ace either.
Another autistic child was described as follows:
bedtime At seven ... y ears the of pediatrician age the patient diagnosed mesis.” At the age of nine
years . . began
to vomit “ psychosomatic . his pediatrician each
reported night
hypere- “de- at

teriorating behavior” and reappearance of regurgitation. By ten years of age the parents sought
psychiatric help. Episodic vomiting reappeared, behavior deteriorated, and he was mumbling to
himself incoherently/"
This behavior is sometimes labelled anorexia nervosa (literally: “ nervous loss of appetite”
):
In school S. refused to take certain previously eaten foods, saying she attempt they could tasted —
a similar pattern occurred at home.
to no eat longer with prompting eat them because but would she
... She would
often did not gag like and the spit way
arge quantities of milk or water were used to help her wash down small amounts of food. S.
up. L
stated that she could not eat because food would make her sick. During the third week of May, S. and
became refused physically t o eat them. ill Subsequently, and vomited a
t on the three sight
consecutive of some morn- foods
ings time she S/s vomited symptoms breakfast were strongly on the bus indicative en route of to
y this
anorexia school. nervosa. B
,
She had a eating ... noticeable and vomiting. weight 1 2
loss . . . a distorted perception of

being but such Alternatively, “indiscriminate” substances these as about sawdust, children
what dog can they turds, have eat — dirt, tendencies meaning

and the
not
to like.
only
bulimia,
113
food
t watch him. It d

idn'
is own feces if you didn'
He would eat h it.
im a b
t bother h
Christopher Gillberg, a leading Swedish researcher, in 1985 found a link between autism
and anorexia n ervosa, noting that such an association had never previously been
recorded/ 14
“ Rumination,” meaning the regurgitation, sucking, and reswal- lowing of partially digested
food, is associated with autism and
30 Autism
severe developmental disorders and falls into the same category of gastrointestinal disorders."5
Soviet researchers have found a t endency to obesity in autistic c hildren, a nd Gillberg
found that one-third of a group of autistics grew “coarser and plumper” with age."6 Although no
systematic data exist on the weights of autistics in the United States, their numerous
disturbances of appetite function suggest the possibility of long-term anorexia or excessive
weight gain.
The food, once eaten, is digested with difficulty. Autistics suffer frequently from colic and
other gastrointestinal pains. The baby may cry with p ain or arch his back. S
tudies o f autistic
children often find a past history of gastrointestinal s ymptoms, “ abdominal p ain,” “ recurrent
gastrointestinal upsets,” etc.
This may be associated with chronic constipation or acute diarrhea; the bowel movements of the
autistic baby may have a sour, acid, or musty smell. Autistics suffer with abnormal frequency
from celiac disease. And their non-autistic siblings seem also to have an unusual incidence of
abdominal pains and gastrointestinal disorders."7 They have difficulty with bowel and bladder
nd even during the day. Or they may have had bowel
control (enuresis and encopresis) at night a
control early in i nfancy, only to lose it at about eighteen months.
Difficulties with elimination foster an inordinate interest in urine and feces and a tendency
to smear t hem around:
He developed an obsession about feces, w

ould hide it anywhere (for instance, i n
oiled your pants, now you c
You s an'
drawers), would tease me if I walked into the room: “ t
have your crayons!”

As a result, he is still not t oilet trained [age 4V
2 ] . H
e never soils himself i n nursery
school , always does it when he comes home. The same is true of wetting. He is proud of
wetting, jumps up and down in ecstasy, says, “ Look at the big puddle he made
!”"8
Headaches, Head-Banging Severe headaches are a feature of

autistic pathology which has been commented on anecdotally but never given sustained
attention."9
Defining A yndrome, Asperger's S
utism: Rett S yndrome 31
Bernard Rimland, whose San Diego-based Institute for Child Behavior Research has files on
10,000 autistic children, feels that they do indeed suffer disproportionately from headaches.
Harvey Jackson, Jr., had frontal headaches painful enough to cause nausea. And Tony
120
W.'s autobiographical account speaks of “ pounding hard migraine headaches.

Of course, if t he headache is being e
” 121 xperienced by a v ery small b aby, he cannot
describe it in w
ords. What he w o is r ock back and forth, roll his h
ill d ead from s ide to side, or
bang it against the cradle, suggest neck walls, (“ or hyperextension” ways f loor, of pick
coping at his ) — with hair all head o f or which ears, pain.
are arch common his back, in or autistics extend and his
In 1982 Norman Geschwind a nd Peter Behan published their finding stuttering,
post-encephalitic handedness — of migraine an i .e. , association syndrome. all
features which we here
headaches, among Their developmental autism, article caused
discuss as part of the
celiac disabilities, disease, a sensation dyslexia, and in left- s ci-
entific circles because of inability to imagine what the connecting thread among these

disparate conditions could be.122
We feel that Geschwind and Behan's findings were a prelimi- nary outline of the
correlations presented in this book. And the connecting thread is found in the childhood
vaccination program.
s Syndrome
Defining Autism: Rett Syndrome, Asperger' The discovery that
autism is accompanied by neurologic s ymptoms never be unexpectedly included i n complex.
Kanner's In first 1971, definition checking showed up on the the condition eleven chil- t o
dren from his first group, Kanner found outcomes ranging “ all the way from complete
deterioration to a combination adequacy with limited though superficially ment” and
ny illness may
f social occupational adjust- a
commented, “ In medicine . . . smooth o
appear in different degrees of severity, all the way from the so-called forme fruste t o the most
fulminant manifestation. Does this possibly a pply also t o early infantile autism?” 121
*
*Forme fruste: t he patient manifests few or no symptoms.
32 Autism
A decade l ater Rimland gave a striking demonstration of t he complexity of autism: he
compared the original diagnoses of 445 autistic children with a “ second opinion” and found
no trace of a positive correlation between them!! The relationship between the two diagnoses
was practically random.124
Rimland's finding h as been confirmed repeatedly. Almost as many c riteria are i n use today

for diagnosing autism as there are writers on the subject.125
Autism cannot easily be distinguished from such “ overlapping” neurologic conditions as
Hetzler and Griffin wrote in 1981: “The
mental retardation, c erebral palsy, and epilepsy.126
extremely heterogeneous autistic population may represent a variety of central nervous
manifestations. system »dysfunctions 127
Deborah Fejn resulting in the in same overlapping year: “There overt behavioral i s consid-
ecessary and
erable disagreement about which symptoms should be considered as n
sufficient for the diagnosis of autism . . . There is also considerable uncertainty about the
degree of symptom over- lap between autism and other severe developmental disabilities,
and probably for this reason,the reliability of diagnoses within the general category of
bility' is poor.
sychosis' or 'severe developmental dis- a
'childhood p
”128
The arbitrariness of the diagnostic process was encapsulated by W
. and M. DeMyer, who
ach inves- t igator looks through his own peephole, finds an
wrote in 1984, “ It seems that e
abnormality, and thus confirms his preconceptions.
While this confusion and disagreement about the diagnosis of autism has sometimes
” 129
been blamed on “ the inexperience or lack of scholarly rigor of diagnosticians,” it would be
more reasonable t o admit that autism does not exist as an independent entity.
It is only a piece of the p ost-encephalitic syndrome. That the diagnosis should be
continually contaminated by other bits and pieces of this syndrome is hardly unexpected.
Why, then, do specialists insist that autism is unique and unre- lated to other neurologic
diseases and disorders? The answer was given by a speaker at the 1980 Conference of the
National Society for Autistic Children:
'
Defining Autism: Rett S yndrome , A sperger s Syndrome 33
Autism is not a specific disorder. I t hink that m akes a lot of us uncomfortable because it's the banner
under which we rally, it's what brings us all together, it's what we all s ommon, and around
hare in c
it's rather is threatening less than real. f or We s omeone need to to think say that about what what we
that are rallying means. I t's n
ot that anyone is saying that the disorder does not exist. That we have
disturbed children is rather apparent. But the trap we can fall into is thinking about autism as if going to
ere . a disease which is . These are the myths that we get caught
lend itself to a singular remedy it . w
up in . . . We are really talking about a spectrum.
1.10
Insistence on the autonomous status of autism reflects to some d egree chologists, the
organizational psychoanalysts, o r psychiatrists, class interest and of other the physicians,
sy-
medical profes- p
sionals who make a living diagnosing, treating, and writing about autism, and f or whom its
existence is a vital necessity. “Chinese and The ensuing definitional Restaurant menu” three
from Group B, etc.” approach- — f uzziness A checklist is two overcome compiled
“
dishes from Group A

by in adopting 1971 listed the
fourteen items and concluded, “ For a diagnosis of autism at least seven of these criteria
should be present. .
The 1987 edition of the Diagnostic and Statistical M anual u sed the same technique:
[For a diagnosis of autism] at least eight of the following sixteen items are present, these to include at
ne from C.m
least two items from A, one from B, and o
If this approach is accepted, two individuals can have totally different patterns of symptoms,
eight each out of the total of sixteen, and both be diagnosed as autistic!!
No single symptom is indispensable. Michael Rutter and Eric Schopler only cally truly
and
wrote be uniquely based

in 1987 on autistic some
that feature. unequivocal
differentiation
Such indication
a of
feature autistic
of has some
cases yet specifi
- “c ould to be identified
.
Only when autism is recognized as merely one particular config- uration of the hundreds
” 132
of symptoms included in the p ncephali- tic syndrome will physicians be able to discard
ost-e
these fruitless efforts
34 Autism
to pin it down more precisely.
For, just as autism cannot readily be d
emarcated from other neurologic states, so it often
cannot be distinguished from psychological ( emotional!) normality. Kanner's As e arly
original as 1964 “essential Rimland diagnostic claimed criteria that some ... c hildren extreme
meeting alone- ness and a desire for the preservation of sameness,” were quite normal in

other respects and in no way autistic.133
In 1981 the DeMyers noted: “A c ontinuum exists among the behaviors of typical autistic
children, other retarded children without overtly or numerous autistic traits, and even
normal children.
Such diagnoses as “ autistic-l ike,” “ with strong autistic features,” “ near-normal,” etc.,
” 134
have become increasingly c ommon. In particular, moderate autistics often resemble the
typical child with a s evere case of “ minimal brain damage.”
Researchers sometimes w onder if these “ high-functioning” autistic children are really “
autistic” or rather constitute a d
ifferent defineable disease:
I've seen a number of children who share specific problems and symptoms with [a utistic] chidren, but
they cannot, even w ith a broadened definition, by any s tretch of the imagination be called autistic.
I've seen two children who are t he most rigid children sameness I 've ever s een, a nd their as r igid
violent as any responses autistic to child minor in shifts. t heir insistence But they are on
social ... have good language relationships, and they are not autistic unless you an autistic child....
want to call everyone who has any symptom Now where do these children belong? . . . I have other
children who have stereotypies. They are not autistic, but hand not they by clapping — definition
even igh
very h level
have regular are stereotypic patterns, some rocking and some linically
they c
children. Not by history and
autistic. I don't
know what to call them, frankly, but they are not autistic.115
There “ in medicine is no . . need for soul-searching. To quote Kanner again, . any illness
may appear in different degrees of severity, all the way from the so-called forme fruste t o
the most fulminant manifestation.” This holds true for autism and, as we will see, for the
gradation t o minimal brain damage, conduct disorder, and
Defining Autism: Rett S
yndrome, Asperger' s

Syndrome 3
5
sociopathic behavior. The near-normal are merely milder versions of the classic autistic
syndrome. They are not entirely cut off from others but have intellectual their capacity for
,
human and contact.emotional 1 6
difficulties which impair

The condition called “ Rett Syndrome,” a severe variety of autism which only affects females
and which f irst came t o attention in 1965, is very probably another aspect of the
post-encephalitic syndrome and generated by the same factors, i.e., the childhood

vaccination program.137
A milder variant of autism is “ childhood-onset pervasive developmental disorder,” which
commences after the age of three.
The condition known as “ autistic psychopathy,” or Asperger's syndrome, after the Viennese
psychiatrist who described the first cases i n 1944, is another mild version of Kanner's
autism. This group i s thought to exhibit h
igher than normal intelligence and unusual
originality.
971 by Van Krevelen:
The symptoms were described in 1
as His a n abnormal personality with approach is a merely cerebral less
The more patient rationality. h
sensitivity, one. What he lacks is understanding o
f, and interaction with, other people's feelings. He
is, so to say, obliged to interpret everything in its literal sense, to analyze the meaning of the words
heard, to study the facial significance expressions of of the his facts fellow experienced m en. Just by
as he him, does to not scrutinize imme- diately understand whether his companion speaks seriously
or jokingly, others. r ealize that Hence he he is his unable may sense be to a of imagine bore humor,
wn peculiar. T he words manifestation He might does hurt not
to others. that if any, his is ... o
age of autistic psychopathy is in the first years of elementary s chool, or earlier if t he parents h
ave not
been able to adjust themselves to the individualistic behavior of their child.... The school community
requires adjustment to rules and norms. Moreover, school- mates soon observe everything out of the
ordinary . .. the behavior of t he autistic psychopath is very unusual; his v ocabu- lary reserved bears
arliamentary spoken address. or townhall . . language . The
more the for mark written of than p
intellectual functioning of the autistic psychopath has three peculiarities.
138
36 Autism
To begin with ... he is unable to learn from others.... The child tion from follows
the teacher. his
own
His methods
intelligence because
may he
enable cannot
him accept
to find instruc
- orig- i nal
solutions. Because o n unsatisfactory student, although

f this he is a he has the capacity t o think
ossess . . . The that third ingredient peculiarity

autochthonously. Second, he does not called sense. p
of concerns intelligence a that tendency might to fos - be ter rather unusual circumscribed ogy erally
relationships. or appeal astronomy to 139
other or “ children — life” in the interest abstract. patterns, Such topics such do as not geneal- gen-
another obstacle to adequate peer
Van Krevelen called this “ lack of intuition”: “ By intuition 1 mean a higher quality of
intelligence, a short-circuited intelligence, by which one is able to skip associations.” A typical
case was t he boy who, when asked to speak at a football rally, predicted that the team was
going t o lose; the e
nsuing round o f boos l ed him finally to modify his initially c orrect prediction,
but the experience bewildered him.
Marginal autistics may be incredibly boring:
Although some autistic children do not talk at all, mildly autistic children are often handicapped by a
tendency to talk too much on, when to t hem concentrating they that are listeners exceedingly on
what may not they interested share are trying t heir in a enthusiasm. t o topic. s
ay, without It does So
not any they occur reac- t alk
tion tosigns of boredom. Such a monologue is not easily interrupted or the tic changed person
to-and-froof is in a poor its normal course listener, conversation by and the sometimes comments is
t best to t herefore, the be autis- com- pletely unaware of the fact
missing. he of seems others; A
that somebody is trying to talk to him.
140
Parents often report that moments to process any the remark mildly he hears autistic . . child . stand
c annot needs several under- socially [this] makes

somebody at a normal rate of speaking ... he him a
bore because he tries to steer the conversation to topics he has anticipated . . . the autistic person . . .
can heed only o ne thing a
t a time and tends to be lost in his own thoughts.141
Van Krevelen noted the occurrence of true autism and Asperger's syndrome in two
brothers.
f these milder cases s hare with the more serious ones
What all o

Defining Autism: R yndrome, Asperger' s
ett S Syndrome 37
is alienation:
These three a utistic adults all conveyed the deep, unquenchable loneliness, the conviction
that they were somehow incapable of forming a relationship which could satisfy t hem.142

And have in their case the intelligence i t may be to appreciate more emotionally their plight.
trying, “ Ronald” because states: they “ I never could have a friend. I really don't know what to
do with other people, really.
”143
Autism, however, also incorporates a streak of naked hostility, a r ejection of contact with
others. “Jerry Goldsmith” responded to psychological testing with stories centering on “
aggression toward the father and on characters dying,” while “Tony W.” stated about himself:
! liked hellish environments, such as the s pook-house at the carnival, Halloween, and horror
aydreamed a lot and tried to actively communicate and get into that w
movies. I d orld. . . . I was
very cold-hearted too. It was i mpossible for me to give or receive love from anybody. I often
repulse it b y turning people o ff . Thai's a problem today, relating to other p eople. I l iked
things over people and didn't care about people at all.
144
The higher-IQ autistic will use verbal aggression, finding out the opponent's weak points and
taunting him.
If autism is a manifestation of vaccine-induced encephalitis, the implications are very
disturbing. The symptoms manifested with pathological intensity in a small group will of
necessity appear in milder form in a much larger proportion of the population. For every “
autistic” who is shut away in an institution there will b e a thousand alienated individuals
functioning as n ormal taxpaying citizens.
The parallel with the alienation and anomie of twentieth-century industrial society is
striking. How much of this loneliness are we inflicting upon ourselves?
Compensating for Ego Weakness: Resisting Change Because the autistic
suffers from “ inability to learn from and cope with new stimuli,” loss of control is an
ever-present threat.145

But control is threatened by change, so change is what the autistic fears and hates the most.
“Small changes in [ “ Ronald's” ] feeding, either in the schedule or the way in which he was
nursed, led to anxious disorganization. . . . A sa toddler, any c hange in his routine c ould
lead to catastrophe. One time, when drinking from a glass, milk went up his nose.
Following this, he refused to drink from a glass for over two years, using a spoon to eat
liquids.
Kanner noted their “ anxiously obsessive desire for the mainte- nance of sameness”:
When John's parents were ready to move to a new home, thechild was frantic when he saw
the moving man roll up the rug in his room. He was acutely upset until the moment when in
the new home he saw his furniture arranged in t he same manner as before. He looked
pleased, all anxiety was suddenly gone, and he went around affectionately patting each

piece.147
When change does occur, it provokes a storm. “There may be resistance and even
.g. , the child may scream
catastrophic reactions to minor changes in the environment, e
when his or her place at the dinner table is changed.” 148
Nothing can be changed in the
daily routine; unpattemed situations are what the autistic fears the most.
A particular instance of incipient loss of control is the autistic's terror at separation from
family and familiar surroundings. Harvey J ackson, Jr., is typical:
lways h
He a ated a ny d
isruption i n his f amiliar r outine, When h e came h ome from vacation, f or
instance, w hen he was nine months o ld , a
nd he s aw t hat his f ather and sisters were not
there, he put up a tremendous fuss. The f amiliar family was not t here . O nce the rest of t
he
family g ot home that time, he calmed down. B ut u ntil then he screamed loud enough t o
wake up t he w hole neighborhood. Even t oday [ age f ifteen] he is m uch better, b e will
ut h

ody home?" He
ask, “ Is any- b likes t hat reassurance.
Once h is sister m
issed h er bus, a ad t o r ush out a
nd l h nd l eave him. H ew ent to the neighbors
crying a nd screaming a nd c om- 146
»
38
Compensating for Ego W eakness: R esisting C hange 3 9
plained that / had left him. I never c ould leave him at a ll . Now he is a l ittle that way with his
younger b rother. He i s afraid of something happening w ith him.
and twirling ness weeks, Another is a a fascination piece with manifestation of the string, with
same objects: arranging of toy — the

spinning
autistic they blocks may preoccupation
a
top, bouncing a ball,

into play identical for hours, with patterns, same- days,
and the like.
Only objects can be really trusted not to c hange or behave unpredictable They stay the way
you leave them. This contrasts with animals, such as dogs, which are always doing the
unexpected. Kanner called attention to this loving and absorbing relationship with objects:
“So intense was this relationship that mino r alterations in objects, or their arrangement, not
ordinarily perceived by the average observer, were at once apparent to these children, who
rage until the change had been undone.
might then fly into a
In the severely autistic child the environment is controlled, and sameness maintained, by
unendingly repeated motions and actions, described as “ ritualistic and compulsive
behavior,” “stereotyped movements,” etc. These take the form of whirling around and around,
shaking their heads from side to side, banging their heads against some object,
hand-flapping, hand-waving, hand-twisting ( choreoathetoid m ovements), opening and
shutting the hands con- tinuously, knocking on objects in a stereotyped way, and the like.
Of all these movements, “ body rocking,” meaning rocking back and forth in a rhythmic way,
is the most common:
Hour stranger his after who hour is our he rocks son. ... t here, Brothers this beautiful and name. He
stares, riveted in his rhythmic little three-year-old sisters rocking. r un by, . calling . . We mentioned
Brian's constant rocking to friends who assured us that most of the children in their family rocked as
babies. However, curtailing Brian's incessant rocking proved to be an impossible task for us.... On
ut the forcefulness minute we stopped and determination he
occasion he did enjoy being tickled, b
was back were in the most chair, frightening rocking again. as he con- H is
stantly threw his whole upper t orso against the back of the rocking chair, crashing it into the wall
behind him.

” 149
150
Autism 40
Rocking may involve banging the head against the headboard of function vide the
the crib
,
of child's possibly
this and life other
to with relieve
repetitive structure. the
pain movements,
They of a are headache

. a way however
, of The
organizing principal
is to pro- the outside
world. As they grow older autistics develop new types of obsessions, rituals, and
procedures:
ameness. For
A persistent problem is use of rituals that have replaced his need for s
example, it takes him up to two hours to take a shower because he has to place the nozzle,
bath m at, curtain, etc. , in an exact relationships and then wash in a prescribed manner. Other
rituals involve dressing, going out of the house, and going t o bed.151 Ruth, a c
harming
preadolescent, went through a period marked by ritualistic involvement with every door
which she had to touch and “ test” prior to opening or closing. She kept excusing herself,
each time, seeking forgiveness for this rather innocent indulgence.152
Compensating for Ego Weakness: Aggression Loss of control, or incipient l oss,
can provoke more or less hostile and violent reactions. The autistic becomes
uncooperative, stub- born, obstinate, n
egative, This is seen in were “Mama,” “ Papa,” small
and things — etc.

the child whose first three words
“ No,” or the one whose first sentence was: “I don't want to. .
. . ” 153

Negativeness is also manifested in “ avoidance o f a requested response by substituting an
alternative.” The high-IQ autistic w
ill go to e xtreme lengths and adopt complicated
strategies to avoid answering questions or complying with requests.
But the reaction can be more violent, commencing with temper full-s cale tantrums, rages
screaming, for which shouting, these and children crying, are and famous.
proceeding to the
The autistic is often furious with the outside world, which is unpredictable and
incomprehensible and seems always t o be acting against h t alterations
is interests. “ Rages a
t the failure of others t o provide him with relief from his constant feeling
in his routine, or a
Compensating for Ego W ggression 41
eakness: A
that something was wrong, left him no peace, only increased anger, any blunted, more
point Even self-centered after of the view a near-normal while but and his by self-assertive.
own.withdrawal autistic 155
Those has inside.
with profound a low difficulty IQ w eeing even
ill be s
One of Leon Eisenberg's original cases, four years old, “ 'related' to the examiners only
insofar as enraged

at interference from without . . he . made demands o r became [ with]
outbursts of aggressive behavior”; at age fifteen he was “destructive.” 156
Jerry Goldsmith is
described at age four: “screams when frustrated”; at age eighteen: “ surly or withdrawn
attitude toward examiner . .. angry, withdrawn attitudes toward relationships.
The frustration threshold is very low in autistics, reflecting the immature or nonexistent ego:
The other night he wanted f ried chicken b as even c ooked, and he took a
efore i t w c up o
f orange
'
juice a nd threw i t a t m
e, because the f ried c hicken wasn t r eady.
The desire f or control and the low level of frustration tolerance easily lead t o “bossiness” or “
bullying,” “demanding h is own way with peers,” and e ven to naked aggression against
persons or objects perceived as s tanding in t he way:
Once s he would even attack a he w
s tranger i n t he s treet. S p t o him a
ould go u nd s ay, Take y our hat
4
off! ' She would tell y ou t hat y ou a re old, because y ou h ave gray hair. And e ven when she is being
affectionate with u s, she h as t rouble s ustaining i t, aggressively exploring m y face, my hair, etc.
Harry, who is twenty-four years old:
. . . had learned to intimidate ished so because
people by staring them down when he doing w
to escape of an his educational size — Harry used physical intimidation activity He had no .
trouble six feet, six inches. Thus . . . as an effective way of maintaining h
is noncompliance
autistic Few lacks restraints any empathetic are
im.'58
when demands were placed on h
imposed relation by with morality others or which decency, might for mod- the
erate incipient aggressive tendencies:

” 154

” 157
42 Autism
Most frustrating to the family was B rian's seemingly non-caring attitude toward others. He did not
want to join in f amily activities, he did n
ot respond t o outreaches of his s iblings, and h
e did n
ot
develop a respect for others' property.159
The and ity ity to underlying deal other could
of so adequately
what they his he could would

theme predict He with
people. not beneath simply what
rationalizations

perceived not do which the was unpredictabil- l eft with his
, empathize as him inabil- others con
- fused
and frightened.
Alienation and cold-heartedness can lead to fantasies of violence as well as actual
violence against people and animals. For a six-year old in school:
ith He became
Interactions play about themes with peers of murder were and associated blood. w
bizarre increasingly stories and
ith such At school verbalizations, he knife and was “ found sawing
destructive preoccupied themes. w
on a ment, with delight, was “ You could aggressive acts, and peer's repeatedly kill someone neck
took or with arm.” a this plastic His knife.” com- t oy
On one occasion he tried to choke a child with a rope. He showed decreasing tolerance to stress and
., brother.tantrums.... 161
.g
increasing disruptive behavior, e
He threatened physical harm to his younger
Tony W. wrote a bout himself as a c hild:
I remember the Yale Child Study Center. I ignored the doctors and did my own thing.... I was also
very hateful and sneaky. I struggled and breathed hard because I wanted t o kill the guinea pig; as
soon as the examiner turned h er back, I killed it. I hated my mother because s he tried to stop me
from being in my world and doing what I liked; so I stopped and as soon as she turned destructive.
her back, I went I would at Evil things astonished it again. I was very rebellious and p
lot to kill my
omb. destroy . . sneaky and . t he world. I also had a very warped
mother me such as an H. and b
sense of humor and learned perverted things very quickly. I used to lash out of control and repeat
ell as t elling people v iolent, w
sick, perverted phrases as w
ild, untrue things to impress t hem.162
160
Billy McCoy:
Compensating for Ego Weakness: A
ggression 4
3
e was considered uncontrollable by all
. . . has spent the past fifteen years i n and o ut of institutions. H
of them because of his fits of the men. r age. institutions The Julia family McCoy is has that learned
says he is that stronger to the l ive only with t han thing six his or fits, her seven during son full-grown
learned which in a boy who can hardly articulate t he sounds necessary to pronounce going his own to
name kill you.” screams 163

loud and clear, “ You son of a bitch, I'm

The mother of an autistic youngster describes driving him in the c ar:
Suddenly I felt like somebody dipped ten razor blades in tabasco sauce before throwing them into
my neck and shoulders. Jeff without warning had plowed his claws into m e. . . . He grabbed a handful
of my hair and started slicing away at me with the t en switchblades Larry thought he had just clipped
and filed down. It was hard t o duck, dodge, and capture him a ame time, especially hemmed up
t the s
ar. . . . Jeff is five years old and still in diapers.
in the c
164
The immediate family, of course, bears the greatest burden— especially the mother
who must often stay home with the child. Many live in a state of near exhaustion. One,
who had just under- gone an operation, described having t o carry a pillow a t all
'
times t o protect herself. Another sought refuge f rom her adolescent son s rages by
We kept t he outside
locking herself i n the family c ar. “ ith a t wo-way
doors locked w
lock day and night because he would run away. I would leave the patio door
unlocked for him to play in t he daytime i n our backyard, where we had a five-foot
fence with a padlock on the g as virtually a prisoner in my home, with a
ate. . . . I w
tiger loose a nd no respite, not even for a night o r a weekend o r a week.
year-old One son family in a locked interviewed room f or with t his barred book
” 165
ad to keep a their real prisoner twenty-

windows— h
in his own home.
An autistic adolescent's weekend at home is described by his younger brother:
go w
The first event occurred about t wo years a hen I w ddie had just come home from
as sixteen. E
Western S tate for a
n overnight
Autism 4 4
on Friday. W e were going to take him back Saturday after lunch.... Friday evening was fairly
uneventful, none of the usual tension in the air that is so characteristic of the times when Eddie
comes home. Part of this tension is due to our own anxiety caused by the memory of previous
overnights with him that have ended in disaster, when we had literally to drag him back to West- ern
State, screaming and crying.
Saturday m ff badly. I came down from my bedroom early and was sitting in our living
orning started o
room trying t o wake up when the house's tranquillity was shattered by some choice words that I do
not care to mention.... Oh, great, I thought, he's starting early. If he was acting this way now, in no
time he would blow up and create an unpleasant situation for the family....
Throughout the r est of the morning, Eddie seemed very keyed up, and I w as starting t o get worried
that he would suddenly lose his control and run out of the house to Lord-knows-where, and we
nts sensed this too, so as soon as we
would spend another Saturday trying to find him. My par- e
could, we got him in the car and on his way. ...
ddie didn't think that was a good idea, so he ran out. . . . My father
That's when the fun started. ... E
and I spent the next thirty-five minutes chasing him all over the scenic routes of Brentwood.
We finally caught him with the help of the local police and had him in the back seat of our station
wagon. I s at with him so that he would n ot hit my dad while he was driving. During the whole ride
back he went through a series of emotional states — first violently upset, then sobbing, then
dad, then crying again....
I66
screaming and swinging at
The tendency to violence can be combined with sleeping difficulties:
ights were as bad as days. W
When he reached puberty, all hell broke loose. . . . N e slept with our

iolent rages he would have during the night. 167
bedroom door locked because of the v
The violence of autistics is thus a mixture of ungovernable impulses and — depending
upon the level of intelligence — justifica- tions and rationalizations of these impulses in
terms of need to protect
the vulnerable ego and to assert one's own point of v
iew in life.
The uncontrollable impulsive component is seen, above all, in violence directed at the self.
Compensating f or E eakness: A
go W ggression 4
5
art of of his the serious first twenty-four
Harry life in has institutions spent a good because p
self-abusive years behavior. o
f his
As early as age 3Vi he wore arm restraints and a football helmet to prevent him from self-abusing.
Between the ages o i and f ifteen he was in and out of various schools and centers for the
f 5V
retarded. At age 15Vi he was placed in a n institution where he began to receive massive his extreme
outbursts continued (2) thigh-hitting i n the form with his of of (1 self-abuse. dosages fists, ) head- (3) of
and ankle-kicking, drugs However, nose-banging as an Harry's attempt and with (4) self-abuse to his
arm-bit- control
fists,
ing. Harry's repeated blows to his face resulted in a permanent disfigurement of his nose as well as a
number of hematomas to his face and body. His ankle kicks had caused his ankles to begin to calcify.
Finally, biting had resulted in numerous scars and scabs on his arms.
168
e flicks very u
is H sed y ou aggressive to ( e ite his o
ven b ith t he a
nw rm, e
yeball), o ang his
thers. b
Slaps t hrows head them on things things, on at t he you. slap head, ...
himself t he arms, He
He used t o p yh
ull m is own hair out w
air and h ngry. a
hen he was a lso digging a ttacked his nails
nd He a
the t eacher i n.When i n he his w
as new five s chool, h sed grabbing t o g
eu er m
rab h and hand
yh
p to h is mouth a nd bite; or h e would d ig h is nails into m
ut i t u
and p is school. l ips hand;
yh
sometimes.They He o
r attacks h
e would his g
rab b y s wollen hair. a
et s o m
edroom g e that
nd the H
e can' t attack there. chew the H
ould h
furniture w e on girls b ny- in
ites a
ithout them getting caught.
thing w
In very severe cases autistic children have bitten off their own lips and fingers, or chunks
ave suffered detached retinas from repeatedly hitting
from their shoulders; they h
themselves in t he face and eyes. having The a greater level of tendency i ntelligence t o
self-mutilation, plays a role, with w
hile retarded those autistics with a higher One IQ very
might hostile simply and hate violent themselves.
sixteen-year-old, interviewed for this book, started biting himself at age fourteen months:
ore m
It i s m e says, '7 hate the w
ental abuse now. H ow all l ong of will us. I H
ay I am. H ave i s t o
eh
e this way? for a I s i t cure. b
looking b ure forever?
ecause he thinks t he doctor will c e him.
" This H
likes to is very h
ard on go to the doctor
46 Autism
Psychologists and psychiatrists have attributed self-destructive- ness to feelings of sexual
frustration. But how can sexual frustration cause a two-year old to start pulling his hair out,
or hit himself on the head until it is black and blue? While self-hatred undoubtedly plays a
role in some cases, a purely neurologic impulse seems also to be at work. Some hit and
pinch themselves only when they are excited, others when angry. The mother of one
nine-year-old was asked why he did it:
Q . Does h e touch people? A . Y es, h
e will touch y our h r hit you. H
air, o e is quite unpredictable
.Q
hat does he s
. W ay if you t ell him n ot t o h eople?
it p A He w
. ill hit you and then s ay, “ You
"
need to face down, meaning
I need to l ie face down on the f loor." Q . D

“ eliberate? A . Sometimes he just
o you think it is d
can' t h
elp himself. Sometimes he d oes it delib-
ants to. T
erately, because he w he self-d ost especially
estructive neurologic impulse is seen m
in a condition peculiar to boys known as the Lesch-Nyhans Syn- d rome (a combination of
mental retardation, with autistic features, inability to speak, and violent aggressiveness
thers within reach). These boys must be kept permanently in
directed at the self and at any o
strait-jackets to prevent them from destroying themselves physically. They are aware o
f
hen their strait-jackets shake loose, they gesture to the
their state and terrified of it, so that w
nurses to come quickly a nd tie t hem in again.
169 Undirected, unfocussed, impulsive violence is, of course, a serious problem o f late
twentieth-century American society. In Chapter alence of V post-encephalitic we discuss
the possibility neurologic that damage. it is related The to very a high common prev-
association of impulsive damage with autism and, as we will see, with minimal brain
damage, makes it very probable that social violence springs in part from the same
causes.
Compensating for Ego Weakness: Hypersexuality An important way to
compensate for one's own perceived inade- quacies is through intensified sexuality, and this
is found quite often
Compensating for Ego W eakness: Hypersexuality 47
in autistics.
In some the sexual function is underdeveloped. Sybil Elgar, a specialist in the care and
training of autistics who heads a residential working community for forty autistic m en and
notes that “ interest in sexual experience is not tics. O

nly a minority of “ more able and
adjusted usual
” women among in England, autis- autistic people” can
become involved
with others. The majority “ lack any capacity for They affection, “ remain tenderness,
self-absorbed and and solicitous lack care of the capacity a to sexual form p
artner.” relation-
ships because their level of social and emotional development is obstructed by the
characteristics of autism.
The wives of some marginal autistics leading normal sexual lives describe them as “ never
very interested, mechanical, never with feelings.” “ I b
ut performed with have t o tell him what
to do.” “ Sex drive n
ormal
no feelings. He uses me like an object. But many parents describe their autistic children as
exed,” and Soviet researchers have found “ precocious puberty” in autistics.172
“ hyper- s The
sexually aroused autistic, moreover, pursues t his gratification for its own sake and not as
part of a relationship with someone else.
Sexual drives tend to be satisfied through masturbation. One of Kanner's first cases, at age
five, “often masturbated with complete abandon.” 173 The same has been reported by others:
“ noisy, incontinent, and destructive, and masturbated excessively during his first weeks on
the pediatric ward, taxing the patience of w ard personnel”; “hypersexuality, expressed in
excessive masturbation and sadomasochistic actions”; “ public masturbation occasionally
noticed at about eight years” (in a girl).174
For a bout t he p
ast year, s
tarting at a ge f our, he has been masturbat- ing . / couldn' t b elieve i t .
Once I f ound him under the c overs, com- p letely n aked, a e had a h
nd h uge e rection. This h as
been a r eal problem for us. W im i t has been a c
ith h onstant thing . Coming h ome from s chool
he would take h is clothes off and g o into the bedroom a nd spend as long t here as l would
let him, and then he w ould c ome o ut naked. It h as d iminished a l ittle since. For a
while it was
onstant .
almost c

” 170

” 171
Seeking Structure: M
usic Mention has already been made of the extraordinary
musical talents of many autistics and their ability to remember and repeat arias, symphonies,
and whole scenes from operas.
According to Rimland, “Astonishing musical ability is found age. in these Kanner children
describes quite frequently.” a one-year-old 173
And [!!] it who is manifested “could hum at and
an early sing many tunes accurately.” Another could discriminate among eighteen
symphonies at age eighteen months; at age four, in kindergarten, “ if there is m
usic, he will
go to the front row and sing.” Another four-year-old “can tell victrola records by their color,
and if one side of the record is identified, he remembers what is on t he other side.
'
176
He l oves m usic . As soon as h ec

omes home h ants to t urn on t he s tereo. H
ew as r aised with
ew
a lot of m round him. I t calms him d
usic a own.
usic v
He l ikes m ery much. H ell , on p
e sings very w itch, a ords. He u
nows all the w
nd k sed to
be v ery i nto c
ommercials. He w
ould h ave rather died than m iss a commercial .
e had a
At age three or four h prodigious m emory. He c ould m emorize m usic and r epeat i t f rom
memory. He could sing a nd hum all k inds o fm
usical t hings a fter hearing them just o nce. H e
would e ven correct people. The most complicated things he knew w ere themes from
television shows— background music and t he l ike, w hich i s not very memorable. O ra theme
from a Beethoven sym- p hony. His teacher said he h ad a three- o ctave range and p erfect pitch.
Leonard, a moderately severe autistic,
age eleven . . . composed his own songs. His piano playing d
. . . by eveloped with v irtuoso
skills, although it was not until his late adolescence that he could p lay his songs with any

feeling, distinguishing a slow, serious classical piece from a lively dance.177
Love of music is not surprising. These children suffer from, among other things, inability to
organize their perceptions and their thoughts. Music, especially when there is a pronounced
beat, will
48
9
Chronological Parallels 4
provide structure for them. “They rock. T
hey hum, and they love to dance.” 17
*
nly time he will rock i s when he hears m
The o usic.
The beat of music for them fulfills the same function as cradle- rocking. Was it pure
coincidence that “ rock music” burst on the world in the late 1950s, just when the first
vaccinated generation was reaching adolescence?
Chronological Parallels After Kanner's first articles on autism, researchers combed
the literature to find if the condition really was unprecedented. Indeed, it seemed to be novel,
as only a handful of cases could b e found before 1943.
By 1958 Kanner had almost 150 in his files, but the 1960s saw a tremendous upsurge. The
Goodwins, prominent child psychiatrists, commented: “Childhood autism had been a rare
e had seen six autistic children during the
entity in the pediatric clinic before 1964. W
preceding twelve years. They had prepared us for complexities in management and uncertain
prognosis. They had not prepared us for the events that followed, as sixty-five children came,
in turn, to the center.
In t he 1960s a rising t ide of parents with autistic children flooded the offices of child
” 179
psychiatrists and psychologists, begging for help they could n ot give.
isely reflected the
The increased prevalence of autism in the 1950s and 1960s pre- c
expansion of mandated vaccination programs during these same decades.
Today autism is a growth industry. The eleven cases singled out by Kanner in 1943
because they differed “so markedly a nd uniquely from anything reported so far” have
pon States the definition
nd in depends t he United u
expanded to 200,000 or known more a
ot
alone. While of autism the precise accepted, total the is inci- n
dence is estimated by the National Society for Children and Adults with Autism at 15/10,000
live births. Since there are three million live births each year in the United States, this
comes to over 4500
0new cases of autism each year.
Autism 5
Total deaths in the United States during the 1980s from “acquired immune-deficiency
180
syndrome” (AIDS) have been about 45,000. Thus the living death of autism has affected as
many children, and their families, as have died from AIDS in thesame period. The first

cases of Rett Syndrome were reported from Austria in 1966.181
The same chronological parallel between autism and childhood vaccination programs is
found in other countries. In Japan, for example, the first autistic was a boy bom in February
1945.182 One of the first public health m easures introduced by the United States
Occupation was a compulsory pertussis vaccination program, and this c ase seems more
than a coincidence. births — Today In France, is lower the Chile, prevalence than

in the United
Austria, tries the first cases of autism reflecting introduction of the of
autism
States
in Japan comparable.
— but
00 live
4.5/10,0
pertussis started
Holland, appearing vaccine and
the in in
Scandinavian this the
same early

decade.
1950s — coun-
In England the pertussis vaccine was introduced on a broad scale 1957. only P rior in to the
this late time 1950s, it had been after used a series only of sporadically trials from by 1946
physi- t o
cians. When a society of parents of autistic children was established in London in 1962, most
of the children were found to have been bom in the late 1950s, with a few from the early
1950s.
In England the incidence of autism is the same as in Japan, 4.5/10,000 live births. Why
these countries have less autism than the United States has never been explained, but it is
probably because the pertussis vaccine is given l ater in these t wo countries than in Japan);
in the coverage United S tates in England ( at s ix months is optional i n E
ngland and,
depending and at two on years cir- c umstances, ranges from eighty to as low as thirty
percent; British physicians, f inally, take more care to elicit contraindications and are less

eager to vaccinate a child at risk than are physicians in the United States.185
183
184
A Puzzling Feature curious als An such unexplained Of frequency Kanner's as
physicians, feature first in well-educated 100 lawyers, of cases, a
utism 96 professors,
families— on of the its initial fathers and especially apearance accountants.
were high-school profession- was its
graduates, 87 had attended college, 74 had graduated from college, and 38 had done
Of the mothers, 92 were high- school graduates, 49 had graduated from
graduate work.186
college, and eleven had done graduate work. This was an astonishingly high level of
educational attainment, especially for women and especially for the 1930s. Also
unexpected was the finding that 70 of the women had taken jobs, while many had continued
working even after marriage! “ To this day,” Kanner observed in 1954, “ we have not
ne autistic child who came of unintelligent parents.”
encountered any o
In 1964 Rimland concluded that “ t he parents of autistic children f orm a unique and highly
f intel- lect and personality.
homogeneous group in terms o
observations that 47 In

” 187
percent 1967
were a of systematic
the correct
study A
.parents 188
of 1970
autistic was
study done children made
proving a had similar
completed that

finding — Kanner s college

' , while a number had done advanced study for the M.A. or
Ph.D. This contrasted sharply with t he parents of other categories of m entally disturbed
s nineteen percent of the parents w
children, where as few a ere college graduates.
189 skewed A ttempts distribution have of been c
ases made, to genetic but without factors
success, in the middle-class to link this
or upper-class population of parents.
One point insufficiently stressed in the early surveys was the high incidence of parents
working in medicine or connected with it. Kanner's first 100 cases included eleven
physicians (five psychiatrists), three Ph.D.'s in the sciences, one psychologist, and one
dentist; of the mothers one was a physician, three were nurses, two were psychologists,
one a physiotherapist, and one a laboratory technician.
190 But there were other medical connections which did not neces-
51
52 Autism
sarily appear in the statistical breakdown. One mother told Kanner:
doctor, but my family didn't have the stamina. I have
I majored in zoology. . . . I wanted to be a
often regretted for two years, then worked in an endocrinology it. laboratory.I taught school
191
In another case the father was a clothing merchant , the mother had “a successful business
record, a theatrical b ooking office in New York.” But h er uncle, a psychiatrist, came t o the
physician's o ffice instead o
f t he father a nd clearly had m uch influence over t he family's
medical decisions. One New England m other had studied a child t ype psychiatrist,
secretary of psychology person; in w athology sees in t he everything college. mother,
hile a p
laboratory In a as high-school a

before a fourth pathological marriage — case graduate ,
a 'hypomanic'
the specimen father “ worked was rather as a
afraid than well; she would throughout not live the through pregnancy the labor.
she was very apprehensive,
Kanner noted: “ Many of the fathers and most of the mothers are perfectionists. . . . The
mothers felt duty-bound to carry out to the letter the rules and regulations which they were
given by their obstetricians and p ediatricians.
But these early data showing a preponderance of educated parents have now been
superseded; since the 1970s the skewed distribution no longer obtains. In the United
States autism is now evenly distributed, with no social class or ethnic group being particularly
favored.

” 192

” 193
194 Hence the conclusion is now reached that the earlier data were mistaken, “based on
outdated research.... No social or psychological characteristics of parents or families have
proven to be associated with autism.
orrect? Was t he earlier research done badly, or did the source p
But is this c
” 195 opulation for
autistic children change b etween 1940-1950 and t he 1970s? This latter p ossibility has not
been investigated.
A real shift in the socio-economic distribution pattern of autism can r eadily be explained in
terms of childhood vaccination. When the pertussis vaccine was f irst introduced, being
offered by theocca- sional forward-looking pediatrician to parents anxious to do “everything
possible” for their children and avid for the latest wonders off
Chapter / Notes 5
3
the medical assembly-line, who were the first takers? Not the blue- collar workers, who could
ree vaccination at public
not afford these frills and are, in any case, often suspicious of doctors. F
health clinics (where today the vast bulk of lower-class children get their shots) was still for the
future. Only the prosperous — who could afford private physicians—

were in a position to
request this vac-

cine. And these same prosperous and educated parents, especially educated
and ambitious mothers with some exposure to medicine, would have i nsisted on it.
This explains the skewed distribution of autistics in the early decades. Kanner, who was
such an acute observer in all other respects, was no less so in this one.
As vaccination programs expanded and became obligatory in nearly every state, rich and
poor alike could seek the benefits of the DPT shot. The incidence of autism evened out, and
researchers assume that the earlier statistics were incorrect!
Today the more enlightened specialists realize that autism is not a discrete entity of
psychological or “emotional” origin, but a many- faceted neurologic condition with close links to
other recognizably neurologic disabilities such as mental retardation and epilepsy.
Although it occurs frequently enough to be classified as a true epidemic, no theory as to
as yet been accepted.
its cause h
The next chapter brings out the parallels between autism and the much more widespread
condition
— minimal brain damage.
Chapter I Notes 1. Kanner, Leo, 1942/1943, 2 50. 2.

Kanner, Leo, 1944. 3. Kanner, Leo, 1942/1943, 242. 4. Kanner, Leo, 1954, 379.
. C
5. Kanner, Leo, 1942/1943, 236. 6. Eisenberg, Leon, 1956, 609-611. 7 reak,
E.M. et a
l. , 1961, 502.
54 Autism
. et al. 1961

emporad, J.R., 1979, 195. 10. Creak, E.M
8. Yates, Alayne, 1984, 396,397. 9. B 9
,
. Cohen, Donald J., 1980, 388. 12. Ibid. , 387. 13. K
502. Cohen, D.J., 1980, 396. 11 atz,
anner, Leo, 1944, 2 15. 15. K
Donald R., 1979. 14. K anner, Leo, 1942/1943, 236. 16. Katz,
atz, Donald R., 1979. 18. Pingree, Carmen, 1984, 331. 19. Kanner,
Donald R., 1979. 17. K
Leo, 1944, 217. 20. Volkmar, Fred R. and Cohen, Donald J., 1985, 49-50. 2 1. Bemporad,
Jules R., 1979, 192. 22. Cohen, D
onald J., 1980, 389. 23. Kanner, Leo, 1944, 217. 24.
anner, Leo and Eisenberg, Leon,
Kanner, Leo, 1949, 422. 25. Kanner, Leo, 1954, 384. 26. K
1957, 62. 27. Kanner, Leo, 1944, 217. 28. Kanner, Leo, 1949, 426. 29. Kanner, Leo, 1954,
384. Kanner, L. and Eisenberg, L.,

chopler, Eric,
1957, 62. 30. Kanner, Leo, and Eisenberg, Leon, 1957, 60. 31. S
l. , 1981, 258.
et a
., 1951, 347-350. 33. Bergman, P. and Escalona, S.,
32. Despert, J.L
6. Betz, Barbara, 1947,

1949, 349-351. 34. Cappon, Daniel, 1953, 45. 35. Loc. cit. 3
ettelheim, Bruno, 1974, 12, 35, 425. 39.
46. 38. B
267. 37. Despert, J.L., 1951, 345-3
Akerley, Mary, 1975, 378. 40 Torisky, Constance V., 1978, 235 41. Katz, Donald R.,
. .
1979. 42. Despert, J.Louise, 1951, 344. 43. Rimland, Bernard, 1964, 47. 44. Chess,
Stella, 1971, 44. 45. Despert, J.Louise, 1951, 345. 46. Quoted in B. Rimland, 1964,
17, 49. 47. DeMyer, W . and M., 1984, 151. 48. R
itvo, Edward and Freeman, B. J.,
1984, 299.
Chapter I N otes 5 5
inbergen, N., 1974, 23. 5
49. Rimland, B. 1964, 65. 50. T 1. S l. , 437. 52. Pingree,
holevar, G.P e t a
ewis, Dorothy O., 1981, Forward. 54. Kanner, Leo, 1942/1943, 250. 55.
Carmen B., 1984, 336. 53. L
eMyer, W. and M. , 1984, 147. 58.
American Psychiatric Association, 1980, 88. 56. Ibid., 89. 57. D
Coleman, Mary, 1976, 28. 59. American Psychiatric Association, 1980, 37. 60. Kanner, 1942/1943,
248. 61. Schain, R. and Yannet, H., 1960, 5
63, 564. 62. Wolf, L. and Goldberg, B. , 1986. 63. American
Psychiatric Association, 1980, 89. Bartak, L. and Rutter,
mitz, E.M. and Ritvo, E.R., 1976, 616. 66.
M., 1976, 119. 64. New York: Harper and Row, 1974. 65. O
nd T. Campbell, 1969, 559. 6 8. K
Katz, Donald R., 1979. 67. Goodwin, Mary S. a atz, Donald R., 1979.
69. Omitz, E.M., 1974, 199. 70. T ates, A., 1984.
sai, L., 1982, 1983, 1984. Sarz, Paul etal., 1985. Y
71. Yamazaki, Kosuktetal., 1975, 330. 72. Sullivan, Ruth Christ, 1979, 113. 73. Kanner, Leo,
1942/1943, 237. 74. Ibid., 2
39. 75. Whitehouse, D. etal., 1984. 76. Kanner, Leo, 1942/1943, 237.
Smith, Donald E.P. et al., 1988.
arlin, Isaac W., 1951, 60. 78. R
987. 77. K
l. , 1
Konstantareas, M. Mary et a utter, M. , 1972, 330. 79.
., 1953, 825. 8 0. C
Sherwin, Albert. C oc. c it. 82. Goodwin, Mary S.
ohen, Donald J., 1980, 389. 81. L
and T. Campbell, 1969, 560. 83. Kanner, Leo, and Eisenberg, Leon, 1957, 56. 84. Katz, Donald R.,
1979. 85. Realmuto, George M. and Main, Bart, 1982, 368. Bemporad, Jules
984, 82.
l., 1
R., 1979, 182. 86. Bemporad, Jules R., 1979, 192. Komoto, Junko et a
Coleman, Mary, 1980, 17.
56 Autism
87. Gastaut, H. etal., 1987. 88. Chess, S., 1971, 39, 44. Myklebust, H.R
. et ai , 1
972, 158. 89.
Cohen, Donald J., 1980, 396. 90. Eisenberg, Leon, 1956, 611. 91. Rimland, B., 1964, 79. 92.
978, 18. 93. I bid., 1
Student, M. and Sohmer, H., 1 8. 9 4. R
osenblum, S.M. e tal., 1 980, 222. 95.
Tanguay, P.E. and Edwards, R.M., 1982, 181-182. 96. Freeman, B.J. and Ritvo, E.R., 1984, 287.
Bartak, L. and Rutter,
Connor, ed., 1 99.
975, 1
M., in Neal O' 97. American Psychiatric Association, 1980, 88. 98. Cohen,
984, 130. Van
Donald J., 1980, 387. 99. Kanner, Leo, 1942/1943, 239. 100. Petty, L.K. et al., 1
Bourgondien, Mary E. and
Mesibov, Gary B., 1987. 101. P . etal., 1
etty, L.K 984, 130. 102. K
anner, Leo, 1942/1943, 238.
103. K omoto, Junko et al., 1 984, 82-83. E
anner, Leo, 1944, 215. 104. K isenberg, Leon, 1956, 609.
ohen, Donald J., 1980, 387. 106. Petty, L.K. et al. , 1984, 132. 1 07. Bemporad, Jules R.,
105. C
1979, 186. 108. Sullivan, Ruth Christ, 1975, 177, 181. 109. Kanner, Leo, 1942/1943, 237.
Pasamanick, B. and Knobloch, H.,
50. Betz, Barbara, 1947, 269. Sher-
1963. 110. Markowitz, Philip. I ., 1983, 2
win, Albert C., 1953, 825. 111. Petty, L.K. , 1984, 130. 112. Stiver, Richard and Dobbins, John P,
71
1980, 70- . 113. Goodwin Mary S. and T . Campbell, 1969, 560. Lotter, V., 1966/
illberg, C., 1983a. G
1967, 136. 114. G illberg, C., 1985a. 115. S
auvage, D. e tal. , 1 985, 197. 116.
i , 1987,
Mnukhin, S.S. and Isaev, D.N., 1975, 106. Gillberg, C. eta
282. 117. Sullivan, Ruth Christ, 1975, 180. Goodwin, Mary S. et al. , 1971,
61. Coleman, Mary, 1976. 19, 221. 1 18. Kanner, Leo, 1942/1943, 236. 119. Sullivan, Ruth Christ,
1975, 177, 181. 120. Personal communication from Bernard Rimland, Ph.D. 121. Volkmar, Fred R.
and C ohen, Donald J., 1985, 51.
Chapter I Notes 5 7
122. G eschwind, N. a nd P. B
ehan, 1982. K olata, Gina, 1983, 1 23. Kanner, Leo, 1971,
312. 1
144-145. 124. Cited in T
inbergen, N., 1974, 20. 1
25. Coleman, Mary, 1976, 1. 1
26. S
chopler, Eric
28. F ejn, Deborah et al., 1981,
nd Griffin, Judith, 1981, 317. 1
etal. , 1979, 4. 127. Hetzler, Bruce a
29. D eMyer, W. and M., 1 984, 145. 130. R eichler, Richard, 1980, 95-9 6, 126. 131. A merican
312. 1
Psychiatric Association, 1987, 38. 132. Rutter, M. and Schopler, Eric, 1987, 172. 1
33. Kanner, Leo
and Lesser, L.I., 1958, 711. R ., 1984, 1
imland, B., 1964, 21. 134. DeMyer, W. and M 35.
46. 1
988. 137. Nomura, Y. Segawa, M. and
l., 1
Reichler, Richard, 1980, 96. 136. Ritvo, E. et a
Hasegawa, M., 1984. 138. American Psychiatric Association, 1980, 90; 1987, 39. 139. Van
Krevelen, D.A., 1971, 83-84. S
ee, also, Wing, L., 1981. Wing,
L., 1986. 1 ewey, M. and Everard,M., 1974, 348-349. 141. Loc. cit. 142. C
40. D ohen, Donald J.,
1980, 389. 143. Ibid., 3
88. 144. Volkmar, Fred R. and Cohen, Donald J., 1985, 50. 145. DeMyer,
W. and M., 1984, 142. Bemporad, J., 1
979, 185. 146. Cohen Donald J., 1980, 387. 147. Kanner,
Leo, 1942/1943, 245. Kanner, Leo, 1944, 215-216. 148. American Psychiatric Association, 1980,
87-88. 149. Kanner, Leo and Eisenberg, Leon, 1957, 56. 150. Pingree, Carmen, 1984, 330, 331.
imons, Jeanne M., 1974, 7. 1 53. Sherwin, A lbert C., 1953,
151. Bemporad, J. R., 1979, 190. 152. S
ohen, Donald J., 1980, 388. 1 55. Everard, Margaret P.,
824. Clark, P. and Rutter, M., 1977. 154. C
1976. 156. Eisenberg, Leon, 1956, 609. 157. Bemporad, J.R., 1979, 181, 185. 158. Foxx, Richard,
1980, 51. 159. Pingree, Carmen, 1984, 331. 160. Bemporad, Jules, R., 1979, 1 91. 161. Petty, L.K.
etal., 1984, 132. 162. Volkmar, Fred R. a
nd Cohen, Donald J., 1985, 50.
58 Autism
163. Katz, Donald R., 1979. 164. F

rom Carolyn Betts, A S f Normal ( 1979). Quoted in:
ind o
pecial K
65. Park, Clara Claiborne, 1985, 115. Sullivan, Ruth, Christ,
15. 1
Park, Clara Claiborne, 1985, 1
1979, 113,
ullivan, Ruth Christ, 1979, 118. 168. Foxx,
orisky, Jesse A., 1 979, 288-289. 167. S
114. 166. T
illiam L., 1972. Nyhan, William L., 1976. 1
Richard, 1980, 50-51. 169. Nyhan, W 70. T orisky, D. and C.,
1985, 214-216, 224-227. Deslauriers, A.,
1978. 1 71. R
itvo, E. et a
l. , 1988. 172. Mnukhin, S.S. and Isaev, D.N., 1975, 106. 173. Kanner,
Leo, 1944, 213. 174. Goodwin, M ary S. a ndT. Campbell, 1969, 561. V erhees, B ., 1976, 58. Stiver, R.L.
and Dobbins, John P, 1980, 69. Lotter, V., 1966/ 1967, 136. 175. Rimland, B., 1 anner,
964, 12. 176. K
ohen, Donald J., 1980, 389. 178. K
Leo, 1942/1943, 217, 236, 238. 177. C atz, Donald R., 1979. 179.
Goodwin, M.S. andT.C., 1969, 558. 180. American Psychiatric Association, 1987, 3
6-37. Figures also
utistic Children and Adults. 181. Nomura, Y. e
supplied by National Society of A l. , 1984. 182.
ta
upplied by the Higashi School, B
l., 1984. 183. Information s
Wakabayashi, S. et a oston, Mass. 184.
Everard, M.P., 1973, 278. 185. Coulter, H. and Fisher, B., 1985, 200-204, 235. 1
86. Kanner, Leo, 1954,
87. Rimland, B., 1964, 38. 188. R
382. 1 utter, M., 1972, 328. 189. C
oleman, Mary, ed., 1976, 12. 190.
24. K
Kanner, Leo, 1954, 382. 191. Kanner, Leo, 1949, 421. 192. Ibid.,4 anner, Leo, 1944, 214. Kanner,
Leo, 1942/1943, 238. 193. Kanner, Leo, 1949, 422, 424. 194. Gillberg, C. and Schaumann, H., 1982,
982,
223. Tsai, Luktetal.,1
reeman, B.J. and Ritvo, E. R., 1984, 286.
211. 195. F
Minimal Brain Damage

In the mid-1950s, a decade after the emergence of autism, medical science and the public
became aware of a spreading disorder among schoolchildren called “ hyperactivity”:
The children show involuntary and constant overactivity which greatly surpasses the normal. This
otor development is often advanced, and histories
may already be present during early infancy. M
t he crib w
ell
frequently indicate that t he child climbed out of
before a year of age. Parents often
say that he walked early and there was “ no holding him” after that, or that he could not be kept in a
play pen and was into everything, h
aving to be tied to keep him in the y ard. 1
The U.S. Public Health Service in 1963 listed nearly 100 signs and symptoms associated
with hyperactivity and altered the name to “ minimal brain dysfunction.”
However, the expression “ minimal brain damage” is preferable, since the “dysfunction” is
the consequence of actual brain damage.
Within a decade minimal brain damage was presenting a major challenge to the American school
system, and to child psychiatry generally. Paul Wender, a leading authority, wrote in 1971 that the
all . . .
disorder “occurs in conjunction with
— and possibly a s the basis of— virtually
categories of childhood behavior disturbances
... embarrassing but true,” and that it is “ probably
the most common single diagnostic entity seen in Child Guidance Clinics.” 2 The Shaywitzes,
professors of pediatrics at Yale Medical School, wrote in 1984 that minimal brain damage is “
perhaps the
59
0
Minimal 6 Brain Damage
most common, and certainly one of the most time-consuming prob- l ems in current pediatric
practice.
And the Journal of t he American Medical A
ssociation in 1988 called minimal brain damage
“ the single most prevalent disability reported by elementary schools and one of the most
common refer- ral problems to child psychiatry outpatient clinics . . . probably the most
researched problem in child psychiatry.” 4
Boys manifest it five or ten times as frequently a
s girls, and it was once thought to be an
exclusively male disorder.
The American Psychiatric Association estimates that three percent ifestation of U.S. of minimal
prepubertal brain children damage suffer (from from thirty one to seventy-five or another man-
percent of these are a ne accepts).5
lso hyperactive, depending upon whose opinion o
But the APA's figures are certainly understated. If the figure was only three percent, this
disorder would not be “ the most common single diagnostic entity seen in Child Guidance
Clinics.” Those who have estimated the prevalence level at fifteen to twenty percent of school
children are closer to the mark.6
But even this may be an understatement. Kathleen Long and David McQueen, studying
the Maryland and District of Columbia school systems in 1984 (where thirteen percent of children
are already in “ special education classes” ), concluded that “[minimally brain damaged] children
ation- ally in public school systems.” 7
are significantly underdetected . . . n
inimal brain damage with hyperactivity is steadily rising.
In any case, the prevalence of m
Defining the Syndrome A 1984 U.S government pamphlet described three typical
cases:
My son Johnny is two years old and has totally disrupted our household since he was an
infant. He has few friends because he kicks, pushes, shoves, and screams at other kids. He
opens the refrigerator and tries to sit in it. He climbs onto kitchen counters, turns off the water
heater and u nscrews almost anything, even the s torm door. Nothing s eems to please him. . .
.
Defining t he Syndrome 61
Tommy can't sit still. He is disruptive at school with his constant talking and clowning around.
He leaves the classroom without the teacher's permission. Although he has above-average
intelligence, Tommy has trouble reading and writing. When he talks, the words come out so
fast no one understands him.
Joe won't go t o school . Instead, he explores the house. When he grew tall enough to unlock
creen door, those explorations s
the s hifted to the neighborhood . He w
as the neighborhood
terror. Once we found Joe wandering down the middle of the street! He looks l ike an abused
child. He has a mass of bruises from bump- ing into anything that gets in his way.
8
As with autism, when the attempt was made to define minimal brain damage, it was seen to
ramify and become associated with other disabilities. //y/wactivity although less (sluggishness)
nd requires an
common; the child is found is lethargic i n this population, during the day a
unusual amount of sleep.9
Minimally brain-damaged children usually have a limited atten- t ion span; even when o f
normal or superior IQ, they do poorly in school because of easy distractibility and failure to
inded.
complete work within the allotted time. Such a child may be called “ absent-m
The opposite occurs also: an excessively long attention span: “ If he's interested,” says the
mother, “ he's there until its completely done.” The five-year old can spend four or five hours
on a building- block project; he s
eems unable to withdraw his attention from the task at hand."
While children were f ormerly thought to “ grow out” of minimal brain damage, this is now
known to occur only in a few of the milder cases. Hyperactivity in particular often slackens
with age. But other symptoms, especially attention-span difficulties, continue into adult life.
There is no cure.

” 10
Once minimal brain damage had been identified as a syndrome, psychologists and
psychiatrists came forward to explain why children were acting in these bizarre ways. But
then, just as with autism, investigators found to their surprise that the MBD syndrome
2was associated with mental retardation, seizures, cerebral palsy, “

rain Damage 6
Minimal B
nd “s
a eurologic signs, and other disabilities which did
oft” n
hard” not readily fit into “
behavioral” or “emotional” categories.
anual estimates that five per- c ent of children with minimal
nd Statistical M
The Diagnostic a
brain damage suffer from one or another of these more serious conditions.12
But this statistic is
nderstated, being distorted by t he aversion of mental hospitals and
likely to be severely u
insurance programs t o multiple diagnoses. When a c hild is diagnosed with two or more
disorders as for instance epilepsy and minimal brain damage— the
— such , ,
m ore
serious neurologic
defect will overshadow the less serious. The diagnosis written down on
the chart will be “epilepsy,” and the minimal brain damage aspect of his condition will be
forever lost to medical statistics- gathering. 11

Nonetheless, there is indeed a high association between minimal brain damage and these
other neurological defects

— which are,
of course, the same disabilities already noted in
connection with autism.Mental r etardation, for example: while many children with minimal

brain damage are of average or even above-average intelligence, on the whole they have
a lower IQ than normal children.
brain damage is three t o four times
By the same token, minima) more c ommon in the
mentally retarded than in those with a normal IQ.'4MBD children also have a high incidence
of seizure disorders: epilepsy, tics, tremors, choreiform (twisting) movements, facial grimaces,
infantile spasms, and others. And, conversely, children diagnosed as “ epileptic” have a
very high incidence of severe learn- ing disabilities and attention-s pan difficulties.15

If the MBD child does n ot have a seizure disorder per se, he may still show one or more of
the “ hard” or “ soft” signs indicating a “ subclinical” neurologic disorder. Half of these children
manifest such typical “ hard” signs as EEG abnormalities and muscle hyper- tony or
hypotony. Typical “soft” signs are motor impairments, extremely poor handwriting, inability
to balance, poor visual-motor coordination, clumsiness, awkward gait, impaired hopping
ability, and a tendency to walk on t he toes.1 ''
Defining the S yndrome 6 3
“Clumsiness” in its m ost severe form becomes cerebral palsy. In one study a quarter of the
children with cerebral palsy were also hyperactive.17
Children with minimal brain damage are disproportionately l eft-handed or ambidexterous
(described technically as “left and mixed laterality” or “ poorly defined unilateral
dominance”). The child cannot readily distinguish right from left, up from down, beside from
behind, etc. If asked to touch his left ear with his right hand, he becomes baffled.18

The 1982 article by Norman Geschwind and Peter Behan mentioned earlier showed a
anded- ness and dyslexia.
significant correlation between left-h
ost-ABC News poll made a curious discovery

A 1987 Washington P sixteen
— that
percent of Americans under thirty are left-
handed or ambidexterous, as against only twelve
percent of those over sixty. Another recent survey found an even greater disparity: thirteen
percent of twenty-year olds were lefties, compared to five percent of persons in their fifties.
The accepted interpretation is that lefties in the past were forced to switch to right-handed
writing while in school, and this may, indeed, be one factor, but is not necessarily the only
one. There is a strong possibility that the epidemic of vaccine-induced sub-clinical
encephalitis since 1945 has generated a disproportionate incidence of left-handedness and
ambidexterity in the under-forty or under-thirty age groups. 19

In the mid-1950s, concomitant
Sleep disturbances are very common in this population.20
with the emergence of minimal brain damage on the medical scene, psychiatrists were
inundated with children who could not sleep at night. Two authorities wrote in 1957: “It has
frequently been observed that, in the present permissive era of child management, the
previously common feeding problems have been replaced to a large extent by sleeping
problems.” 21

The MBD child turns d ay into night. Hyperactivity i ncreases at bedtime, with difficulty in
falling asleep. Or the child falls asleep at the proper time but wakens after a few hours. A
emeanors may follow, from talking or singing in bed to turning on the lights
variety of mis- d
and rampaging through the house in noisy and sleep-dis- t urbing play.22

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VACINAÇÃ

O assalto médico ​ ​noamericano

North Atlantic Books ​Berkeley, ​California ​O ​Centro ​de ​Empirical

New ​ ​citar americano

©​1988​The​Time ​Inc. ​ ​Co​Magazine. ​Todos os ​direitos reservados​.

editores​ ​endereços​': ​North ​Atlantic Books ​2800 ​Woolsey ​Rua Berkeley,

Capa ​e ​projeto do livro ​por ​Paula ​Morrison ​Typeset b

Unidos ​da ​América

Ciências, ​uma ​sem fins lucrativos ​educacional ​corporação ​cujos objetivos

das a​ rtes, ​ciências, ​das humanidades,

Coulter, ​Hanis ​L. ​(​Harris ​Livermore​)​, ​1932​- ​616,8​'​0471​

1 1​​ 3​5​7​15​18​24​28​30​384046​48​49​51​59 60​

217 229 239​249

Introdução​: ​“​A ​Mais I​ munizada ​Criança ​da ​História​!

assolaram ​a ​Ásia​África, ​e ​Latina ​América​ - ​peste​bubônica, ​febre​amarela, cólera, ​tifo ​e

Quase ​todo ​mundo ​vai ​concordar​ - os​ ​médicos ​que ​

​ hot ​in ​the Dark​

​ aioria ​imunizados ​Criança ​na "​ A​História" XII​

"A ​maioria ​imunizados C

o​autismo, ​desenvolvimento ​dis​- ​ e

Mas ​a ​organizada ​profissão​ ​

“cuidados​saúde” ​em - ​em

o ​resto ​ ​do ​mundo ​* ​ou ​

​ sforço f​ ugaz para

encontrado ​bruta ​e sustentado “impairment

ego ​Fraqueza do ​Kanner ​e outros ​foram ​rápidos ​em perceber ​a

aparente d ​ e. ​. .​ ​pessoal i​ dentidade ​a ​um ​grau ​INAP​- ​reapropriação ​à ​sua ​idade.

Isto ​parece ​um ​paradoxo: ​como ​é ​ego​-​fraqueza ​reconciliado ​com ​total a

Ele ​acha que o mundo gira em torno dele.​ E

Ronald, ​um ​moderadamente ​adulto​autista, ​afirma:

Mas ​essa ​auto​-​absorção ​não pode ​suportar a e

​ e ​dizer “​ sim"​\ ​concordar ​com ​uma ​oferta ​ou

and ​especially ​of ​the dark​ — “​ ​night ​terrors​.​ ”

Tony ​M​.​, ​a ​near​-​normal ​autistic​, w

In ​a ​1949 ​article ​he described ​a f​ amily​'​s ​visit ​to ​the ​psychiatrist​:

per​- s​ onality ​development​.​” 25

​ ​tripartite ​theory​.​The ​poor ​ego ​development ​of ​autistic

children​, ​in ​particular​, opened

task ​of ​the ​ego ​sufficient ​mother​, ​causing formation​

err ​leading ​and ​in ​ego two

begs ​the ​question ​as t​ o ​what leads ​to ​the ​original ​

​ ​protect ​it​— ​but ​these w

accomplished ​by ​the ​pattern ​of ​withdrawal​ —​ are ​purchased​, ​how​- ​

​ egation ​of ​further ​ego ​growth ​. ​. .​ ​etc​. ​etc​.36

​ he ​sensuous ​pleasures ​associated with ​infant ​care​, ​which

I ​would ​improvement ​gladly​, ​in ​at ​him​ — ​a ​ I​

cure ​their child ​of autism​

​ ​no ​their indication ​were​, own

Bernard ​ Rimland​'​s ​ 1964 ​ Infantile

withstand ​formed never

​ he child​'​s ​withdrawal and other ​phenomena ​of ​autism ​must

s​-​eye ​view ​of ​this ​sort ​of ​program ​(​1984​)​:

Evaluations ​at ​the ​handicapped ​center ​were ​unfortunately ​carried o

A ​Neurologic ​Theory ​of ​Autism ​Rimland​'​s ​work ​sparked ​a

affective ​contact ​with ​possessing ​“​splinter people​.​” ​skills​”​ —​ 54 ​

revealed ​that ​encounters ​with ​indi​- ​three​-​quarters ​talent​ — ​memories​, ​intellectual

Autistics ​have ​a ​sixty​-​five p

Cranial ​Nerve ​Palsies ​Finally​, ​the ​neurologic ​interpretation w

He ​can ​hear t​ he ​higher ​pitch,​ ​the ​higher ​ranges​, b ​ an'​ t​ p

of ​what coded​, ​is ​etc​. h

porally ​patterned ​stimuli​.

and ​Brahms​, selections

enumerations ​echolalia​)​ — ​repetition ​ stereotyped even

O assalto médico noamericano

North Atlantic Books Berkeley, California O Centro de Empirical

New citar americano

©1988TheTime Inc. CoMagazine. Todos os direitos reservados.

editores endereços': North Atlantic Books 2800 Woolsey Rua Berkeley,

Capa e projeto do livro por Paula Morrison Typeset b

Unidos da América

Ciências, uma sem fins lucrativos educacional corporação cujos objetivos

das a rtes, ciências, das humanidades,

Coulter, Hanis L. (Harris Livermore), 1932- 616,8'0471

1 1 357151824283038404648495159 60

217 229 239249

Introdução: “A Mais I munizada Criança da História!

assolaram a ÁsiaÁfrica, e Latina América - pestebubônica, febreamarela, cólera, tifo e

Quase todo mundo vai concordar - os médicos que

hot in the Dark

aioria imunizados Criança na " AHistória" XII

"A maioria imunizados C

oautismo, desenvolvimento dis- e

Mas a organizada profissão

“cuidadossaúde” em - em

o resto do mundo * ou

sforço f ugaz para

encontrado bruta e sustentado “impairment

ego Fraqueza do Kanner e outros foram rápidos em perceber a

aparente d e. . . pessoal i dentidade a um grau INAP- reapropriação à sua idade.

Isto parece um paradoxo: como é ego-fraqueza reconciliado com total a

Ele acha que o mundo gira em torno dele. E

Ronald, um moderadamente adultoautista, afirma:

Mas essa auto-absorção não pode suportar a e

e dizer “ sim"\ concordar com uma oferta ou

and especially of the dark — “ night terrors. ”

Tony M., a near-normal autistic, w

In a 1949 article he described a f amily's visit to the psychiatrist:

per- s onality development.” 25

tripartite theory.The poor ego development of autistic

children, in particular, opened

task of the ego sufficient mother, causing formation

err leading and in ego two

begs the question as t o what leads to the original

protect it— but these w

accomplished by the pattern of withdrawal — are purchased, how-

egation of further ego growth . . . etc. etc.36

he sensuous pleasures associated with infant care, which

I would improvement gladly, in at him — a I

cure their child of autism

no their indication were, own

Bernard Rimland's 1964 Infantile

withstand formed never

he child's withdrawal and other phenomena of autism must

s-eye view of this sort of program (1984):

Evaluations at the handicapped center were unfortunately carried o

A Neurologic Theory of Autism Rimland's work sparked a

affective contact with possessing “splinter people.” skills” — 54

revealed that encounters with indi- three-quarters talent — memories, intellectual

Autistics have a sixty-five p

Cranial Nerve Palsies Finally, the neurologic interpretation w

He can hear t he higher pitch, the higher ranges, b an' t p

of what coded, is etc. h

porally patterned stimuli.

and Brahms, selections

enumerations echolalia) — repetition stereotyped even

precise intonation; or there

one to two P.M . h

had t o b eld upright so he could b

were actually the

cally, the to found with foreign abstract — symbols. concreteness

cranial nerves. Student and Sohmer in 1978 investigated

” since lay, like speech, is a largely sym-

This generates their pervasive fear and anxiety

ones — “emotional lack i n actual Thus o f inability

of the and autism late paranoia— memory

igestive, and Bowel Disturbances 29

loss . . . a distorted perception of

t watch him. It d

He developed an obsession about feces, w

have your crayons!”

Headaches, Head-Banging Severe headaches are a feature of

W.'s autobiographical account speaks of “ pounding hard migraine headaches.

dishes from Group A