Friday, September 4, 2015

Steve Silberman's bizarre take on Kanner's work and influence in the field of autism

Steve Silberman’s book, Neurotribes,  soon to be number eight on the New York Times bestseller list, is now the hottest news story and commodity in the world of autism.  He’s been lauded by the New York Times, NPR, and other media outlets for meticulous research on the history of autism and how it relates to what’s going on today. 

One of the underlying themes of Silberman’s book is that autistics were underdiagnosed in the past, until Lorna Wing’s work changed the world view of autism, resulting in higher rates of diagnosis.

Silberman cites Leo Kanner, the person credited for first discovering the syndrome of autism in eleven children he saw over the course of some years during the late 1930’s and early 1940’s, as  the culprit.  His reasoning is that Kanner, who first gave the condition of the children he assessed a name had a very restrictive criteria for diagnosing autism.  His definition was those of lower functioning autistics as opposed to Asperger’s, Frankl’s, and later Wing’s more expanded definition which included people more mildly on the spectrum.

One of Silberman’s tenets is that many people who should have received an autism label were denied appropriate services and supports that could have helped them cope because of Kanner’s parsimony.  This also lead people not to embrace the neurodiversity model of autism in which services and accommodations can solve or at least mitigate problems but instead look for causes and cures.  Silberman writes:  In real world terms being locked out of a diagnosis often meant being denied access to education, speech and occupational therapy, counseling, medication, and other forms of support For undiagnosed adults, Kanner’s insistence that autism was a disorder of early infancy meant decades of wandering in the wilderness with no explanation for constant struggles in employment, dating, friendships and simply navigating the chaos of daily life.  While by building foundations of a society better suited to its need and interests. After stating this, he goes on to subsequent chapters in which he alleges various ham radio operators and very prominent people in the IT field are autistic or have or had autistic traits. 

He makes numerous talking points in his book, interviews and blog posts to support this allegation.  He writes about Leo Rosa (Son of neurodiversity proponent and one of the authors of the thinking person’s guide to autism), a boy on the lower end of the spectrum, stating that Kanner’s influence still prevailed by the time this boy, not born until the twenty-first century by the time he was diagnosed.

Silberman posts the following comment on the Marginal Revolution blog:

The most significant and obvious way in which Kanner’s understanding of autism was monolithic is that every patient described in that paper is a child. Kanner’s model of autism did not include teenagers and adults. That’s not exactly his fault — he was a child psychiatrist. But the exclusion of teenagers and adults from autism was an omission of Kanner’s that Lorna Wing went on to fix with the invention of Asperger’s syndrome (Wing, “Asperger’s syndrome: A clinical account, 1981) and the broadening of the criteria to include all age groups (as well as the expansion of the lay concept of autism to include adults that followed “Rain Man.”) And note: even in that 1943 paper, Kanner makes the surprising assertion, “There is no fundamental difference between the eight speaking and the three mute children.” That’s overlooking a lot of heterogeneity for the sake of delineating a category. Lorna and Judith Gould originally felt that “Kanner’s autism” as a useful concept should be thrown away (“the findings of the present study bring into question the usefulness of regarding childhood autism as a specific condition” – Wing and Gould, 1979); but they ended up compromising and creating the image of the spectrum, which echoed Asperger and Georg Frankl’s concept of the autistic “continuum” that included children and adults.

In his book, Silberman states that Kanner would have excluded an individual that his colleague George Frankl (allegedly formerly Asperger’s colleague) had written about for an autism diagnosis because he had the genetic condition tuberous sclerosis.  He writes that epilepsy was also a basis on which Kanner excluded diagnoses of autism.  Silberman quotes writer Adam Feinstein, author of “The History of autism”, as stating he’d only seen 157 cases of autism by 1957 and that Bernard Rimland had stated that Kanner told him he’d excluded nine out of ten people that other doctors had referred to him for a possible diagnosis as being autistic. 

Before examining these talking points, here is Kanner's original article He also followed the cases into adulthood nearly thirty years later.

In actuality, there was a wide range of functioning between the eleven children whom Kanner (and perhaps George Frankl and others) evaluated.  Eight out of eleven of them had speech and could carry on semi-normal conversations.  Silberman, to bolster his argument, quotes Kanner as saying “There is no fundamental difference between the eight speaking and the three mute children.”  However, he omits the first part of this sentence.  As far as the communicative functions of speech are concerned, there is no fundamental difference between the eight speaking children and the three mute children.  Silberman then talks about Kanner’s description of some of the eight speaking children and how Kanner emphasizes their speech deficits, but neglects to cite the parts of Kanner’s 1943 paper where he emphasizes some of the instances of speech in the so-called mute children.  So, it was only in terms of speech, citing both the idiosyncratic speech of the eight milder children and some instances of speech in the more severely afflicted three cases.

Kanner’s first two cases, Donald and Fredrick, would be considered high-functioning even by today’s definition where a high percentage of autistics are still considered to have intellectual disabilities.  Alfred, one other case had an IQ tested at 140.  Even one of the mute chldren, Virginia, scored 94 on the Merril-Palmer nonverbal IQ test and the testing psychologist stated that this was likely an underestimation of her intelligence.  Some of the others would be considered more severe so there was a wide range between Kanner’s cases.     

Kanner ends his paper by stating that autism may be more common than it appears as well as emphasizing differences between the kids:  The eleven children offer as to be expected offer individual differences in the degree of their disturbances.  But even a quick review of the material makes the emergence of a number of essential common characteristics appear inevitable.  These characteristics form a syndrome not heretofore reported which seems to be rare enough yet is probably more frequent than is indicated by the paucity of observed cases. 

In spite of Silberman’s allegations, Kanner seemed to have been far more prescient than almost all of his successors to date as far as taking an interest in adult autism.  In the first paragraph of his 1943 paper he writes:  Since none of the patients has obtained an age greater than eleven years this must be considered a preliminary report to be enlarged upon as they grow older. 

Kanner indeed kept his promise, publishing a follow-up paper on his eleven charges in 1971 when he was well into his seventies.  He first reports on Donald T, who has done relatively well in spite of his autism, obtaining a college degree and working as a bank teller and would certainly not appear to be low functioning as an adult.  He reports on Frederick W who worked at the national office of air pollution and was lauded by his supervisor.  Another individual, Herbert, though still mute worked on a farm and carried out useful tasks. 

Though he states a patient of George Frankl’s who had tuberous sclerosis and epilepsy would not have been diagnosed by Kanner on that basis, Silberman neglects to provide any documentation for this in his copious endnotes.  This certainly is not true as Kanner child number ten, John F. did in fact have epilepsy and a focal abnormality in his left occipital lobe on an EEG which Silberman did not mention in his book.  Elaine (case 11) also went on to develop epileptic seizures.  However, this started in her twenties as reported in Kanner’s follow-up article and it is unclear whether or not her epilepsy was known in the 1940’s when Kanner first wrote about her. 

Did Kanner regard autism as necessarily being rare in the 70’s?  Based on one comment he made in the follow-up article, the answer would appear to be no:  It is well known in medicine that any illness may appear in different degrees of severity, all the way from the so-called forme fruste to the most fulminant manifestation. Does this possibly apply also to early infantile autism?
Kanner wrote this in 1971 at least a few years before Lorna Wing’s and Judith Gould’s attempt to find more people with autism and consider it a spectrum that Silberman alleges.

Autism wasn’t even classified as a category in the IDEA until 1991 which is also correlated with the huge spike in diagnoses.  Services for children weren’t widely available until then.  One of the few things Silberman gets right is that no one really cares about the problems of autistic adults.  This is nothing new in spite of the fact that Kanner, going back to the nineteen forties actually did take an interest in his patients as adults and followed them for nearly three decades.   

It would seem that blaming Kanner for this is indeed a stretch.  This historical perspective on Kanner’s work may serve the purpose of helping Silberman score points for the neurodiversity movement, but really does not seem to me to accomplish anything else.  This is aside from the fact that it is plain inaccurate.

  It is unlikely that any of the reporters from New York Times or NPR or any other media outlets that have publicized his book have ever read Kanner’s original paper in addition to his follow-up and most likely ever will.  No one of any importance will ever realize what Kanner really said and did in spite of Silberman’s spin on this work.  

27 comments:

Autism Northern Ireland said...

Big fish in small pond comes to mind here (Silberman)

There are only a handful of autistics writing about autism, when compared to the world of authors in general. Thank you for being one of them who "dares" to challenge the "autistics r us" approach to understanding autism.

Silberman hasn't a clue about my child's autism and to date, I have learned nothing from him that has been useful in any way.

I had no intention of buying Silberman's book, and await the day when more parents of autistic "children" write books about what happened to their children in adulthood minus the neuro b.s. and cognitive dissonance.

I enjoy reading what you write as do many others. Your writing is the calm in the storm of increasing nonsense out there about autism.

I expect you could become quite wealthy should you decide to succumb to the "we are more special than you" approach to autism, and the neuroD nation (ugh).

What kind of person(s) does Mr Silberman's writing appeal to and why? That is the question which needs answering. What need is he and others like him fulfilling?




jonathan said...

Thanks for the kind words. If it were that easy to get wealthy writing "we are more special than you stuff" there would be a lot of rich neurodiversitites around.

Silberman's writing could appeal to lots of different people, such as people interested in the IT field which he's been writing about for years and the idea that there is some sort of autistic ability that could contribute to that as well as the fact that since Cavendish, Dirac and other scientists were autistic that autism and savant skills could contribute to that.

Also it appeals to some mentally ill people who allege (rightly or wrongly) that they are autistic so it can make them feel better about themselves.

Also to some parents like Shannon Rosa who tried every trick in the book to help their child and when nothing worked embraced neurodiversity as an escape valve.

Roger Kulp said...

Possibly the best written,most thought through reveiew of Silbermann's book I have read so far.I would like to see this blog post picked up by another site where it has wider readership.Perhaps someplace like Huffington Post,or anther news site.You really need to look into into it.Silberman's book should not be allowed to stand without public rebuttal.But if it is published elsewhere,I would like to make a few additional points you would need to add first.

You make a very valid point about Donald and Frederick being high functioning.Their cases,as well yours and mine,disprove the widely held belief that before the DSM-IV,you had to be nonverbal and profoundly intellectually disabled to receive an autism diagnosis.There are three very important facts,that most people,possibly Silberman,ignore.Before the publication of the DSM-IV,children were diagnosed at a much older age than they are now.The age at which are diagnosed with autism has been steadily dropping.Nobody ever would have thought 30,40,50 years ago,that a child would be diagnosed with autism before the age of two.But this is pretty much the norm these days.Children did not used to be diagnosed until they had been in school a few years.Often while in elementary school.This was pretty typical in the days before the DSM-IV.

I was first diagnosed in 1971,at the age of ten.But it had been obvious to my teachers,that I had serious developmental and learning disabilities,and serious behavioral problems,that my teachers tried to help me with.Starting in kindergarten.It was clear from the start,something was very wrong,but no one knew what it was.

This kind of gets to the fact so many people who are very high functioning are not diagnosed until they are adults.A child who has serious problems,may have another psychiatric or developmental disorder diagnosis as a child,but it may not be autism.They may get an autism diagnosis later in life,but a child with serious problems would get by without some sort of diagnosis and/or services.They would not slip under the radar of good teachers.

Kanner worked at Johns Hopkins.The first time I was diagnosed,it was by a psychologist associated with Johns Hopkins,who worked with the Baltimore County school system.It was possible this man worked with,or was trained by,Kanner.Which was why he would have recognized autism in 1971.

My medical stuff had not quite kicked in at this time.I now know,from my Facebook groups,that it is not unknown in mitochondrial autism,for a child to have the autism,and other brain related stuff from birth,and for the mitochondrial disease not to kick in until puberty.

Secondly,if children were diagnosed with autism,back in the 1940s to early 1980s,often the first thing that most psychiatrists or psychololgists would have suggested,would be that the child be shipped off to an institution,not be showered with the type of help and services they are today.This was what was suggested for me.Had it not been for my mother's intervention,I would have ended up in one of the most notorious of institutions,Rosewood in Owings Mills,that was just down the road from where we were living at the time.I am still scratching my head as to why this was not recommended for you.

Silberman's book is innately flawed,because he is trying to view autism in the past through the prism of how it is seen today,not the way it was seen at the time.Hindsight is always 20/20.I can't believe no one who has reviewed this book has not pointed this out.I have no doubt that had Silberman submitted this as a thesis to a developmental psychology professor at any good university,that it would receive a failing grade.

......I'm Anonymous said...

"Also it appeals to some mentally ill people who allege (rightly or wrongly) that they are autistic so it can make them feel better about themselves.

Also to some parents like Shannon Rosa who tried every trick in the book to help their child and when nothing worked embraced neurodiversity as an escape valve."

No truer words have ever been written.

jonathan said...

Roger: Actually institutionalization and/or placement in residential boarding schools was recommended for me at a young age. Thankfully, my parents did not take them. I was not diagnosed until the seventies also, and other than "fine motor coordination problem" or thinking of myself as hyperactive (ADHD nowadays) I really didn't have a formal diagnosis that I'm aware of.

Kanner was apparently still writing stuff (including that follow-up i linked to) in 1971 when you were diagnosed. I'm not sure how active he was as an academic psychiatrist when he was well into his seventies though. It is quite possible that the person who diagnosed you was in fact a protege of Kanner.

None of the interviewers who gave Silberman positive marks has a clue about the autism literature or what it is like to be autistic. They just wanted to be on the bandwagon for something popular.

One of the problems with rebutting Silberman's work is that though I read both Kanner's original paper and his follow-up I'm not as familiar with Asperger's work and some of the other things he found in his research. Some of it was in German and he used translators. Also, I'm not familiar enough with the life of Henry Cavendish, Paul Dirac and the others he self-diagnosed to write a good rebuttal. Though I have tried my best for several years to rebut posthumous diagnoses and the general idea of it.

I don't think the Huffington post or anyone else is really interested in me or my ideas. They all want to seem to jump on the neurodiversity bandwagon.

Roger Kulp said...

Not quite.

The link at "targeted treatments" is one I sent you in a Facebook PM.Send me your copy of the book,so I can read it,and write a counter article.I don't want to give Silberman any more money than I have to.I want to try to submit my own "counter editorial".And Huffington Post might just the lace to do it.Note what he says about uncertain funding.

jonathan said...

I'll check out your link. I have the kindle copy of his book and right now it is not available for kindle's loaning feature even if you had a kindle yourself. I understand you don't want to give him any money, but maybe you could get the book at the library, but it might be a while before it is available there.

I wish there was some way I could get you a copy of his book without giving you more money. To write a really effective rebuttal you might have to be extremely well-read in all of Kanner's and Asperger's writings as well as other things and it might be hard to write a short rebuttal length article that would accommodate the space limitations of the magazine for such a length book.

Petra said...

Thank you for your informative blog!

I started searching for Kanner and Asperger and who was first as Silberman apparently (I haven't read the book) stated that Asperger described it first and that they worked together (which I hadn't heard or read before) so I was trying to find the connection - which appears to be Georg Frankl.

It appears that the way it is described by Silberman is sensationalist with political connotations relating to that era.

Is the Kanner 1971 follow-up paper freely available? Regarding the Asperger paper: as German is my home language and I think I have (I hope) the original article I could read both, Asperger's and Frith's and let you know how accurately it was translated. As far as I know, Frith is originally German, and her work as well as that of Lorna Wing and others of that time is excellent.

jonathan said...

Petra: I linked to Kanner's follow-up in the post hereit is again. here is a link to asperger's paper in the original german. I don't read German so if there are any discrepancies between Asperger's paper and the way it's been previously translated, let me know.

jonathan said...

Petra: Also, I don't think anyone claimed that Asperger's and Kanner ever worked together. In his original 1943 paper, Kanner names a Georg Frankl who did some work with Case 1 (Donald T.) and Case 11 (Elaine. Silberman claims Frankl diagnosed or worked with the first three cases in his book and various interviews, but Kanner only lists Frankl in regards to the first and last case. Silberman alleged that there was a Georg Frankl who worked with Asperger in Austria then with the help of Kanner emigrated to the USA to escape the holocaust and that he did research showing the two Georg Frankl's were one and the same and that since he worked with Asperger first that shows that Asperger recognized autism before Kanner did. Indeed there is some sensationalism and spin in Silberman's book, but not having all of the references Silberman gives and not being able to read german, i can't verify all of this.

Claudia Mazzucco said...

I’ve read on Facebook somewhere that autistic people were exterminated in concentration camps during the Second World War. A reader of Neuro Tribes has come to this conclusion while reading the book. Is that so? Does Silberman provide historical evidence for this? And what is the next claim Silberman going to make? Let me guess: that General Franco shipped people suffering from HIV/AIDS to the concentration camps of his friend Adolf during the Civil War in Spain in the 1930s? That Joseph Stalin euthanized patients suffering from CTE (chronic traumatic encephalopathy) during the 1950s? And just how in the hell could the Nazis read Kanner’s seminal paper while the Second World War was at its chilliest in 1943–44 and long-distance communications network (telegraph and telephone system) were interrupted and blocked?

jonathan said...

Silberman devotes an entire chapter to the eugenics movement in his book, but, as far as I can recall, only relates it to autism in a roundabout fashion. It is true that the nazis did plan to exterminate people with any kind of disabilities or genetic defects, so it is quite probable that some autistic people were euthanized during the third reich, but I can't recall if Silberman documents it.

Long before neurotribes came out, it was speculated that Asperger only wrote about his four extremely high functioning cases in order to save the lower functioning ones from the nazis and that shaped his views on autism, but i am not sure if anyone knows for sure. I suggest you read neurotribes as soon as you can if you have not done so already.

Yuval L said...

I just read the book. On the whole, it's pretty confusing. However, what concerns me the most is the use of the "royal we". He seems to not bother to differentiate between different variations of the traits associated with Autism in the different people he observes, and concludes that Autism is always positive.

I read the anecdote about the future astronomer and about how he received individualized tutoring. To be fair, I often wonder what my life would have been like had I not gone to a noisy high school and noisy university, and had been permitted to learn what I want to learn, without requirements or tests. While I discovered the use of electrolyte supplements in treating some forms of Autism (so far, the biggest effect I've noticed is that I feel calmer and am more internally organized), I wonder what else I could have discovered in this manner. Then again, it might have come to nothing whatsoever.

jonathan said...

Yes, the royal we is old news, Silberman takes a cavalier attitude toward the suffering of people on the spectrum and their families.

We can never know what would have been if things had been different.

Arkady Bazarov said...

Jonathan
I've just discovered your review and I've just written my own blog that sounds uncannily like your take on Silberman's comments (I didn't steal from you, uh, I stole from Tyler Cowan's piece). I would add that Silberman also disingenuously misses the first half of the Wing and Gould sentence that clarifies they did not junk Kanner but actually found "Unlike the other named syndromes, the behavior pattern described by Kanner could be identified reliably..." Asperger's only looked at children, Wing and Gould's study of 1979 were under 15s (that's kids I think) and Wing's follow up of 1981 used adults but they were diagnosed with 'other mental health conditions' and most don't fit the 'modern' conception of Asperger syndrome (2 out of 6 case studies are "retarded" says Wing). And of course Kanner could only see children as autism as a diagnosis in the US was a new concept by definition, so all adults would have probably been "institutionalized." Kanner clearly points out at the beginning of his paper "Since none of the patients has obtained an age greater than eleven years this must be considered a preliminary report to be enlarged upon as they grow older." The Frankl story seems to have been concocted by Silberman and is now a "fact" referenced on wiki back to Neurotribes (where, of course, there's no reference). I want to believe that Silberman's intentions are pure but he's so disingenuous here and in interviews and on his TED talk I can't bring myself to read his book. Great blog though. Thanks.

jonathan said...

that's interesting about Wing's paper which I haven't read. Yes, Silberman seemed to cherry pick some quotes about Kanner and left off some things, but Kanner's work is what i've read. I'd be interested in proof that the Frankel story was concocted. As you probably know, there was a George Frankel (or is it Frankel)that worked with Kanner and helped evaluate Donald and Elaine (Kanner's first two cases). There may have been a George Frankel that worked with Asperger's also, but the papers were probably in German and no English translation may be available. Interestingly, there was another George Frankel on the internet I found that did some work with autism but he was born in 1921, so he couldn't possibly be the same one that worked with Kanner (or Asperger) since he would have been a teenager at the time he evaluated Donald and Elaine. So it may be a common name.

Arkady Desmoulins said...

The Atlantic carries an article with interesting stuff by Silberman (though without the actual documents for some reason, and I assume these aren't in the book, which I haven't read):
http://www.theatlantic.com/health/archive/2015/08/autism-history-aspergers-kanner-psychiatry/398903/#article-comments

It's still vague but interesting stuff. The "concoction" I meant is Silberman suggesting Kanner knew about an "autistic continuum" via Frankl but suppressed it because he was a sort of Dick Dastardly/Mojo Jojo evil character of the psychiatric profession, "burying" Frankl and Asperger whereas we couldn't possibly know this. The problem is that it's reported widely now as a fact rather than Silberman's opinion. I'm skeptical because Silberman makes claims, as here in the Atlantic, that Kanner "trumpeted from the rooftops" his discovery of autism. Which is nonsense, the 1943 piece was first published in the "Nervous Child" journal. It's just silly the way Silberman's got himself a villain and puts words in his mouth, and makes up deeds and actions using crazy hyperbole like “Asperger clearly discovered autism first.” Huh?
The Gould and Wing article is here:
http://autism.justinecassell.com/autism08/wiki/images/1/1b/Wing_Gould_SevereImpairments.pdf
But I can save you an hour of complete boredom by telling you it's complete gibberish, comparing what they call "severely retarded" children with "socially impaired children" and they find the "socially impaired" are a little bit more likely to be "autistic" (21 in 10,000) though the "severely retarded" were around 50% Down syndrome so I'm confused about the validity of the study. And they appear to weirdly use exactly the same criteria as Kanner but add on criteria that are exactly the same as Mary Ainsworth's (nurture) Attachment Patterns (1978). Really bizarre. Sorry for going on.
Thanks again. (sorry, I changed my surname yesterday just to confuse things)

Anonymous said...

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jonathan said...

@ Arkady Actually Silberman was never that specific about the reason in his book or the interviews and talks that i've seen him in. Silberman stated that Kanner would have had to have known about Asperger's work because he was up on all the literature, was able to read German without the need of a translator and referenced the journal (forgot its name) that Asperger's 1944 article was in various papers he wrote, though I have not been able to verify this. In interviews, Silberman admitted that he did not know the specific reason but speculated it was possible that he thought Asperger was a nazi or a nazi sympathizer so that is why he never mentioned his work. According to Silberman, though Kanner originally published his work in Nervous Child which was not considered a prestigious journal, he'd made a deal to publish follow-up work about the eleven children in a much more prestigous journal which he did.

Arkady Desmoulins said...

Hi Jonathan...The Silberman continuum conspiracy thing: Asperger knew autism was a spectrum (continuum) in his work in the 30s and Frankl therefore knew this and Frankl working for Kanner must have known but Kanner suppressed it is in a discussion piece in Vox:

http://www.vox.com/2015/8/31/9233295/autism-rights-kanner-asperger

"By burying Asperger — and Frankl too — he [Kanner] buried the spectrum until it was rediscovered by Lorna Wing in London in the late 1970s, early 1980s." Rediscovered? If you read Asperger's paper he goes out of his way NOT to make it a diagnostic criteria but a pediatric observation piece (wing notes this in her 2005 paper Opening Pandora's Box).

I'm also skeptical about Kanner reading of Asperger's work as I wondered if articles coming out of Nazi Germany would be so instantaneously and freely available in 1944 in the US (and why on earth did no one else notice it, there were enormous amounts of German speaking Jewish refugees working in the sector in the US (Silberman highlights there were two working for him from Asperger's team and that Kanner worked to "extract" more to safety...why didn't Frankl say something?)...The difficulty is that Silberman doesn't reference anything. All psych(iatrists and ologists) I'm sure are self-aggrandizing egotists and would want there work trumpeted from the rooftops. But weirdly Asperger is the good guy who doesn't "trumpet" his findings...he was a good guy, though he was a pediatrician not a psychologist/iatrist as Silberman has also mistakenly said in articles and even that might have a bearing on why the psychiatric community ignored it for so long, Wing was a child development psychologist after her own child was ironically diagnosed with "classic autism" in 1959 under Kanner's "monolithic" diagnostic criteria. It's just the black and white nature of Silberman's narrative (along with Wing "inventing" Asperger's, you know like Newton invented gravity).

I do believe Silberman is genuinely passionate about his perspective but he distorts so many arguments and the "autistic community" have fallen over themselves to uncritically praise him I'm naturally skeptical. I'm an NT Brit cynic for my sins. Hope I haven't ranted on too much here. Thanks.

jonathan said...

Arkady, that's all interesting and some good points. However, Kanner was still publishing journal articles well into his seventies. In fact his adult follow-up of the 11 cases was published in 1971 and I think he published some other stuff later. Silberman notes in all that time Kanner never referenced Asperger's work in spite of the fact that he cited articles in the journal that asperger's work appeared in some of his other writings. Even if it was not available in 1944 and sometime later, Silberman argues Kanner would have had access to it. I'm not sure why Kanner never referenced Asperger and even Silberman concedes he does not know for sure, but the press built up the thing about Kanner being evil and trying to suppress the work. I'm not sure why Frankl would not have said anything, that is a vaild point.

Silberman provides a list of references on his website though I don't have the url handy. He also has copious end notes in "neurotribes" and I don't recall if he mentions any of this in them. He did neglect to mention any basis for Kanner's rejecting epilepsy as a criteria for diagnosing autism in spite of the fact that two of his eleven cases went on to have seizures though, as you already know. I'll have to check out that link.

Arkady Desmoulins said...

Hi Jonathan, hope you don't mind me replying again...I agree, it is odd that Kanner doesn't reference Asperger (it was noted before Silberman; Viktoria Lyons makes the same point in a 2007 in a childstudycenter Yale piece as does Adam Feinstein 2011) however, Lorna Wing, in her 2005 paper Opening Pandora's Box says she met Asperger and he was quite adamant that 'his syndrome' was a different syndrome to Kanner's and they "agreed to differ"...could it be that Kanner simply also believed that Asperger's was a different syndrome so didn't bother referencing it...It's also interesting that there were lots of papers in German describing Asperger's work and comparing it with "classic autism" pre-1970 (Wing cites Bosch 1962 and Gerhard Bosch is often cited as using the term Asperger syndrome in the 1950s) yet Kanner doesn't mention those as far as I'm aware either. The Frankl problem is that every reference on the internet is just a regurgitating of Silberman's assertion...Frankl left Austria in 1937 and Asperger didn't publicly speak about his idea of the "psychically abnormal child" until 1938...The odd thing is that this supposed groundbreaking study doesn't seem to be available in English...I've seen lots of suggestions that Asperger was working on autistic psychopathy in 1934 but I found an article in German saying he didn't get the post in Vienna until 1935, jeez, I'm sounding obsessive like Kevin Costner in JFK or something...Yeah, I've seen Silberman's biblio for Neurotribes...it's very very long and includes references to myriad subjects (pacific island diseases?) which being an old cynic I think is a bit of bamboozling (I used to do the same with essays at university)...Perhaps I should grab a copy of Neurotribes and hold onto opinions until I've read it...I did not know that Frankl also wrote a piece in the Nervous Child in 1943 Language and Affective Contact though...it is odd that if he knew about the grand conspiracy he still "toured the US with Kanner" as Silberman suggests...hi ho, who knows? Thanks

jonathan said...

Yes it is possible Kanner believed it was a different syndrome since the kids asperger's described were different than his cases, but can't be sure. One reason cited for Frankl's complicity is that he was so grateful that Kanner saved him from the Nazis. But I saw that reference also that Frankel left Austria in 1937 and that was before the Nazis annexed Austria, so I suppose there are a lot of interesting questions. Since you do seem to be somewhat obsessed with the issue I suggest you do read neurotribes. It's mostly, in my opinion, a boring plodding book, but some aspects, particularly the neurodiversity slant on things make it worth reading.

Anonymous said...

Re the NAZI Euthanasia program: http://www.ushmm.org/information/exhibitions/online-features/special-focus/nazi-persecution-of-the-disabled

http://adst.org/2014/11/a-soldier-uncovers-the-horrors-of-the-nazis-hadamar-camp/?fdx_switcher=true

Graeme Sutherland said...

The Georg Frankl mentioned as working with Asperger before WWII must not to be confused with George Frankl, the philosopher, psychoanalyst and writer: born Vienna 12 December 1921; died London 25 December 2004. George Frankle was imprisoned in Dachau but escaped and was able to relocate to England in 1939 (not the USA) where he later became a British citizen. See: http://www.independent.co.uk/news/obituaries/george-frankl-18089.html

Anonymous said...

Im reading all this and wondering what you all find so distasteful or wrong about the idea of neurodiversity. Maybe I do not understand it completely? I think every human being is "different" with certain strengths and weaknesses. I did read Silberman's book and it helped me understand many of the reasons Autism is misunderstood even today by so many. I have two kids who with ASD diagnoses and have to fight for their acceptance at school and even within the family.

You seem very educated on the matter, and I would love to understand where you are coming from - do you think kids should not get certain therapeutic services at a young age? Is it because they are not helpful? Do you think Autistics should not be classified in another group separate from the general population? I'd love to learn more...thank you.

Clare Smith said...

I'm half-way through reading Silberman's book. to answer the first commentator's question - he's writing for people like me. I was diagnosed with Asperger's Syndrome 3 years ago, aged 57. My daughter, now 17 was diagnosed as an Aspie on the same day. We're still learning about it and about ourselves.
I can't see anything wrong with the idea of neurodiversity, which Silberman defines as conditions like Autism, ADHD etc which are "naturally occurring cognitive variations with their own strengths rather than conditions with only deficits and dysfunctions". My daughter much prefers to think of herself in evolutionary terms as a positive variation in humankind, rather than someone who's got something 'wrong' with them.
We're still largely invisible to the NT world, and Silberman's book goes a long way to talk to people who're ignorant about us - anything that does that is a good thing, I think.