Class notes
Autism Spectrum Disorders
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- University Of Cape Town (UCT)
Notes on Autism to help you get good marks!
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Autism Spectrum DisordersLecture 1: Introduction to Autism/ASD
Prescribed readings:
- Adams, E. N. (2010) – When Quirks and Quick Learning Create a Quandry: Mild Autism
- Robinson (2016) – Kanner, Asperger, and Frankl: A third man at the genesis of the autism diagnosis
What is Autism?
Autism is a neurodevelopmental disorder (brain develops atypically).
• Many more males on the spectrum than females (research currently suggests that males are 6
times more likely to be diagnosed with ASDS, though this number keeps changing)
• Not culture- or race-specific (affects all cultures and races equally – though numbers may not
reflect this because of under-diagnosis, poor autism awareness, cultural reasons, and lack of
assessment tools.
• Individuals have severe impairments in social relatedness and language development, and
unusual, repetitive, and/or stereotypic patterns of behaviour
• Demonstrate impairments in 3 primary areas (Adams, 2010):
1. Social functioning and interest in social relationships
2. Communication
3. Repetitive or stereotyped interests and behaviours
(In the Adams reading the clinician provides the evidence on pp. 240-241 in a nice summary)
(While there is an increased chance of advanced skills within this population, it is still very rare. There
many more males than women in terms of diagnoses – there are biological reasons and non-biological
reasons for this)
History of Autism
- For a long time, Leo Kanner was credited with the ‘discovery’
of Autism. In 1943, he published his first article on this, where
he described children as having “come into the world with an
innate inability to form the usually biologically provided
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, affective contact with other people”. Since then, there was much debate as to what Autism entailed,
and the gold standard manual for diagnosing mental conditions (the DSM) has constantly changed
how Autism is viewed and changed over the years.
- In more recent years, there has been major Autism Awareness campaigns, and if you look this up, you
will find various infographics telling you more about how an Autistic individual could present
- In the states, Autism Speaks is the largest autism advocacy organization. It sponsors autism research
and conducts awareness and outreach activities aimed at families, governments, and the public.
Kanner Asperger, Frankl
Kanner & Asperger
- While Kanner has for quite some time been credited with first identifying Autism, Robinson reading
provides some clarity. For many years there has been much controversy surrounding who was the first
clinician to identify Autism. In 1943, Leo Kanner published his seminal paper on this in the US, and
in 1944, Hans Asperger published his first paper in Austria. This was strange as these two had
claimed never to work with each other or communicate their ideas, yet they both used the term
‘autistic’ to describe the case studies in their papers.
- Both of them used the term autistic to describe the children in their papers, and both described what
they called autistic behaviour:
• Seemingly detached from other people
• In their own world
• Preferred to play alone
• Don’t show love or respond to parental affection
• Fixation on objects rather than people
• Need for routine and ritual
• Some degree of obliviousness to the unspoken cues of others
- These traits they describe are important traits of today’s diagnostic criteria for Autism. You would
also see them in the numerous infographics out there.
- There were two key differences across the studies and the thinking of these two clinicians:
1. Kanner’s study was comprised of several children who did not speak or were minimally
verbal with cognitive impairments, while Asperger’s study was comprised of children who
generally spoke with clear and precise speech and had good cognitive skills.
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, 2. The second is concerned with the aetiology/causes for autism.
- While many still speak of Asperger Syndrome, the latest diagnostic criteria has removed this
category/label for Autism, but it is worthwhile noting that Asperger’s first publication describes what
we would have until recently labelled as individuals with Asperger’s syndrome
- Asperger’s Syndrome – higher functioning individuals with at least average cognitive ability and no
speech difficulty (unlike majority of Autistic individuals). Kanner’s study described the opposite side
of the spectrum.
Frankl
- The story of Autism’s definition, however, is more complex than this. The real unsung hero
explaining how Kanner and Asperger would come up with the term ‘autistic’ while they were miles
apart during the second world war with no communication between the two, is George Frankl.
- Frankl was an Austrian clinician who worked with Asperger and shared his ideas on this presentation,
guiding Asperger’s thinking. Frankl emigrated to the states where he came to work with Kanner,
guiding Kanner’s thinking.
- Frankl, along with his colleague Anni Weiss, were actually the first to publish cases of autistic
behaviour in children they worked with in the early 1930’s. However, they never used the term
‘Autistic’ to describe the behaviour. The did, however, describe key aspects that presented in these
individuals, including:
• Withdrawal
• Fixation on objects
• Love of ritual and routine
• Strange speech
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