The Swiss psychiatrist Eugen Bleuler (1857-1939) coined the term schizophrenia, and did more as a pioneer: he was the first to use the word autism when he named a group of symptoms common to schizophrenics: detachment, loneliness and social inability.
However, autism was recognized as a separate disease after Bleuler, when scientists Leo Kanner (1894-1981) and Hans Asperger (1906-1980), who worked without influence, made similar descriptions of clinical cases.
Almost simultaneously, the two gave the same name to the disorder they were studying. Until then, autistic children did not receive a proper diagnosis, they were left with the label of having mental retardation or any behavior disorder.
“He seems to be curled up in his own shell, living inside himself, oblivious to everything.” This was a father’s accurate description of the condition of his son, one of Dr. Kanner, a synthesis that fit the other children studied very well.
The boy lived by stacking objects, kept the habit of shaking his head from side to side, showed an intense aversion to changes and attachment to a rigorously repetitive routine. All of these habits have been recognized as cardinal symptoms of autism. Some of the clinical cases had creativity for a specific subject, an islet of inventiveness.
Psychiatrist and pediatrician Hans Asperger identified different courses of autism, the manifestations made up a mosaic of possibilities. Some people had surprising intellectual abilities, like Elfried Jelinek, one of his patients, who would receive the Nobel Prize for Literature in 2004.
Until a few years ago, those capable of cognitive feats were said to have Asperger’s syndrome, but with difficulty in social interactions, and problems in understanding non-literal communication, such as those that accompany play, gestures, looks and facial expressions. We currently prefer the diagnosis of autism spectrum disorder, a complex and heterogeneous neurodevelopmental disorder.
It was thought that the vast majority of autistic people had an intellectual disability, but in fact, 50% or less do. To refer to individuals with intelligence quotient scores equal to or greater than 70 points, medicine for a time used the words “high-functioning autistic spectrum disorder.”
The implicit intention was to refer to patients without severe intellectual disability. But over time, the term high functioning reinforced the idea that autism brought great benefits to life. In contrast to the unromantic reality, many “high functioning” individuals live in isolation, unemployed and permanently dependent on others.
There are, however, autistic people who manage to establish and maintain solid social relationships and also achieve great autonomy. In this group are those who have exceptional memory, or high IQ, or outsized vocabulary, or other surprising cognitive skills like being able to maintain hyperfocus.
Hyperfocus is a state of mind in which there is complete absorption of a task by one person, who is disconnected from everything else. Therefore, any overhang not consistent with the activity is ignored.
Anyone can experience the hyperfocus moment, usually during pleasurable activities, such as video games, or a special sporting moment. However, it is erroneously assumed that this state is a unique peculiarity of non-typicals. If it happens at work, hyperfocus will determine productive gains that can be admired and envied.
The phrase “autism is booming” appeared in another column of this Folha de S.Paulo. If anyone really takes this meaning seriously, he probably does so to excuse himself from his own incompetence or mediocrity.
With the trump card of having typical neural development, he insinuates that those who surpass him only do so because he is atypical. It also disregards the entire environment full of inconvenience caused by autism. Or it’s none of those things, just a free and frivolous judgment, like believing the moon is made of cheese. A fanciful but permissible thought.
Also fantastic was the theory of pediatrician DW Winnicott (1896-1971), who, based on nothing, blamed mothers for their children’s autism. In his theory, the mother, unable to meet the specific needs of each period of the baby’s maturation, forces him to organize defensively. Autism would be this defense, of making oneself invulnerable to the agony caused by maternal incompetence, isolating oneself within oneself.
You, my dear and possibly lay reader, with a shred of criticism, will be able to contradict by yourself the nonsense interspersed with this thesis. If you like, there is a vast amount of serious work that belies Winnicott. You will find them easily, I leave this task in your hands.
Only optimism as a civic virtue accepts the would-be pediatrician: to believe that it is possible to discover the genesis of autism, through a superficial inference disguised in far-fetched rhetoric. Winnicott’s theory even seems sophisticated, but the mental foundation that the anchor is the same that makes someone believe that the moon is made of cheese.
References:
1. Kandel ER. “The Disordered Mind: What Unusual Brains Tell us About Ourselves”. Farrar, Straus and Giroux,; 2018
2. Baumer N, Spence SJ. “Evaluation and Management of the Child With Autism Spectrum Disorder. Contin Lifelong Learn Neurol”. 2018 Feb;24(1):248.
3. Alvares GA, Bebbington K, Cleary D, Evans K, Glasson EJ, Maybery MT, et al. “The misnomer of ‘high functioning autism’: Intelligence is an imprecise predictor of functional abilities at diagnosis”. Autism 2020 Jan 1;24(1):221–32.
4. Lincoln AJ, Courchesne E, Kilman BA, Elmasian R, Allen M. “A Study of Intellectual Abilities in High-Functioning People with Autism.” J Autism Dev Disord. 1988 Dec 1;18(4):505–24.
5. Ashinoff BK, Abu-Akel A. “Hyperfocus: The Forgotten Frontier of Attention”. Psychol Res. 2021 Feb;85(1):1–19.
6. Araujo CAS de. “Winnicott and the Etiology of Autism: Considerations About the Emotional Condition of the Mother”. Clinical Styles 2003 Jun;8(14):146–63.
7. Opinion – Luiz Felipe Pondé: “The Autism Diagnosis Turned into a Hype Style Trend” [Internet]. Folha de S.Paulo. 2022 [cited 2022 Sep 3]. Available from: https://www1.folha.uol.com.br/colunas/luizfelipeponde/2022/08/o-diagnostico-de-autismo-se-transformou-numa-tendencia-de-estilo-hype.shtml
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