Autism in the Golden Era

Working on a new crime/fantasy story, and have settled on a sympathetic character who is what we call today "autistic," a la Dustin Hoffman in Rain Man. To keep the story simple and suspenseful (no cell phones!), I've set it in October 1941.

Did the U.S. medical profession recognize autism in 1941? If so, did they label it that, or did they have another term for it? And what was the usual treatment -- commitment to an institution such as an asylum . . . or if the patient's family had sufficient funds, to a "rest home" of some kind?

It was only just coming into understanding at that point -- there had been some research done in Austria in the 1930s, but the diagnosis and the terminology took a while to fully penetrate in the US. People with conditions we'd describe as autism today were often termed "savants," and while some were institutionalized depending on whether they were high-functioning or not, others were exhibited as entertainment: a number of radio's Quiz Kids, notably Gerard Darrow, displayed traits that would be probably be diagnosed today as Asperger's Syndrome.

Lizzie, after I posted here I went to Wikipedia. Apparently Leo Kanner of Johns Hopkins coined the expression "early infantile autism":

"Donald Triplett was the first person diagnosed with autism.[222] He was diagnosed by Leo Kanner after being first examined in 1938, and was labeled as "case 1".[222] Triplett was noted for his savant abilities, particularly being able to name musical notes played on a piano and to mentally multiply numbers. His father, Oliver, described him as socially withdrawn but interested in number patterns, music notes, letters of the alphabet, and U.S. president pictures. By the age of 2, he had the ability to recite the 23rd Psalm and memorized 25 questions and answers from the Presbyterian catechism. He was also interested in creating musical chords.[223]"

I had in mind giving my autistic boy a savant-like ability, basically a compass in his head, so that he always knows what direction he's moving in. That, however, is not crucial to the plot. His isolation and socially-withdrawn qualities are.

That sounds a lot like the aforementioned Gerard Darrow -- who before he was old enough to go to school displayed an expert-level knowledge of birds and insects, but who grew up with severe issues functioning in society. As long as he was able to perform as a radio personality he got along, but once he was too old to be a "Quiz Kid," he proved unable to adjust to an independent adult life, and died broke and alone at the age of 48. He was one of many child savants to be ill-used by the society of the Era.

If you're going to do this properly you will obviously need to do some research and explore how autism was understood or diagnosed in practice by doctors and psychiatry more generally and also how the condition (and difference in general) was seen by lay people. If you are thinking of those rare examples of people who also had extraordinary gifts (which could end up a corny device, to be honest) you may need to differentiate between autism and Aspergers Syndrome, the later is often described as high functioning autism.

This distinction between these has been and still is contested space. My own experience of psychiatry (part of my work involves managing mental health service provision in homeless communities) is that this condition was often wrongly diagnosed. Many people who later were diagnosed with Aspergers were formally diagnosed with personality disorders, bi-polar disorder and even schizophrenia. And therefore treated as such, often creating a whole range of different behaviours based on medication and institutional living. People often behave according to how they are treated, particularly before 1950 when the medical model ruled with an iron fist. The interesting thing about Aspergers, as opposed to more generally understood autism, is that children do not generally show any significant cognitive delays or problems learning language, so their experience of childhood can be very different.

Seb,

You're right about the research, and in a longer work I'd have room to go into it -- and would need to. But this is a short story, a sort of vintage-set Twilight Zone episode. The focus, I think, should be on the boy's relationship with his older brother, who loves him, has tried to protect him all his life, and doesn't want to see him forced into an asylum.

Benzadmiral said:

Seb,

You're right about the research, and in a longer work I'd have room to go into it -- and would need to. But this is a short story, a sort of vintage-set Twilight Zone episode. The focus, I think, should be on the boy's relationship with his older brother, who loves him, has tried to protect him all his life, and doesn't want to see him forced into an asylum.

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My good friend's son is Asbergers (now a 38 yr old) and I hang out with him from time to time in an attempt to alleviate his social isolation. In my limited exposure to the condition it seems that there is a very wide continuum of behaviours on the Asbergers spectrum. As a fellow writer I suggest you get a very clear picture of this young fellow in your story, who is he, where does he fit on the spectrum etc? My Asbergers acquaintance is not at risk for institutionalization but his particular symptoms make it very difficult for him to operate in the society at large. He is a very difficult man to be around, all while being very very smart, aware (particularly being aware of his being Asbergers) and conscious of his limitations.

belfastboy said:

My good friend's son is Asbergers (now a 38 yr old) and I hang out with him from time to time in an attempt to alleviate his social isolation. In my limited exposure to the condition it seems that there is a very wide continuum of behaviours on the Asbergers spectrum. As a fellow writer I suggest you get a very clear picture of this young fellow in your story, who is he, where does he fit on the spectrum etc? My Asbergers acquaintance is not at risk for institutionalization but his particular symptoms make it very difficult for him to operate in the society at large. He is a very difficult man to be around, all while being very very smart, aware (particularly being aware of his being Asbergers) and conscious of his limitations.

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If the characters were in a big city ca. 1941, or were well-educated people, the question about his diagnosis could come up. I do have a character in a flashback say that a doctor told her the boy was " 'artistic,' or somethin' like that. Dunno what that means. Never seen him draw or paint anythin’." (I leave it to the modern reader to figure out what the doctor really said.) However, the two leads grew up in rural east Texas in the Thirties, and so it's not like their mother would, or could, have taken the boy to a psychiatrist (or as they were once known, an "alienist").

My research on the topic so far suggests that Boo Radley in To Kill a Mockingbird lies somewhere on that spectrum, too.

belfastboy said:

Asbergers

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(Hans) Asperger, if you please.

I don't think there was such a thing when I was a young lad at school, no more than there were all the various allergies and syndromes.

There probably wasn't. Remember, before 1960, probably earlier in some places, later in others, there was little integration of any kind. Black people did not attend school with white people, especially in the South. Children now referred to as "special needs" were kept out of school altogether. There was little if any accommodation for children with physical handicaps, at least if they were wheelchair-bound. Children with serious issues tended to be hidden away, either at home or eventually in an institution. Kids who got into serious trouble or at least did so more than once were sent to reform schools.

We tend to forget so many things of the past, for better or worse, and one thing was that parents seemed to have very little say in things once the authorities took over. Parents didn't seem to involve themselves in school they way they do now (for better or for worse). Even so many little things have changed. Kids don't leave school at lunchtime (I went home for lunch in grade school), they don't take showers in school, and they didn't drive to school. In fact, even in a small town of about 7,000 when my mother was in school, the high school might have been termed an "inner city school." There was no parking log, although to be honest, it was built when cars were not common. I went to the same school building as the junior high school. I think one of my high school teachers started before my mother graduated in 1932, 32 years before I graduated. My father never went to high school and that's something else that has changed.

It is interesting to think about allergies and the like and wonder why it seems to be a recent problem. I don't recall any mention of any when I was going through school. I do recall vividly one boy who was physically handicapped (crippled, as the term was). He had what were basically non-functional, stunted legs. But he could sure get around on his crutches and he was in no way socially excluded or backwards. I don't remember anyone else like that, however.

We have friends who have a son, now in his 20s, who I think has Asperger's. He is a little awkward and exhibits some peculiar nervous affectations when something bothers him. But he has a driver's license and managed to get through community college. But someone else here said that people tend to behave the way they're treated. Both his parents were past 40 when he was born.

"Special Education" classes were becoming more common in the 1940s, but it was still more common for special-needs children to either be stuck in the back of the classroom and ignored or sequestered off in a "special school." Our district had what was called "The Brick School," which was a surplus building where all kids with special needs were sent. They had no interaction with the rest of the school population, and in fact the Brick School was two miles away from the rest of the school buildings, so the general school population usually had no idea they even existed.

This arrangement continued in our district into the 1990s. Special-needs kids weren't "mainstreamed" into the general population until the schools were rebuilt, with facilities incorporated to accomodate their needs. My nephew is autistic, and attended school after this change -- and had a very difficult time with things.

As far as food allergies go, it was once the practice to assume that kids displaying them were just "finicky eaters," and to force feed children the item in question to get them used to it. My mother tried to do this to me with onions when I was very small, and I ended up very very sick. The same thing happened a few years later with my brother and eggs -- and he nearly died from it.

Food allergies aren't as epidemic as they seem from the publicity they get -- less than one percent of the population is allergic to peanuts. You just hear about it more now.

There is a whole range of children in school who require something extra from the school system, from children who are virtually non-functional under any circumstances to children who are just learning English. The so-called ESOL kids are the least of the school's problems because the kids pick up English fairly quickly, according to my wife. After all, schools have had to address that issue for as long as there have been public schools, though some school systems have had little or no experience with it. Even the little schools in West Virginia coal camps had students whose parents were immigrants, usually from Italy. These days, of course, they come from nearly everywhere except Western Europe.

Schools haven't had as much experience with special education (I'm speaking of decades here) but even when I was in school, classes were sometimes divided into the fast group and the slow group. The problem is that special ed consumes a lot of school resources and some school districts don't have a lot of resources to begin with. My daughter works in a grade school in the special needs class. The student teacher ratio in that class is about two to one--and they have their hands full (this is k or pre-k through 2nd grade).

BlueTrain said:

We have friends who have a son, now in his 20s, who I think has Asperger's.

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Is he able to make and hold eye-contact or not?

Benzadmiral said:

Did the U.S. medical profession recognize autism in 1941? If so, did they label it that, or did they have another term for it? And what was the usual treatment -- commitment to an institution such as an asylum . . . or if the patient's family had sufficient funds, to a "rest home" of some kind?

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That information should be easy to find online. Additionally, I'd suggest asking about it on a psychology forum (for professionals not laymen and families) rather than on a fashion forum. I currently work in mental health and will tell you there is a lot of information available about this, but the most accurate stuff is going to come from current professionals; not laymen.

Keep in mind psychology and psychiatry are fairly young fields as sciences go.

Good luck



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Trenchfriend said:

Is he able to make and hold eye-contact or not?

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Yes, pretty much, but he clearly does not behave the same as others. One has to make an effort to treat him as "normal," whatever that is. I think the expression is high functioning. His language skills are mostly normal, with occasional stuttering. I don't think there are any distinguishing physical characteristics, unlike, say, Down's Syndrome. Someone in the neighborhood has a child, now in her 20s, maybe older, who is severely mentally retarded. She does not go to school.

totallyfrozen said:

That information should be easy to find online. Additionally, I'd suggest asking about it on a psychology forum (for professionals not laymen and families) rather than on a fashion forum. I currently work in mental health and will tell you there is a lot of information available about this, but the most accurate stuff is going to come from current professionals; not laymen.

Keep in mind psychology and psychiatry are fairly young fields as sciences go.

Good luck

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Certainly, if I were looking for help or information about autism today, I'd be checking with mental health professionals. But my focus -- for the purpose of my story -- is on the attitude of, and the knowledge available to, the general public in 1941. Considering the near-encyclopedic knowledge people here have about that period, it seemed the best place to check.

http://www.webmd.com/brain/autism/what-does-autism-mean

https://www.google.com/amp/amp.parents.com/health/autism/history-of-autism/

http://projectautism.org/history-of-autism

There ya go, my friend.

Yes, autism was known in the 40's. The term was just beginning to be used in the 40's so chances that a psychiatrist would have used the term in 1941 are slim to none. [emoji846]


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totallyfrozen said:

http://www.webmd.com/brain/autism/what-does-autism-mean

https://www.google.com/amp/amp.parents.com/health/autism/history-of-autism/

http://projectautism.org/history-of-autism

There ya go, my friend.

Yes, autism was known in the 40's. The term was just beginning to be used in the 40's so chances that a psychiatrist would have used the term in 1941 are slim to none. [emoji846]


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Ha. So then it looks like, as of '41, the term was used, but only by some doctors, to describe a symptom (as they thought) of schizophrenia. Which fits with my character's background. His mother and brother are both worried that, if no one is able to care for him, he'll wind up in an asylum somewhere.

Benzadmiral said:

Certainly, if I were looking for help or information about autism today, I'd be checking with mental health professionals. But my focus -- for the purpose of my story -- is on the attitude of, and the knowledge available to, the general public in 1941. Considering the near-encyclopedic knowledge people here have about that period, it seemed the best place to check.

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You're right. Sorry...