J Autism Dev Disord (2016) 46:340–341
DOI 10.1007/s10803-015-2541-3
COMMENTARY
Leo Kanner’s Mention of 1938 in His Report on Autism Refers
to His First Patient
Dan Olmsted1 • Mark Blaxill1
Published online: 1 August 2015
Ó Springer Science+Business Media New York 2015
Abstract Leo Kanner begins his landmark 1943 case
series on autistic children by stating the condition was first
brought to his attention in 1938. Recent letters to JADD
have described this reference as ‘‘mysterious’’ and specu-
lated it refers to papers published that year by Despert or
Asperger. In fact, as Kanner goes on to state, 1938 is when
he examined the first child in his case series. An exchange
of letters with Despert and later writing by Kanner also
point to the originality of his observations.
Keywords History
Leo Kanner
Infantile autism

Louise Despert
Childhood schizophrenia
Correspondents to your Letters column have recently
debated ‘‘the mysterious mention of the year 1938’’ in Leo
Kanner’s landmark 1943 paper, ‘‘Autistic Disturbances of
Affective Contact’’ (Kanner 1943). Our research, and
Kanner’s own words, clarify that the reference is to the
year Kanner examined the first child referred to him who
exhibited this novel syndrome—in other words, the start of
the case series.
Fellowes writes it is ‘‘unclear what ‘1938’ refers to and this
ambiguity has led to controversy,’’ including the idea that it
references a ‘‘largely unknown paper by Asperger’’ or, as
Fellowes argues, ‘‘this mysterious year of 1938 refers to a paper
written by New York based child psychiatrist Louise Despert.’’
‘‘The issue at stake is simple,’’ he concludes. ‘‘Who first
described autism?’’ (Fellowes 2015).
& Mark Blaxill
mblaxill@comcast.net
Dan Olmsted
Olmsted.dan@gmail.com
1
Bear Creek, WI, USA
123
Kanner begins his paper with the sentence, ‘‘Since 1938,
there have come to our attention a number of children
whose condition differs so markedly and uniquely from
anything reported so far, that each case merits—and, I
hope, will eventually receive—a detailed consideration of
its fascinating peculiarities.’’
In the following paragraph Kanner writes: ‘‘Case 1.
Donald T. was first seen in October, 1938, at the age of
5 years, 1 month. Before the family’s arrival from their
home town, the father sent a thirty-three-page typewritten
history that, though filled with much obsessive detail, gave
an excellent account of Donald’s background.’’
Thus it was the arrival of Donald T. that Kanner says
alerted him to the existence of this novel disorder. Archival
material reflects that. On January 29, 1942, Kanner wrote
Ernest Harms, editor of the journal The Nervous Child,
who had invited him to guest-edit an upcoming edition:
‘‘As to the issue due early in 1943, I wonder what you think
of the general topic, ‘Affective Contact of Children’? I
might have [a] paper of my own on ‘Autistic Disturbances
of Contact in Small Children.’ I have followed a number of
children who present a very interesting, unique, and as yet
unreported condition, which has both interested and fas-
cinated me for quite some time.’’ (Kanner 1942).
Kanner referred to this sequence again in 1979. ‘‘In
1938, five-year-old Donald T., brought to my clinic from
Forest, Mississippi, made me aware of a behavior pattern
not known to me or anyone else theretofore. When I saw a
few more children presenting similar characteristics, I
reported in 1943 eleven cases in some detail in a now
extinct journal, The Nervous Child. This is the article so
frequently cited ever since.’’ (Kanner 1971).
A year after ‘‘Autistic Disturbances,’’ Asperger descri-
bed a milder disorder, chiefly differentiated by the presence
of functional language. We examined Kanner’s entire
J Autism Dev Disord (2016) 46:340–341
archive at the American Psychiatric Association and found
no correspondence with, or mention of, Asperger prior to
the publication of ‘‘Autistic Disturbances.’’
Kanner’s connection with Despert is more complicated,
but in our view it reinforces, rather than reduces, Kanner’s
claim to priority. In the APA archive we found several
letters between the two, initiated when Despert wrote
Kanner not long after publication of ‘‘Autistic Distur-
bances.’’ ‘‘In that article you certainly have clearly and
concisely defined a clinical entity which had baffled many
observers,’’ (Despert N.D.) she wrote, but in a follow-up
letter made her true complaint clear: ‘‘However, if you will
permit me to say so, I object to the coining of new ter-
minology for entities which, while perhaps not so carefully
described, have been previously reported.’’ (Despert 1943).
Kanner politely but firmly replied that ‘‘I also want you
to know that I am thoroughly familiar with your own work,
which in my opinion and that of many others, represents a
genuine contribution to our knowledge of schizophrenia’’
in children. And, he noted, ‘‘I have, as is inevitable, seen
typical schizophrenic children at a very early age.’’
Then Kanner drew a distinction between such ‘‘typical
schizophrenic children’’ and those he described in 1943:
‘‘What strikes me in the group which I have discussed in
my paper is the apparent disability from the beginning of
life to form adequate affective contact rather than with-
drawal from adequate or near adequate contact already
established. This is the essential thing which, in my mind,
sets the group off from other infantile schizophrenics of my
acquaintance or those reported in the literature.’’ (Kanner
1943).
The ‘‘essential thing,’’ then, was what he called in the
paper ‘‘inborn disturbances of affective contact.’’ ‘‘The
children of our group,’’ he wrote Despert, ‘‘have all shown
their extreme aloneness from the beginning of life, not
341
responding to anything that comes to them from the outside
world.’’ (While Kanner subsequently recognized a category
of regressive autism and viewed it as distinct from child-
hood schizophrenia, it is still characterized by early onset,
within the 3-year time period of infancy.)
A survey titled ‘‘Schizophrenia-like Psychoses in Young
Children,’’ by R.A.Q. Lay, at Guy’s Hospital in London,
supports Kanner’s argument (Lay 1938). Published in
1938—the same year Kanner saw Donald T. at Hopkins—
it would be expected to capture any case descriptions
matching Kanner’s striking syndrome. But none had the
unique cluster of behaviors Kanner laid out in such
meticulous detail—including the presence of the disorder
from early infancy.
This timing remains the essential clue to the disorder:
Something happened to bring a new condition to the
attention of child psychiatry.
References
Fellowes, S. (2015). Did Kanner actually describe the first account of
autism? The mystery of 1938. Journal of Autism and Develop-
mental Disorders. Published on-line, February 5, 2015.
Kanner, L. (1943). Autistic disturbances of affective contact. The
Nervous Child, 2(2), 217–250.
Kanner, L. (1971). Follow-up study of 11 autistic children originally
reported in 1943. Journal of Autism and Childhood Schizophre-
nia, 1, 119–145.
Lay, R. A. Q. (1938). Schizophrenia-like psychoses in young
children. Journal of Mental Science, 84, 105–133.
Leo Kanner letter to Ernest Harms, January 19, 1942, in APA
archives.
Leo Kanner to Louise Despert, July 15, 1943, letter, APA archives.
Louise Despert to Leo Kanner, July 12, 1943, letter, APA archives.
Louise Despert to Leo Kanner, undated letter, APA archives.
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