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Imani Blackshear

Professor Cook

English 1201.2v2

2 May 2021

How has Autism Changed Overtime?

Over the last century, the developmental disorder, autism, has

evolved tremendously. Even though it was first recognized in 1911,

by German psychiatrist, Eugene Blueler, it was not officially known

until the 1980’s. Since then, autism has drastically changed whether

it be the name of the disorder, the diagnosis, or the effective,

individual treatment plans and their various symptoms.

Beginning in 1911, German psychiatrist, Eugen Bleuler

originally characterized autism as a severe case of schizophrenia. He believed that people with

this disorder have completely been brainwashed to avoid the unsatisfying truths and have

replaced them with fantasies and illusions. Throughout the 1920s and the 1950s, psychologists

referred to the word autism as the “inner life” of a patient with autism. It was not until 1960, that

researchers found out that autism was rooted into the preliminary stages of child-development

and now referred to autism as a “lack of an unconscious symbolic life”. The United Kingdom,

child-psychiatric researcher, Michael Rutter conducted the first ever genetic-study of autism. He

claimed that autism was more of deficiency in a child rather than a made-up fantasy. Later in that

year, diagnoses for kids with autism rapidly increased in Britain and more researchers studied

deeper into this matter for more of an understanding (Evans).

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Not only were people in Britain researching autism, Americans began to research more

into this developmental disorder as well. Originally known as “delayed echolalia” in the early

1940s, Austrian-American psychiatrist, Leo Tanner, began studying autism and believed it to be

an emotional disorder. It was later believed to be birthed by cold and unemotional mothers

according to the Austrian American psychiatrist, Bruno Bettelheim. During the 1950s,

Bettelheim believed that children with autism were not born that way and could be undiagnosed

with shock therapy and psychotropic drugs if used properly. However, due to later research in

the 1960s, scientists denied this claim as they found out that autism is deeply rooted into the

child’s brain development. As time went on, the name for this developmental disorder changed

from, “delayed echolalia,” “childhood schizophrenia,” to “pervasive developmental disorder.”

As research over autism became more popular, later in the 1980s, the “Diagnostic and Statistical

Manual of Mental Disorders'' was published (Zeldovich). Between, 1952 to 2012, the

“Diagnostic and Statistical Manual of Mental Disorders'', evolved immensely. This manual has

helped guide doctors and scientists identify and diagnose a person who may have a mental

disorder. There are several different DSM manuals that each cover a new diagnoses method for

autism and other mental disorders. Prior to the first DSM, in 1930, Catholic priest, Thomas V.

Moore, gathered data from at least 367 “psychotic” patients and studied each patient. Following

his study, he found 40 different symptoms that came from the scores of cognitive ability tests,

and behavior rating scales that he conducted with each patient. To lower this scale, he qualified

each symptom into eight categories, such as cognitive defect, catatonic syndrome, uninhibited or

kinetic syndrome, non-euphoric manic syndrome, euphoric manic syndrome, delusional

hallucinatory syndrome, syndrome of constitutional hereditary depression, and syndrome of

retarded depression. After identifying and providing evidence of the symptoms, Moore was able
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to provide a new diagnosis tactic to help identify someone with a mental disorder. In 1934,

Moore’s diagnosis data was published and at least 128 people were diagnosed with a mental

disorder. This later influenced the American Psychological Association to create the DSM-1

(Blashfield et al.).

In 1952, the American Psychological Association, published

“the Diagnostic and Statistical Manual of Mental Disorders”

(DSM-1). The APA wanted to unify the diagnostic terms of all

psychiatrists and create an organization that was acceptable to

all members. The DSM-1 differentiated the organic brain

syndromes from “functional disorders” and focused on organic

and psychotic disorders. Between the years of 1949 to 1959,

research over the DSM-1 was being taken in place. Researchers such as Phillip Ash, began

digging more into this manual and testing the diagnosis tactics that were provided. After having a

psychiatrist interview numerous patients, he was able to diagnose 52 patients. Furthermore, Ash

believed that the DSM “lacked adequate reliability when being used clinically to assign

diagnoses.” Ten years later, British psychiatrist decided to test the analysis of the psychiatric

classifications that were used around the world. He noticed that each country had their own

classification and believed that each of those countries should try to create a consensual

environment that everyone could use. After hearing about this, the World Health Organization

decided to fund a series of international committees to help create this consensual system that

could better help define ways to diagnose someone with a mental illness. This later led to the

“International Classification of Diseases-8”, which was translated to be DSM-2 for Americans

and was published in 1968. The update for the DSM, had 193 diagnostic categories and disorders
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such as anxiety disorders, depressive disorders, personality disorders (PDs), and disorders of

childhood/adolescence were added (Blashfield et al.).

Following the DSM-2, the DSM-3 was later published in 1980. The leader of an

innovative classification system, Robert Spitzer, was appointed to lead the changes to the DSM

in 1974. As he studied psychotic and depressive disorders, Spitzer was able to create a broader

classification system and add to the DSM-2 creating it to become DSM-3. Multiple disorders

such as anxiety were all combined into one category such Anxiety Neurolysis. Additionally,

autism became its own category. In addition, disorders such as PTSD and “ego dystonic-

homosexuality” were added to DSM-3. Seven years later, 1987, DSM-4 was published but only

as a revised version of the previous manual and had over 297 diagnoses. In 1994, the DSM-4

was published and more sought out by researchers. American psychiatrist, Allen Frances, was

appointed by the APA, to lead the research for this manual. Frances created 13 workgroups that

aimed to study the previous manuals and perform careful literature reviews associated with the

various diagnostic categories that were provided. Frances and his colleagues grew the DSM-4 up

to 383 categories that even included sub-categories. At the time people with autism were

classified with disorders like, autistic disorder, Asperger’s syndrome, pervasive development

disorder, and childhood disintegrative disorder (Blashfield et al.).

In 1999, DSM-5 was published and was made differently than the previous manuals.

Many people were able to watch the DSM-5 grow because of the new use of the internet.

Additionally, the American Psychology Association allowed viewers to comment and put their

own point of view into the manual if it was factually correct. In 2010, the first draft of the DSM-

5 was published and over 8,000 people gave feedback. In 2011, it was released again and gained

up to 365 more categories and left over 2,000 people with comments. As time progressed, the
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DSM manuals received more criticism online which led to American psychologist, David Kupfer

to become the lead of the new DSM manual. He had over 500 mental health professionals

grouped into a category of thirteen. After his workgroups, the DSM-5 gained a total of 541

diagnostics that could help identify someone with a mental disorder. Additionally, the DSM-5

recognizes five distinct ASD specifiers such as with or without accompanying intellectual

impairment, with or without accompanying language impairment, associated with a known

medical or genetic condition or environmental factor, associated with another

neurodevelopmental, mental, or behavioral disorder and catatonia. Furthermore, with diagnosing

a person with autism, the DSM-5 provided common symptoms that researchers saw in a patient.

These included a lack of communication, a repetitive pattern, developing a relationship with

other people, and fixated interest. Researchers noticed that people who had autism had a delay in

language and/or social development (Blashfield et al.).

Although the DSM manuals consisted of the three vital qualities of autism and specified

the criteria needed to diagnose a child with autism, researchers are still unsure of the primary

causes of autism (Zeldovich). However, in 1998, researcher Andrew Wakefield and his

colleagues claimed that early U76 childhood vaccinations are the cause of autism. This caused a

widespread panic in families who have a member with ASD. Additionally, this caused many

people to become anti-vaccinators. Following some research, scientists classified Wakefield’s

claim false, which consequently led to Wakefield’s

medical license to be revoked in 2010. Since then,

experts have studied that autism could result from a

combination of genetic and environmental influences

such as ASD in family genes, premature birth, and the

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parents' ages (“Autism Spectrum Disorder”). Along with the environmental influences,

researchers have found that states such as California, Texas, North Carolina, and Utah, have

higher rates of people diagnosed with autism. In “What Causes Autism and Why Are More and

More Kids Being Diagnosed with It?,” Doctor Anna E. Mazzucco, states that “Some scientists

have suggested that higher amounts of environmental toxins in these areas may explain the

relatively high rates of autism.” Additionally, after more research, scientists have noticed that

more boys are diagnosed with autism than girls. According to the CDC (Centers for Disease

Control), autism is 4 times more common in boys than it is in girls. Researchers have stereotyped

this developmental disorder as a “boys’ disease” (Mazzucco).

Moreover, after researchers classified the potential causes that could lead to autism, they

have also found new treatment methods. In 1934, Hungarian psychiatrist, Ladislas Joseph von

Meduna, began shock therapy. Although shock therapy did induce seizures, Meduna tested this

therapy on his patients who had schizophrenia and 95% of them recovered to mental stability.

This later inspired the Italian neurologist, Ugo Cerletti to develop an electroconvulsive therapy

for psychiatry. Later many doctors began using this process for autism and it is still periodically

used today. Furthermore, along with this therapeutic session, doctors began suggesting that

people with autism should go on dietary restrictions. However, dietary therapy for ASD, have

remained unproven to be effective by experts. Many believe that these restrictions have caused

the symptoms of autism to worsen and lead to anxiety and depression (“Autism Spectrum

Disorder”).

Austrian-psychiatrist, Sigmund Freud decided to develop an alternative treatment plan for

kids with autism. He became the father of psychotherapy and psychoanalysis. Freud believed

that all people possess unconscious thoughts, feelings, desires, and memories which later led him
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to develop psychoanalysis therapy, making the unconscious conscious. Freud also believed that

traumatic childhood events can have a significant effect on our adult life such as anxiety

developing over time. After other doctors observed that Freud's work was working, they decided

to add onto this. In 1950, parentectomy, the removal of a parent (or both parents) from the child,

became the most common treatment until American scientist, Temple Grandin, developed the

squeeze machine for children with autism. This treatment was used to relax those on the

spectrum and relieve stress. Parents and doctors still use this therapeutic method today by using

weighted blankets and hugging their child tightly (Sinclair).

In 1970, medical doctor, Guy Berard, developed the auditory integration which led to

many psychiatrists to use in their treatment plan. This therapy would be a 20-half-hour session

for ten days. Berard believed that these sessions could cure autism and other mental disorders.

To test his theory, the American Academy of Pediatrics decided to make this an experimental

therapy procedure. However, after many failed attempts the New York State Department of

Health recommends that this treatment method should not be used on younger kids with autism.

This process caused kids with developmental disorders to be left confused and highly

uncomfortable. Later in the 1970s, pharmaceutical treatments became a new plan.

Pharmacological therapies were used to help a patient throughout their day. One treatment drug

is Clozapine, was used for aggression and tantrums. This treatment was more towards kids with

schizophrenia and to help lessen the suicidal thoughts they had. Even though this treatment

lowered the patient's aggression, it did cause many of them to have seizures. Another treatment

would be Risperidone, as it is directed towards kids with autism related irritability. After some

time studying, scientists have found that children that range from the age of 5 to 17 have

improved tremendously and were highly effective. However, the only common side effects were
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dizziness, increased appetite, drooling and fatigue. Many of the other treatments, however, are

still not proven to be effective by scientists (Sinclair).

After hearing the new numerous treatment plans for autism, many families began to start

campaigns to shut down “mentally retarded” institutions and demanded more of an effective

treatment plan for kids with autism. Additionally, pressure groups such as the UK Society for

Autistic Children, began to ensure that new effective methods would be provided for kids with

autism so they can adjust to the new social norms. Doctors later began to develop new behavioral

treatments for kids with autism to fasten this process (Evans). This idea was spread worldwide

and gave many researchers the idea that children who are suspected to have autism should have

early intervention and referral for testing. Today the average age to get diagnosed for autism is at

four years old, however, doctors have begun testing children around eighteen to twenty-four

months. Developmental and behavioral pediatrician, Dr. Marilyn Augustyn, suggests that getting

early intervention can help families get the best effective treatment for their child, although it

may be expensive. Many doctors suggest that kids who are on the autism spectrum should

undergo the A.B.A program (Applied Behavior Analysis), which can help identify certain

triggers, specific behaviors, and ways to respond to the child when they exhibit good behavior.

According to Dr. Augustyn, this treatment has proven to be more effective overtime as she has

noticed that her patients seem to be communicating more socially than usual (Klass, M.D.).

Overtime, autism has changed in a variety of ways. From the changing of its name to the

diagnosis and the treatment plans, autism has had a radical shift since the early 90s. Even today,

while autism is still being researched new advances are servicing every day. Many researchers,

psychiatrists, and psychologists have deeply influenced the evolution of this developmental

disorder since the early 1900s.

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Works Cited

Apoorva Mandavilli. “How ‘Shock Therapy’ Is Saving Some Children with Autism |

Spectrum | Autism Research News.” Spectrum | Autism Research News, 26 Oct. 2016,

www.spectrumnews.org/features/deep-dive/how-shock-therapy-is-saving-some-children-

with-autism/. Accessed 28 Mar. 2021.

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Blashfield, Roger K., et al. “The Cycle of Classification: DSM-I through DSM-5.”

Annual Review of Clinical Psychology, vol. 10, no. 1, 28 Mar. 2014, pp. 25–51,

10.1146/annurev-clinpsy-032813-153639.

Evans, Bonnie. “How Autism Became Autism.” History of the Human Sciences, vol. 26,

no. 3, 8 May 2013, pp. 3–31, 10.1177/0952695113484320. Accessed 21 Mar. 2021.

Klass M.D., Perri. “Early Treatment for Autism Is Critical, New Report Says.” The New

York Times, 6 Jan. 2020, www.nytimes.com/2020/01/06/well/family/early-treatment-for-

autism-is-critical-new-report-says.html. Accessed 21 Mar. 2021.

Mazzucco, Anna. “What Causes Autism and Why Are More and More Kids Being

Diagnosed with It?” National Center for Health Research, 17 Apr. 2014,

www.center4research.org/causes-autism-kids-diagnosed/. Accessed 28 Mar. 2021.

Sinclair, Elizabeth. “History of Autism Treatment.” Applied Behavior Analysis Programs

Guide, 2018, www.appliedbehavioranalysisprograms.com/history-autism-treatment/.

Accessed 21 Mar. 2021.

Zeldovich, Lina. “Spectrum.” Spectrum | Autism Research News, 29 May 2018,

www.spectrumnews.org/news/evolution-autism-diagnosis-explained/. Accessed 21 Mar.

2021.