Autism History And Statistics

Autism Through Ages Baffles Science

By Robert Williams Jr., June 12, 2000 at Health24 News

For years past people with autism were placed in institutions all over the world. Autism is not a modern problem, even though it has only recently gained vast recognition. It is difficult to discuss the history of autism treatment without paying particular attention to the history of "autism" as a concept and the ways in which autism has been conceptualized and theorized about over the past 100 years.

The ways in which we understand and think about autism have directly and indirectly formed our conceptual responses to autism over the years. The very concept of "treatment" carries with it many presumptions about the nature of autism, its origins and its potential outcomes. The history of autism is not a linear one, and regardless of the past or present debates over treatment, origin or outcome, as more and more studies and research are conducted the greater the understanding of autism will become.

Swiss psychiatrist Eugen Bleuler first introduced the term autism in 1911. Autism and autistic stem from the Greek word "autos," meaning self. The term autism originally referred to a basic disturbance in schizophrenia, in short, an extreme withdrawal of oneself from the fabric of social life, but not excluding oneself.

Bleuler also coined the term ambivalence to designate one of the major symptoms of schizophrenia, the others being autism, disturbances of effect (emotion) and association (thought disorders). Ambivalence is a coexistence of two opposing drives, desires, feelings or emotions toward the same person, object or goal. The ambivalent person may be unaware of either of the opposing wishes. Bleuler felt that there were normal instances of ambivalence--such as the feeling, after performing an action, that it would have been better to have done the opposite; but the normal person, unlike the schizophrenic, is not prevented by these opposing impulses from deciding and then acting. Bleuler's schizophrenia differs in terms from the Freudian theories, in which ambivalence was described as feelings of love and hate toward the same person. (E.L. Horwitz, "Madness, Magic, and Medicine: The Treatment and Mistreatment of the Mentally Ill." [Lippincott, 1977])

In the early 1900s, psychologist Carl Gustav Jung introduced the well-known personality types, extroverts and introverts, further broadening Sigmund Freud's psychoanalytical approach. However, this approach appears to have indirectly classified the autistic person as a schizophrenic introvert. Jung saw the activity of the extrovert directed toward the external world and that of the introvert directed inward upon him- or herself. Jung, who removed from the term the sexual character ascribed to it by Freud, called this general activity or drives of the individual the libido. The extrovert is characteristically the active person who is most content when surrounded by people; carried to the neurotic extreme, such behavior appears to constitute an irrational flight into society, where the extrovert's feelings are acted out.

The introvert, on the other hand, is normally a contemplative individual who enjoys solitude and the inner lifeof ideas and the imagination. Severe introversion was believed to be characteristic of autism and some forms of schizophrenia. (C.G. Jung, "Psychological Types." [tr. 1923, repr. 1970]) Jung did not suggest strict classification of individuals as extroverted or introverted, since each person has tendencies in both directions, although one direction generally predominates. Jung theorized a patient could achieve a state of individuation, or wholeness of self. (E.H. Ackernecht, "A Short History of Psychiatry." [Hafner, 2d ed., rev., 1970])

In 1944, American Bruno Bettelheim directed the Chicago-based Ortho-genic School for children with emotional problems, placing special emphasis on the treatment of autism. Bettelheim believed that autistic children had been raised in unstimulating environments during the first few years of their lives, when language and motor skills develop. He saw parents unresponsive to their child as an underlying cause of autistic behavior. (L. Wing, ed., "Aspects of Autism." [1988]) Although subsequent studies of the parents of autistic children have discredited Bettelheim's psychological explanation, his ideology carried into the general populace for generations to follow, germinating red herring terms like "refrigerator mother."

The highly complex treatment of childhood autism began with the early-childhood development pioneers Leo Kanner and Hans Asperger, who each published accounts of this disorder. Kanner published his report in 1943 while at Johns Hopkins. He conducted a case study of 11 children who appeared to share a number of common characteristics that he suggested formed a "unique 'syndrome' not heretofore reported." He titled the article, "Autistic disturbances of affective contact," and characterized the children as possessing, from the very beginning of life, what he called an "extreme autistic aloneness." The following year, Asperger published "Autistic psychopathy in childhood." The article presented a case study of several children whom he described as examples of "a particularly interesting and highly recognizable type of child." Both Kanner and Asperger believed that the children suffered from a fundamental disturbance that gave rise to highly characteristic problems.

They both chose the word autism, a term coined by Bleuler in reference to the aloneness experienced by schizophrenic patients, in order to characterize the nature of the underlying disturbance. The common feature of this disturbance was that the children seemed unable to entertain normal relationships with people.

In contrast to Bleuler's schizophrenia, the disturbance observed by Kanner and Asperger appeared to have been there from birth. Kanner's paper has become the most quoted, while Asperger's paper, written in German during World War II, was largely ignored. The belief has grown that Asperger described quite a different type of child, not to be confused with the one Kanner described.

Asperger's definition of autism or, as he called it, "autistic psychopathy," is far wider than Kanner's, including cases that showed severe organic damage and those that shaded into normality. In 1943 and 1944, "autistic disturbances" and "autistic psychopathy" became known as syndromes. (U. Frith, "Autism: Explaining the Enigma." [1989]) Asperger's syndrome as defined today is clearly not what Asperger intended, but having this special category has proved clinically useful.

Kanner's syndrome is often used to indicate the child with a constellation of classic, "nuclear" features, resembling in astonishing detail the features that Kanner identified in his first, inspired description. Again, the category is clinically useful since it communicates a prototypical pattern. From the 1980s through the early 1990s, the cause, prognosis, and treatment of autism were vigorously under study. Research suggested that a genetic defect caused the disorder, which was presumed to be some form of autoimmune disease or degenerative disease of nerve cells in the brain.The preferred treatment for the autistic child was special education, stressing learning in small increments, and a strict behavioral control of the child.

In general, about half of the children with autism were considered mute; those who remained mute through age 5 were given a poor prognosis for recovery. The children with autism who spoke were given a prognosis that they would fare better, and possibly even recover. (Autism, ENCARTA'95; Computer program; [1995]) Since 1911, the understanding of autism has grown to such a degree that we know there is not yet a cure.

However, researchers all across the nation are working diligently to produce more information on autism, and possibly a cure. "Cure" means "restoration of health; recovery from disease." To "recover" means "to regain a normal or usual condition, as of health." While "cure" and "recovery" prognoses for autism might have been the expectation of 80s and early 90s, they do not represent expectations today.

Today we know that with highly structured and appropriate interventions the behaviors of a child or adult with autism may change to the point where he or she may appear to no longer have autism to the untrained person. However, while they have changed, they still have the autism.

In 1995-1996, only 5.6 million children (ages 0 to 21), or about 12 percent of public school children, were enrolled in special education programs. The number of students participating in federal programs for children with disabilities has increased at a faster rate than the total public school enrollment.

Between 1977 and 1995 alone, the number of students involved in federal programs for children with disabilities increased 47 percent, while the total public school enrollment decreased by 2 percent. These counts are based on reports from the 50 states and submitted to Congress to aid in the enactment of the Individuals with Disabilities Education Act by the National Center for Education Statistics, U.S. Department of Education, "Digest of Education Statistics," 1997.

It is also noted in this study that as early as 1976, as new types of disability categories began to emerge (specific learning disabilities, serious emotional disturbance, multiple disabilities, other health impairments, autism, preschool disabled), the percentages of federal programs for students with mental retardation disability began to lower.

It is evident that autism as a diagnosis was non-existent prior to the early 1900s, and the people who had what we call autism today were diagnosed with some other disorder. It was not until the mid 1900s that people with autism were no longer institutionalized for their problem. Despite the persistence of old theories, no factors in the psychological environment of a child or adult have been shown to cause autism. There is no proof that autism is due to bad parenting, neglect, abuse or tragedy.

Children with autism are not unruly youngsters who choose not to behave. Professionals have long since disproved all of these "causes" and theories. Unfortunately, the general understanding of the word autism hasn't kept up with the newer medical research shared today. It is proven that people with autism can lead happy and productive lives when appropriate supports and therapies are provided.

Link for Children with Autism Served Under IDEA

http://www.ideadata.org/tables27th/ar_aa3.htm

The US Department of Education:
Twenty Eighth Annual Report to Congress

Table AA3

Number of Children Ages 6-21 Served Under IDEA, Part B
By Disability,

2003


STATE	ALL DISABILITIES	SPECIFIC LEARNING DISABILITIES	SPEECH OR LANGUAGE IMPAIRMENTS	MENTAL RETARDATION	EMOTIONAL DISTURBANCE
ALABAMA	85,213	40,561	16,348	12,639	3,038
ALASKA	15,991	8,365	3,614	775	765
ARIZONA	100,173	56,296	17,393	8,108	7,483
ARKANSAS	56,123	22,496	10,765	11,480	653
CALIFORNIA	613,813	333,766	133,732	38,751	27,119
COLORADO	72,774	32,151	14,492	3,546	9,187
CONNECTICUT	65,817	26,962	13,052	3,351	7,193
DELAWARE	16,386	9,066	1,656	2,203	865
DISTRICT OF COLUMBIA	12,941	6,242	1,306	1,569	2,281
FLORIDA	362,500	179,453	76,564	39,030	36,829
GEORGIA	170,688	52,262	36,501	28,202	24,206
HAWAII	20,982	10,150	1,212	1,982	2,858
IDAHO	25,285	12,823	4,655	1,746	1,170
ILLINOIS	285,393	141,314	55,576	27,696	30,120
INDIANA	153,457	63,093	36,536	22,025	13,929
IOWA	67,732	37,209	7,150	11,750	7,406
KANSAS	55,949	24,142	9,992	4,952	3,808
KENTUCKY	83,564	17,955	18,188	17,816	5,670
LOUISIANA	90,547	35,181	19,948	11,048	4,799
MAINE	33,137	12,658	7,552	940	3,327
MARYLAND	101,760	40,636	22,076	6,694	9,719
MASSACHUSETTS	144,220	71,670	16,863	12,466	13,428
MICHIGAN	214,827	97,364	42,323	25,213	19,811
MINNESOTA	101,206	36,825	16,263	9,548	17,076
MISSISSIPPI	58,854	30,080	15,519	4,954	1,117
MISSOURI	128,453	59,745	30,067	12,060	8,297
MONTANA	17,637	9,389	3,471	1,119	1,008
NEBRASKA	40,116	15,305	10,273	5,457	2,363
NEVADA	40,268	24,673	6,256	1,968	2,220
NEW HAMPSHIRE	28,725	13,389	4,859	979	2,676
NEW JERSEY	222,727	108,099	43,863	6,337	13,214
NEW MEXICO	46,158	25,710	8,381	1,722	2,768
NEW YORK	387,077	182,995	68,614	14,721	41,391
NORTH CAROLINA	172,938	69,639	28,560	27,744	10,137
NORTH DAKOTA	12,543	5,042	3,323	1,129	1,191
OHIO	234,219	94,309	35,395	47,846	18,032
OKLAHOMA	85,276	46,614	11,302	7,158	4,788
OREGON	68,630	31,702	15,642	4,351	4,597
PENNSYLVANIA	248,800	138,643	37,874	26,800	24,057
PUERTO RICO	69,126	40,650	10,162	10,963	828
RHODE ISLAND	29,293	14,231	5,645	1,247	3,072
SOUTH CAROLINA	99,259	47,036	21,658	14,672	5,978
SOUTH DAKOTA	15,220	7,225	3,315	1,266	859
TENNESSEE	111,506	49,841	24,197	13,550	3,762
TEXAS	466,164	251,607	72,029	26,514	36,241
UTAH	51,012	28,328	9,556	3,104	2,981
VERMONT	12,292	4,349	1,813	1,230	2,041
VIRGINIA	156,366	69,949	23,371	13,897	13,013
WASHINGTON	110,663	49,264	16,398	5,734	5,046
WEST VIRGINIA	45,168	17,903	10,901	9,060	2,227
WISCONSIN	112,435	48,795	18,714	11,994	16,144
WYOMING	11,219	5,108	2,636	600	1,017
AMERICAN SAMOA	997	839	45	41	8
GUAM	2,260	1,682	214	89	22
NORTHERN MARIANAS	600	390	33	62	5
VIRGIN ISLANDS	1,573	699	230	348	72
BUR. OF INDIAN AFFAIRS	7,999	5,038	1,187	417	567
U.S. AND OUTLYING AREAS	6,046,051	2,866,908	1,129,260	582,663	484,479
50 STATES, D.C., P.R.	6,032,622	2,858,260	1,127,551	581,706	483,805
-------------------- Please see data notes for an explanation of individual state differences. Developmental delay is applicable only to children 3 through 9. Data based on the December 1, 2003 count, updated as of July 31, 2004. U.S. Department of Education, Office of Special Education Programs, Data Analysis System (DANS).

Table AA3

Number of Children Ages 6-21 Served Under IDEA, Part B
By Disability,

2003


STATE	MULTIPLE DISABILITIES	HEARING IMPAIRMENTS	ORTHOPEDIC IMPAIRMENTS	OTHER HEALTH IMPAIRMENTS	VISUAL IMPAIRMENTS
ALABAMA	1,332	952	562	5,517	424
ALASKA	435	145	68	798	38
ARIZONA	2,051	1,632	644	3,473	517
ARKANSAS	1,208	610	198	7,261	229
CALIFORNIA	5,330	9,907	12,031	28,736	3,708
COLORADO	3,049	1,268	7,449	0	321
CONNECTICUT	2,126	783	134	9,731	298
DELAWARE	0	247	1,864	0	46
DISTRICT OF COLUMBIA	760	109	62	286	29
FLORIDA	0	3,491	4,176	15,287	1,153
GEORGIA	0	1,551	982	20,341	565
HAWAII	330	377	95	2,135	63
IDAHO	465	270	105	1,667	97
ILLINOIS	548	3,590	2,490	16,133	1,061
INDIANA	1,528	1,920	1,455	6,832	827
IOWA	420	813	874	487	162
KANSAS	2,187	540	403	6,504	192
KENTUCKY	3,595	567	469	10,530	396
LOUISIANA	1,020	1,273	1,293	9,477	417
MAINE	3,222	245	63	4,138	88
MARYLAND	5,206	1,219	424	10,799	507
MASSACHUSETTS	4,955	1,058	1,017	5,576	444
MICHIGAN	2,835	2,966	8,685	7,595	833
MINNESOTA	300	1,992	1,563	10,363	334
MISSISSIPPI	559	612	527	2,566	269
MISSOURI	1,037	1,233	588	11,571	471
MONTANA	528	179	68	1,488	64
NEBRASKA	362	603	429	3,715	203
NEVADA	788	477	330	2,314	162
NEW HAMPSHIRE	371	256	118	4,353	121
NEW JERSEY	25,098	1,644	544	16,674	388
NEW MEXICO	1,030	516	222	2,773	177
NEW YORK	21,622	5,275	2,632	37,118	1,792
NORTH CAROLINA	1,734	2,046	1,012	21,635	624
NORTH DAKOTA	0	134	115	1,042	49
OHIO	13,378	2,480	2,196	13,629	1,017
OKLAHOMA	1,458	821	427	5,514	374
OREGON	0	811	749	6,407	295
PENNSYLVANIA	2,677	2,710	997	6,744	1,152
PUERTO RICO	1,055	742	456	2,962	532
RHODE ISLAND	290	208	113	3,792	67
SOUTH CAROLINA	198	1,167	747	5,968	378
SOUTH DAKOTA	766	136	89	1,143	36
TENNESSEE	1,692	1,295	916	10,357	688
TEXAS	8,080	5,706	4,644	47,255	2,510
UTAH	1,380	536	164	2,244	237
VERMONT	84	124	88	1,672	31
VIRGINIA	2,630	1,359	735	21,559	458
WASHINGTON	2,520	1,285	679	19,094	292
WEST VIRGINIA	0	407	187	3,615	223
WISCONSIN	0	1,473	1,182	9,969	403
WYOMING	94	143	128	1,206	52
AMERICAN SAMOA	29	16	3	11	4
GUAM	55	31	18	69	13
NORTHERN MARIANAS	24	14	10	21	5
VIRGIN ISLANDS	38	23	0	67	10
BUR. OF INDIAN AFFAIRS	166	61	15	229	33
U.S. AND OUTLYING AREAS	132,645	72,048	68,234	452,442	25,879
50 STATES, D.C., P.R.	132,333	71,903	68,188	452,045	25,814
-------------------- Please see data notes for an explanation of individual state differences. Developmental delay is applicable only to children 3 through 9. Data based on the December 1, 2003 count, updated as of July 31, 2004. U.S. Department of Education, Office of Special Education Programs, Data Analysis System (DANS).

Table AA3

Number of Children Ages 6-21 Served Under IDEA, Part B
By Disability,

2003


STATE	AUTISM	DEAF- BLINDNESS	TRAUMATIC BRAIN INJURY	DEVELOPMENTAL DELAY
ALABAMA	1,319	6	274	2,241
ALASKA	291	14	64	619
ARIZONA	2,131	75	370	0
ARKANSAS	1,040	14	169	0
CALIFORNIA	19,034	164	1,535	0
COLORADO	879	64	368	0
CONNECTICUT	2,041	45	101	0
DELAWARE	387	44	8	0
DISTRICT OF COLUMBIA	208	9	23	57
FLORIDA	5,915	60	542	0
GEORGIA	3,956	17	459	1,646
HAWAII	618	4	72	1,086