The history of autism is an evolution in understanding, transforming a psychological term into a distinct medical diagnosis. Before the condition was clinically recognized as a unique neurodevelopmental difference, its traits were often misattributed to other severe mental health conditions. The journey to the first formal diagnosis involved separating a specific pattern of behaviors from broader concepts of psychosis, a process that unfolded over decades of observation and clinical research.
Origin of the Term “Autism”
The word “autism” was first introduced into the scientific lexicon around 1911 by Swiss psychiatrist Eugen Bleuler. Bleuler coined the term, or autismus, while studying the symptoms of schizophrenia, a disorder he also named. He derived the word from the Greek root autos, meaning “self,” to describe a pathological inward turning or self-absorption.
Bleuler used “autism” to characterize a withdrawal into a fantasy-based inner world, resulting in a detachment from reality. This conceptualization described a symptom of psychosis in adults, not a standalone developmental condition in childhood. This initial use established a historical link between autism and schizophrenia that took decades of research to break.
The Landmark 1943 Diagnosis
The first clinical description of the condition as a distinct syndrome occurred with the work of Dr. Leo Kanner at Johns Hopkins Hospital. In 1943, Kanner published the groundbreaking paper “Autistic Disturbances of Affective Contact.” This publication is widely regarded as the moment a unique form of neurodevelopment was formally diagnosed and separated from other psychiatric labels.
Kanner’s paper detailed the case histories of 11 children he had observed since 1938. He described a unique constellation of behaviors, notably an “extreme aloneness” present from the beginning of life, an inability to relate to people, and a profound desire for “sameness.” The children exhibited repetitive movements and a meticulous fascination with objects, often displaying unusual memory for details but lacking the capacity for typical social conversation.
Kanner carefully distinguished this “early infantile autism” from childhood schizophrenia, emphasizing its early onset and innate quality. He noted the children’s difficulties with communication, including echolalia and referring to themselves in the third person. The publication established a new diagnostic entity based on observable, specific criteria, providing a clinical framework for recognition and study.
Parallel Discoveries and Early Recognition
Almost simultaneously, a similar but distinct set of observations was made by Austrian pediatrician Hans Asperger in Vienna. In 1944, Asperger published his doctoral thesis, “Autistic Psychopathy in Childhood.” He described boys who shared social and communicative difficulties with Kanner’s patients, yet often displayed sophisticated language skills and typical or superior intelligence. These children showed intense, narrow special interests and often presented with motor clumsiness.
Asperger’s work used the term “autistic” but described a phenotype initially considered separate due to the preservation of language. His findings remained largely unknown to the English-speaking world for decades, primarily because his work was published in German. In the 1980s, British psychiatrist Lorna Wing brought Asperger’s concepts to prominence, suggesting that Kanner’s and Asperger’s groups represented variations of a single, broader condition. This introduced the foundational idea of a spectrum, which eventually unified these separate descriptions.
Formal Integration into Diagnostic Manuals
Despite the foundational work of Kanner and Asperger in the 1940s, autism did not receive official recognition in major diagnostic manuals for nearly four decades. Clinicians often categorized it under broader diagnoses like childhood psychosis or schizophrenia. The condition was first formally recognized as a distinct developmental disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III), published in 1980.
The inclusion of “Infantile Autism” in the DSM-III was a significant turning point, providing standardized criteria that separated it definitively from schizophrenia. Subsequent revisions refined the criteria, with the DSM-IV in 1994 grouping autism with related conditions, including Asperger Syndrome, under Pervasive Developmental Disorders.
The concept of a unified spectrum was fully realized in the DSM-5, released in 2013, which consolidated all sub-diagnoses into a single category: Autism Spectrum Disorder (ASD). This change acknowledged the extensive overlap in symptoms and the wide range of severity among individuals. Parallel recognition has also occurred in the World Health Organization’s International Classification of Diseases (ICD).