Autism in Childhood - Seven

Autistic Psychopathy in Childhood, ex Die ‘Autistischen Psychopathen’ im Kindersalter. Asperger, H. (1944) Archiv für Psychiatrie und Nervenkrankheiten, 117, 76-136.Translated and annotated by Uta Frith. From “Autism and Asperger syndrome” Edited by Uta Frith. ISBN-10: 052138608X

©1991 Cambridge University Press.

Part Seven

Autistic Intelligence

The skills that a child acquires grow out of a tension between two opposite poles; one is spontaneous production, the other imitation of adult knowledge and skills. They have to balance each other if the achievement is to be of value. When original ideas are lacking achievement is an empty shell; what has been learnt is merely a superficial and mechanical copy.

Autistic intelligence is characterised by precisely the opposite of this problem. Autistic children are able to produce original ideas, Indeed, they can only be original, and mechanical learning is hard for them. They are simply not set to assimilate and learn an adult’s knowledge. Just as, in general, somebody‘s good and bad sides are inextricably linked, so the special abilities and disabilities of autistic people are interwoven.

This becomes clearer when we look at the language production of autistic children. They, and especially the intellectually gifted among them, undoubtedly have a special creative attitude towards language. They are able to express their own original experience in a linguistically original form. This is seen in the choice of unusual words which one would suppose to be total outside the s here of these children.

It is also seen in newly formed or partially restructured expressions which can often be particularly accurate and perspicacious, but also, of course, often quite abstruse. [47]

It is worth mentioning here that all young children have a spontaneous way with words and can produce novel but particularly apt expressions. This is what makes for the charm of child language, Beyond the toddler age, in our experience at least, such spontaneously formed expressions are found only in autistic children. As an example, we can mention a six- to seven-year-old autistic boy who defined the difference between stairs and ladders as ‘The ladder goes up pointedly and the stairs go up snakedly’. [48]

Especially rich in original language productions was an eleven-year-old autistic boy: ‘I can’t do this orally, only headily.’ [49] (He wanted to say that he had understood something but could not express it verbally.)‘My sleep today was long but thin.’ (This is also an example of autistic introspection.) ‘To an art-eye, these pictures might be nice, but I don’t like them.’ [50] ‘I don’t like the blinding sun, nor the dark, but best I like the mottled shadow.’ To the question whether he was religious: ‘l wouldn’t like to say I’m unreligious, but I just don’t have any proof of God.’ [51]

Behind the originality of language formulations stands the originality of experience. Autistic children have the ability to see things and events around them from a new point of view, which often shows surprising maturity. [52] The problems these children think about are usually far beyond the interests of other children of the same age. [53] A good example for this is our second case Harro L. Often a very narrow, circumscribed and isolated special area can show hypertrophic development.

We know an autistic child who has a particular interest in the natural sciences. His observations show an unusual eye for the essential. He orders his facts into a system and forms his own theories even if they are occasionally abstruse. Hardly any of this has he heard or read, and he always refers to his own experience.

There is also a child who is a ‘chemist’ He uses all his money for experiments which often horrify his family and even steals to fund them.

Some children have even more specialised interests, for instance, only experiments which create noise and smells. Another autistic boy was obsessed with poisons. He had a most unusual knowledge in this area and possessed a large collection of poisons, some quite naively concocted by himself. He came to us because he had stolen a substantial quantity of cyanide from the locked chemistry store at his school!

Another, again, was preoccupied by numbers. Complex calculations were naturally easy for him without being taught. We are reminded here of our First case, Fritz V., which, however, also shows us the possibility of failure. The same child who astounded others by solving complex maths problems had the most serious learning disabilities at school, and could not learn the simple calculation methods that were taught there.

Another autistic child had specialised technological interests and knew an incredible amount about complex machinery. He acquired this knowledge through constant questioning, which it was impossible to fend off, and also to a great degree through his own observations. He came to be preoccupied with fantastic inventions, such as spaceships and the like, and here one observes how remote from reality autistic interests often are. [54]

Another distinctive trait one finds in some autistic children is a rare maturity of taste in art. [55] Normal children have no time for more sophisticated art.Their taste is usually for the pretty picture, with kitschy rose pink and sky blue. The artfully stylised children’s books, so fashionable fifteen to twenty years ago, are therefore as unchildlike as possible. Fortunately, matters have now improved in this respect.

Autistic children, on the other hand, can have a surprisingly sophisticated understanding, being able to distinguish between art and kitsch with great confidence. They may have a special understanding of works of art which are difficult even for many adults, for instance Romanesque sculpture or paintings by Rembrandt.

Autistic individuals can judge accurately the events represented in the picture, as well as what lies behind them, including the character of the people represented and the mood that pervades a painting. Consider that many normal adults never reach this mature degree of art appreciation.

Related to this skill is the autistic person‘s ability to engage in a particular kind of introspection and to be a judge of character. [56] While the normal child lives unself-consciously and appropriately interacts with others as an integrated member of his community, these children observe themselves constantly.

They are an object of interest to themselves, and they direct their attention towards the functions of their body. Here is an example; a nine-year-old autistic boy suffered badly from homesickness [57] in the evening (homesickness always being worst at this time), saying: ‘If one lays one’s head on the bolster, then there is such a strange noise in the ear and one has to lie very quietly for a long time and that is nice.’

The same boy also described an occasional micropsy: ‘At school, I sometimes see that teacher has a tiny head, then l don’t know what it is; it is very unpleasant to me that I see this way. Then I press my eyes very hard [demonstrates how he does this], and then it gets better.’

These peculiarities lead us to a digression. As always, the miraculous automaticity of vegetative life is at its best when left unconscious. When attention is directed towards it we invariably find disturbances of these functions.

amburger has always emphasised that educators should never direct the child’s attention towards eating, sleeping or elimination, since this would only disturb these automatic functions. [58] With autistic children, however, their own bodily functions are in the forefront of their consciousness anyway. The functions are not only registered and taken seriously, but they are also often disturbed.

Especially frequent are eating and sleeping difficulties, which can lead to serious conflicts within the family.

Just as these children observe themselves to a high degree, so they also often have surprisingly accurate and mature observations about people in their environment. They know who means well with them and who does not, even when he feigns differently. They have a particular sensitivity for the abnormalities of other children, Indeed, abnormal as they themselves may be, they are almost over-sensitive in this respect.

Here we have to solve an apparent contradiction, which will, however, lead us directly on to a very important point. We want to demonstrate that the essential abnormality in autism is a disturbance of the lively relationship with the whole environment. We claim that this disturbance explains all peculiarities shown by autistic individuals.

Now, how can one reconcile this contact disturbance with the special clear-sightedness which is implicit in the examples just described? How can somebody with disturbed relationships experience so much so consciously? The contradiction is only apparent.

The normal child, especially the young one, who stands in a proper relation to the environment, instinctively swims with the tide. Conscious judgement does not come into this and in fact can occur only when one has some distance from the world of concrete objects.

Distance from the object is the prerequisite of abstraction of consciousness, and of concept formation. Increased personal distance which characterises autistic individuals and which is also at the heart of their disturbed instinctive affective reactions, is, in a sense, responsible for their good intellectual grasp of the world.

This is why we can speak of ‘psychopathic clarity of vision’ in these children, since it is seen only in them. This ability, which remains throughout life, can in favourable cases lead to exceptional achievements which others may never attain. Abstraction ability, for instance, is a prerequisite for scientific endeavour. Indeed, we find numerous autistic individuals among distinguished scientists, The contact disturbance which gives rise to a helplessness in the matters of practical life is typical of the absent-minded professor, and has made him immortal in jokes and cartoons. [59]

Unfortunately, in the majority of cases the positive aspects of autism do not outweigh the negative ones. We have mentioned repeatedly that autism occurs at different levels of ability. The range encompasses all levels of ability from the highly original genius, through the weird eccentric who lives in a world of his own and achieves very little, down to the most severe contact-disturbed, automaton-like mentally retarded individual.

Our third case, Ernst K., may give an idea of people in the middle group.A further example for this group is an eight-to-nine-year-old boy who, when asked ‘What is the difference between wood and glass?’, replied ‘The wood grows and gets a dirty skin, it attracts the dirt from the soil, and it gets so hard that it sticks to the tree and does not go away any more, This is how the soil fixes itself to the tree. If one drops glass, then it breaks even though it has been welded together, because the stickiness which is welded in lets go, and then it breaks’ Clearly this abstruse theory is weird rather than original!

From this middle group there is a smooth transition further along the range to those mentally retarded people who show highly stereotyped automaton-like behaviour. Sometimes they have crackpot interests which are of no practical use. They also include ‘calendar people`, who know the name of the saint for every clay of the year, or children who, long before they enter a special school, know all the tram lines of Vienna with their terminals, or children who show other feats of rote memory. [60]

So far, we have looked at the intelligence of autistic children from the point of view of their own spontaneous productions and their own interests. Now we shall turn to learning and schooling. Obeying only spontaneous impulses and never paying attention to social demands may well lead to originality but will also lead to learning failure. The truth of this statement is borne out in almost all our cases.

The very same children who can astonish their teachers with their advanced and clever answers fail miserably at their lessons. What they find difficult arc the mechanical aspects of learning which the least clever, even somewhat retarded, pupils find easy, in other words, reading, writing and arithmetic (multiplication tables!).

Sometimes, school subjects happen to coincide with the child's special interest. For instance, some of these children may learn to read particularly easily because they absorb all reading material from an unusually early age, say six or seven years (normally, children become bookworms around the age of ten). [61] ‘Savant’ calculators can certainly do well at school arithmetic, although there are some noticeable paradoxes here.

The obsession to go his own way in all circumstances and the exclusive use of his own self-invented procedures can prevent the child from assimilating the calculation methods the school wishes to instil. These children make life difficult for themselves. They are bound to make errors and to arrive at the wrong results. Examples are described in the first case (Fritz V.) and the second (Harro L.).

Another example is of an autistic boy who was just starting school, but could pose and solve the problem of how many seconds there are in two hours, However, when asked to work out 5 plus 6, he said, ‘I don’t like little sums, I‘d much rather do a thousand times a thousand’. After he had produced his ‘spontaneous‘ calculations for a while, we insisted that he solve the given problem.He then presented the following original, but awkward method: ‘Look, that’s how I work it out. 6 and 6 equals 12. and 5 and 6 is 1 less, therefore 11.’

This boy was also particularly prone to being distracted, that is, distracted from within. This type of distraction impairs the performance of many autistic children.

We regularly find a disturbance of active attention in autistic children. Here we are not, or not only, talking about the common-or-garden problems of concentration. These are problems that we find in many neurologically disordered children who are constantly distracted from work by external stimuli, especially restlessness or movement.

Autistic children on the other hand are, from the start, not interested in directing their attention to outside stimuli, in this case, what the school wants them to attend to. They follow their own ideas, which are mostly far removed from ordinary concerns, and do not like to be distracted from their thoughts. Nevertheless, autistic children can often be quite easily influenced from outside, in this as well as in other matters. [62]

It is little wonder, then, that most autistic children have severe learning difficulties, With the cleverest children, teachers may overlook the problems in mechanical learning. Usually, however, teachers despair at the tortuous efforts required of them and of the children themselves.

In many cases, there are also characteristic conflicts between teacher and parents. Parents are generally inclined to judge their children favourably, and if the child shows original and inventive ideas then they will often believe him to be particularly intelligent. Teachers tend rather to see the failure in the taught school subjects and give bad marks. This easily leads to conflict where both parties are to some extent right.

At this juncture, another point concerning the practice of intelligence testing needs to be made. Most intelligence tests, especially those devised by Binet and subsequent modifications, deliberately avoid testing school knowledge because this is thought to depend largely on exogenous factors. Instead, the tests exclude tasks where learning and environment play a role. Strictly speaking, this is, of course, impossible.

Now, the Binet test, especially at older age levels, involves above all logical, abstract thinking, Since this is what autistic children often find congenial, they may achieve a high score, which would give a false picture of their intelligence.

The difficulties of these children will, however, be revealed in tests involving learning, Here one can readily witness the particular kind of learning failure that has just been described.We therefore use learning tests to tell us not only about the scholastic knowledge of these children, but also about their methods, attention, concentration, distractibility and persistence. [63] Clearly there are influences of exogenous factors, for instance the possibility of teaching neglect, and one has to be aware of them. Of course, this is also true for IQ tests if their results are to be of real value. To mention just one example: the verbal fluency of socially advantaged children can often produce deceptively high test results.

Behaviour in the Social Group

It has been my aim to show that the fundamental disorder of autistic individuals is the limitation of their social relationships. The whole personality of these children is determined by this limitation. So far, we have looked at the children by themselves and seen how the disorder affects expressive functions and intellectual performance. However, the nature of these children is revealed most clearly in their behaviour towards other people.

Indeed, their behaviour in the social group is the clearest sign of their disorder and the source of conflicts from earliest childhood. These conflicts are especially pronounced in the smallest social uni that is, the family. The fact that schizophrenics too suffer their worst conflicts within the family provides a parallel example. The reason is simple: the family unit is based on the emotional bonds of the members to each other. The children in the family are influenced strongly by these feelings, by the interplay of feeling between parents and children. Neither the schizophrenic, with limited affect, nor the autistic individual knows what to do with these particular feelings. They face them with incomprehension and even rejection. Thus parents suffer deeply from the unfeeling behaviour of their children.

It is thus mainly within the family that ‘autistic acts of malice’ occur. These acts typically appear to be calculated. With uncanny certainty, the children manage to do whatever is the most unpleasant or hurtful in a particular situation. However, since their emotionality is poorly developed, they cannot sense how much they hurt others, either physically, as in the case of younger siblings, or mentally, as in the case of parents.[64] There can sometimes be distinctly sadistic acts. Delight in malice, which is rarely absent, provides almost the only occasion when the lost glance of these children appears to light up.

Similarly, there are negativistic reactions, as we saw in the case of Fritz V. [65] These can often be caused by failure and frustration in the practical matters of life. We have already discussed the gaucheness of autistic children and their need to learn by way of intellectual effort. They can learn only with the help of elaborate rules and laws and are unable to pick up all those things that other children acquire naturally in unconscious imitation of adults.

Parents find the learning problems particularly hard to understand. They expect compliance in the daily routines of washing, dressing and eating. Therefore it is precisely these situations which give rise to scenes and to the negativistic and malicious reactions.

Having just considered aggressive reactions within the social unit of the family, we have to take into account the isolation of the autistic child within the family. This isolation occurs when there are siblings, but it applies equally to only children, which autistic children usually are. ‘It is as if he were alone in the world’ is a common enough description. ‘He dwells among people as if a stranger’, ‘he seems to take no notice of what happens around him’.

Of course, one is sometimes surprised at how much is absorbed of what goes on despite the apparent lack of interest. The child sits preoccupied, perhaps apart in a corner, or even in the middle of a happy, noisy group of siblings or peers. He is like an alien, oblivious to the surrounding noise and movement, and inaccessible in his preoccupation. He is irritated only if someone breaks into his isolation.

The young autistic child is often engaged in stereotypic activity. Sometimes we find the simplest movement stereotypies, such as rhythmic rocking. Sometimes there is monotonous play with a shoelace which goes on for hours or with a particular toy, for instance, a whip or an old doll, which is treated almost like a fetish.

The children often enjoy rhythmical beating and hitting, and forming patterned rows with their toys, for instance, they sort toy bricks according to colour, form or size, or according to some other unfathomable rule rather than building with them. It is usually impossible to tear them away from, their play or their preoccupations.

A seven-year-old autistic boy showed severe eating problems because he never stopped looking at the little specks of fat that were swimming on the surface of his soup. They interested him excessively to look at, to move to and fro or to blow at. Seemingly, the changing forms were alive and meaningful to him. [66]

In everything these children follow their own impulses and interests regardless of the outside world. In the family one can largely adjust to these peculiarities in order to avoid conflict, and simply let these children go their own way. Only when it comes to the daily chores of getting up, getting dressed, washing and eating do we get characteristic clashes.

In school, however, the freedom to indulge in spontaneous impulses and interests is heavily curtailed. Now the child is expected to sit still, pay attention and answer questions. Autistic children can do none of these things, or do them only with great difficulty. Causes for open conflict are now multiplied.While parents can often cope with the oddities of small autistic children on their own, at school they are almost always referred to child guidance centres because they cannot be handled in the ordinary way.

In the first two cases we pointed out the learning and conduct problems in school that are due to autism. It was also mentioned that autistic children are often tormented and rejected by their classmates simply because they are different and stand out from the crowd. Their conduct, manner of speech and, not least, often grotesque demeanour cries out to be ridiculed. Children in general have a good eye for this and show great accuracy in their mocking of conspicuous character peculiarities.

Thus, in the playground or on the way to school one can often see an autistic child at the centre of a jeering horde of little urchins. The child himself may be hitting out in blind fury or crying helplessly. In either case he is defenceless. The situation can be so bad that the mother must accompany the child to protect him from this sort of cruelty.

The child may need a minder to the end of his school years and often beyond. [67] In favourable cases, however, it is possible for autistic children to earn respect, even if it is mixed with ridicule, either through sheer intellectual prowess or through particularly ruthless aggression.

Continue reading: Autism in Childhood - Part Eight

47 The original words and phrases produced by autistic children are more often than not characterised by a disregard for the listener's ability to comprehend their meaning, and particularly the reason for there use. Asperger tends to stress the originality and overlook the inappropriateness of idiosyncratic language.

48 ‘Die Leiter geht so spitz und die Stiege so schlangenringelich’

49 ‘Mündlich kann ich das nicht, aber köpflich.’

50 ‘Fur ein Kunstauge sind solche Bilder vielleicht schön, aber mir gefallen sie nicht.’

51 ‘Ich möcht nicht sagen dass ich unfromm bin, aber ich hab so klein Merkmal von Gott.’

52 An interesting example of a seven-and-a-half-year-old boy; quoted by Asperger in his 1952 textbook also serves to illustrate the capacity to make original observations and the ability to draw causal inferences that one can find in bright autistic children:

GLASS/MIRROR ‘A mirror is not much different, a sheet of glass that is painted with mercury on the back; it mirrors back the picture before the glass; why mercury is able to do this, l don’t know, perhaps because it is so dark. I have found out that you can't see yourself when there is something dark behind the glass. When there was light behind it, l have never been able to see myself. In our house we have a glass door; you can see yourself in it only when the light behind it is not switched on.’

Incidentally, this example shows the same mixture of personally remembered episodes and factual knowledge as is found in the answers given by Fritz and Harro.

53 Very often the interests of autistic children cannot he described as advanced; rather they are outside the interests of their normal peers. However, their reasoning with biological or physical concepts appears to be ahead of their reasoning with psychological concepts (Baron-Cohen, 1989) while the opposite is true of normal children. Often a very narrow, circumscribed and isolated special area can show hypertrophic development.

54 About ten years later, Asperger points out in his textbook (1952) that spaceships are no longer a fantastic invention. He jokingly suggests that the inventors might have been autistic.

55 The claim that autistic children have a special gift for art appreciation is very surprising. One can imagine, however, that bright autistic children may well give refreshingly unconventional responses to high art and literature.

56 Introspection and self-reflection usually refer to mental rather than physiological processes. Asperger’s examples all pertain to observations of physiological states. If the autistic child has difficulty in conceiving of mental stares, the biological concepts might well take on special prominence in such a child‘s life. The idea of personality that would follow from a biological theory would be quite different from that derived from a psychological one. From this viewpoint the claim that autistic children can read character in others is a most unlikely one. However, autistic children may unerringly know which person really loves them precisely because they tend to he behaviourists. They would ignore the person who merely talks sweetly but does not in fact help them.

57 Experience in boarding schools for autistic children over many years confirms that severe homesickness can occur but is not particularly common. Asperger later on suggests a reason for the type of homesickness he observed; the missing of daily routines. As highlighted by Kanner, great unhappiness can result from even apparently trivial changes in familiar habits.

58 Asperger pays homage here to his mentor at the University Paediatric Clinic where he was trained. Hamburger was the director at the tine this work was carried out and no doubt influenced it.

59 The image of the unworldly professor is indeed reminiscent of autism. Kanner too evokes this image when describing parents of autistic children: ‘Many of the fathers remind one of the popular conception of the absent-minded professor who is so engrossed in lofty abstractions that little room is left for the trifling details of everyday life.

60 Why special skills in autistic individuals so often involve feats of rote memory is as yet unexplained. The spontaneous predilection for calendar skills and transport is also an unsolved mystery. Through Asperger's observations we know that these odd interests were as conspicuous then as they are now.

61 Asperger himself is known to have read all of the works of Grillparzer, one of Austria's greatest playwrights, by the time he was nine.

62 Asperger's observations on disturbance of active attention in autistic children arc interesting and deserve to bee followed up by systematic investigation. An obvious question is whether links could he made from attention disorders to narrow preoccupations. Those autistic individuals with strong special interests might, for instance, also show a pronounced lack of distractibility.

63 Unfortunately, we are not given any examples of such learning tests. Innovative as the idea is, it is difficult to evaluate the evidence for Asperger’s claims of mechanical learning failure.

62 Asperger's observations on disturbance of active attention in autistic children arc interesting and deserve to bee followed up by systematic investigation. An obvious question is whether links could he made from attention disorders to narrow preoccupations. Those autistic individuals with strong special interests might, for instance, also show a pronounced lack of distractibility.

64 Again, we hear about a or malice; this time, however, Asperger suggests that the cause might he a poorly developed sense of how much another person may be hurt. This idea firs well with the hypothesis that autistic individuals usually tail re rake account or mental states. Further discussion of this topic see chapter 1 of “Autism and Asperger syndrome”. Edited by Uta Frith. ISBN-10: 052138608X.

65 Negativistic reactions include refusing to do what one is required to do or doing exactly the opposite

66 The appearance of rapt attention and deep absorption in their own preoccupation: may be partly responsible for the belief that autistic children have a rich inner imagination. However, there is little evidence to suggest that autistic children have the same sort of fantasy life as normally developing children.

67 A delightful example mentioned by Asperger at a later date (1952) was that of a boy who regularly dived into a watch-maker's shop, which was situated right next to the school gate, to escape his tormentors. The watchmaker got to like the boy and the two of them spent much time together discussing philosophical questions.