The concept of autism as we understand it today began to take shape in the early 20th century.
The term “autism” actually predates modern diagnostic criteria by several decades.
It was first coined in 1911 by Swiss psychiatrist Eugen Bleuler, who used “autismus” to describe a symptom of schizophrenia: extreme self-isolation and detachment from reality (Bleuler, 1911).
“Aut” is the prefix for self, as in autopilot, automobile, automatic.
So essentially, autism means a state of condition that centers on the self of an individual.
But in the early 20th century, autism was not considered its own condition.
Rather, it was one of several behaviors seen in patients with severe mental illness.
The idea that it could be a distinct developmental disorder hadn’t even yet taken hold.
Early Misunderstandings in Mental Health
Throughout the 1920s and 1930s, children who displayed characteristics we now associate with autism — such as difficulties with social interaction, delayed language and repetitive behaviors (stimming, e.g., finger flicking) — were often misdiagnosed.
Many were labeled with childhood schizophrenia, intellectual disability (back then known as “mental retardation”) or even as “feebleminded.”
The lack of clear diagnostic boundaries meant that autism was largely misunderstood.
Some kids were institutionalized, while others were subjected to treatments aimed at correcting what was seen as emotional disturbance or psychosis.
Psychosis means a detachment from reality; an example is a delusion that one is being followed by the CIA. Hallucinations often come with a disorder of psychosis.
Grunya Sukhareva’s Overlooked Contribution
One of the earliest and most accurate descriptions of what we now call autism came from Russian psychiatrist Dr. Grunya Sukhareva in 1926.
In her paper, she described a group of boys who had difficulty with social integration, were highly focused on specific interests and used language in unusual ways.
Her work, published in Russian and later in German, went largely unnoticed in the West until it was rediscovered decades later (Chown, 2012).
Looking Ahead
While these early efforts laid some groundwork, autism would not be formally recognized as a distinct condition until the 1940s.
The diagnostic picture remained blurred, and kids who were, as we say to day “on the spectrum,” were often mischaracterized or mistreated due to the limited understanding of their needs.
Next: Part 2 in this 10-part series: Dr. Leo Kanner’s 1943 Paper Defines Infantile Autism
