The History of Autism: From Pathology to Pride

Autism as a clinical category is less than 100 years old. In that relatively short time, the understanding of what autism is — and how to respond to it — has shifted dramatically. Understanding that history is important context for the debates happening right now about acceptance, treatment, and identity.

The early years: Kanner and Asperger

The word "autism" in its clinical sense was introduced in 1943 by Leo Kanner, an Austrian-American psychiatrist at Johns Hopkins. Kanner described a group of children with what he called "autistic disturbances of affective contact" — children who seemed to withdraw into themselves, had unusual relationships with objects, and often had echolalia (repeating words or phrases).

Around the same time, Austrian pediatrician Hans Asperger was describing a similar but distinct group in Vienna. Asperger's work, published in 1944, described children who were highly intelligent but had significant social difficulties — what would later come to be called Asperger syndrome.

Both were working from a deficit model, but both also recognized strengths in the children they were studying. Asperger famously wrote that "a dash of autism" was likely necessary for achievement in certain fields.

The refrigerator mother era

In the 1950s and 1960s, the dominant theory about the cause of autism was psychogenic — the idea that autism was caused by cold, distant mothering. Bruno Bettelheim, a psychologist at the University of Chicago, was the primary proponent of what came to be called the "refrigerator mother" theory.

This theory was not only wrong — it was devastating. Mothers of autistic children were blamed for causing their children's autism through emotional neglect. Many children were institutionalized on the theory that removing them from their mothers would allow them to recover.

This era is a reminder of how much harm can be done by confident clinical theories that have not been rigorously tested — and by a system that would rather blame parents than ask harder questions about the brain.

The behavioral era

Beginning in the 1960s, behavioral approaches — particularly those of Ole Ivar Lovaas at UCLA — became dominant. Lovaas developed intensive behavioral therapy for autistic children, using reinforcement to teach desired behaviors. Early versions of this approach used aversive conditioning, including electric shocks, which were eventually abandoned.

The Lovaas approach became the basis for Applied Behavior Analysis (ABA), which remains the most widely covered autism intervention in the United States.

The rise of the autistic self-advocacy movement

In the 1990s, autistic people began organizing to speak for themselves. Online communities allowed autistic people to connect across geography and recognize shared experiences. In 1996, Jim Sinclair published "Don't Mourn for Us," a landmark essay addressed to autism parents that articulated what autistic people needed from the world — not a cure, but acceptance.

The Autistic Self Advocacy Network was founded in 2006 by Ari Ne'eman. The neurodiversity movement — the framework that autism is a natural human variation rather than a disease — grew out of this community.

Where we are now

The diagnostic category has expanded significantly. The DSM-5 (2013) consolidated the previous separate diagnoses — autistic disorder, Asperger syndrome, PDD-NOS — into a single "autism spectrum disorder." This has increased the diagnosed population significantly and brought more families into the conversation.

The advocacy landscape is contested. Organizations like Autism Speaks — historically the most funded autism nonprofit in the US — have faced significant criticism from the autistic community for funding cure research without meaningful autistic leadership. Organizations like ASAN represent the acceptance framework.

Understanding this history is not academic. It shapes the choices available to families right now — the therapies being offered, the organizations being funded, the way autism is talked about in schools and media and policy.

WeBearish exists in that history. And it exists because that history shows that the people closest to autism — autistic people and their families — have consistently had to fight to be heard.