Understanding Autism Treatment in the Early 20th Century

Autism has been treated and viewed very differently throughout history. In the early days of modern psychology, specifically up to 1914, the understanding and treatment of what we now call autism were vastly different from today's concepts.

Early Definitions and Misunderstandings

One reference book from the early 20th century defines the term "autism" as "morbid introspection," taken from the Greek word autos. During this period, the term was used to describe extreme social withdrawal, a symptom often associated with various psychiatric illnesses. While this description has some merit in a broad sense, it captures only a part of what is known about autism today.

The First Use of the Term

The first use of the term "autism" in professional literature was in 1911 by Swiss psychiatrist Eugen Bleuler. He used it to describe a cluster of symptoms that were often considered to be a form of schizophrenia. This classification is more understandable given that autism and schizophrenia share many negative symptoms, such as social withdrawal, disconnectedness, and emotional apathy. However, it would be another 70 years before autism was recognized as a distinct disorder in any diagnostic manual.

Late Recognition and Misclassification

The lack of a recognized classification for autism led to a significant gap in understanding and treatment. When researchers and clinicians began to study cases more seriously in the middle decades of the 20th century, their focus was primarily on children, characterized as having "developmental" disorders. Adults with similar traits were often labeled as "defectives," and it was largely too late to intervene meaningfully. Even today, the prevailing view is that early intervention is crucial, though much has changed since the early 20th century in how we treat autism.

Early Treatment Approaches

Before autism was fully understood, treatment approaches were often ineffective and sometimes even harmful. Early clinicians had little knowledge about how to address the core deficits in children with autism. Treatment methods varied widely from one doctor to another and often included practices that today would be considered traumatic.

Common Treatment Methods of the Time

Two of the most common treatments for the "symptom" of autism in the mentally ill, as they were bundled together at the time, included:

Behavior Modification

Behavior modification, or behavior therapy, aimed to shape and change behaviors of autistic individuals through positive reinforcement and other techniques. However, the methods used were often harsh and focused on suppressing symptoms rather than understanding the underlying causes.

Clinical Interventions

Clinical interventions included a variety of practices such as psychotherapy, which was often psychoanalytic in nature. These interventions were often conducted in institutional settings and typically involved long-term, intensive care that could be emotionally taxing for both the patient and the practitioner.

Conclusions and Reflections

The early 20th century saw very limited and often ineffective treatment options for individuals suspected of having autism. The term and concept of autism were only beginning to take shape, and much of the treatment reflected a lack of understanding and compassion. Today, we have more nuanced and effective approaches, but the historical context provides valuable insights into the evolution of our understanding and treatment of autism.