Several Disorders on a Continuum or One?

In 1943, Leo Kanner described 11 children as having come into the world without the usual disposition to make social contact, a condition he called early infantile autism (Kanner, Nervous Child 2:217–250, 1943). In his description of these 11 children, Kanner noted that despite their limited interest in the social world, they were highly engaged with the nonsocial aspects of the environment and had difficulties with change. In 1944, Hans Asperger, an Austrian pediatrician, described four children who had difficulty integrating socially into groups despite having seemingly adequate cognitive and verbal skills, a condition he called autistischen psychopathen im kindesalter, which translates to “autistic personality disorders in childhood” (Asperger, Arch Psychiatr Nervenkr 117:76–136, 1944). Asperger was apparently unaware of Kanner’s classic description of autism, and, thus, the focus both authors made on the marked social dysfunction is remarkable and speaks to the centrality of social deficits as the defining feature of these disorders.