Academic journal article American Annals of the Deaf

Deafness and Autistic Spectrum Disorders

Academic journal article American Annals of the Deaf

Deafness and Autistic Spectrum Disorders

Article excerpt

An orientation to autistic spectrum disorders (ASD), also known as autism, is provided, and the specific syndrome of autism and deafness is addressed. The two conditions have in common a major problem: communication. Case histories are provided, the development of treatment for autism is discussed, and the separate disorders that make up ASD are defined. Important medical conditions often present in ASD are named, and their roles in treatment and diagnosis are described. Because autism is generally regarded as increasing in prevalence, some say to epidemic proportions, there is an increase in children who are both deaf and autistic. The resulting pressure on day and residential school programs for the Deaf to accept and educate these difficult, multiply disabled children is increasing. The parents of autistic children are a sophisticated, politically active group who are demanding services through legal and legislative means, among others.

Most readers of the American Annals of the Deaf are relatively unfamiliar with autism but know a lot about deafness. For that reason, the primary intent of the present article is, first, to orient readers to autism, and second, to address the specific syndrome of autism and deafness.

Both conditions have one major problem in common, that of communication. However, the cause of the difficulty in an individual who is just deaf is different from that in an individual who is autistic. Thus, for persons who are both deaf and autistic, there is a double reason for difficulty with communication. In addition, the tasks of both diagnosis and treatment become far more complex (Steinberg, 2008; Szymanski & Brice, 2008).

Discovery of Autism and Early Treatment

In contrast to deafness, which has been recognized throughout human history, autism was not discovered until 1943. Leo Kanner (1943), a child psychologist, used keen powers of observation to detect and describe the symptoms of the condition he named autism. Prior to his discovery, autism was usually misdiagnosed as childhood schizophrenia, mental retardation, organic brain syndrome, or some other disorder.

Kanner based his discovery on his work with 11 children he was treating. He noticed that they behaved similarly to each other but distinctly differently from the many other patients he had seen in his years of practice. Although there have been some changes in the wording of the criteria he set forth over 60 years ago (see Table 1), they remain conceptually valid today, especially for Asperger disorder and other conditions characterized by higher levels of functioning than are often found with autism.

The next milestone in the history of autism came with the 1967 publication of Bruno Bettelheim's book The Empty Fortress. Originally from Vienna, Bettelheim stated that he earned his doctorate in psychology following his release from a German concentration camp. He also indicated that he had been trained by Sigmund Freud (Jepson & Johnson, 2007).

On the basis of these alleged credentials, his obvious skills as a writer, and his impressive demeanor, Bettelheim was appointed to the faculty of the University of Chicago and made director of the Orthogenic School, an institution affiliated with the university that specialized in the treatment of autistic children and their parents (Jepson & Johnson, 2007).

Bettelheim's approach to treatment was to separate autistic children from their parents, whom he described as cold, unfeeling individuals who had forced their sons and daughters into mental isolation (Sicile-Kira, 2004). While their children were in his residential school, the "refrigerator parents," as he described them, were required to go into psychoanalytic therapy to cure their alleged psychopathology.

Bettelheim's basic theoretical concepts about the cause of autism and its treatment were widely accepted and implemented in the United States and elsewhere for the next two decades or more. …

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