An International Survey of Mental Health
Professionals on the Etiology
of Infantile Autism
Victor D. Sanua, Ph.D.
My purpose in this paper is to examine the causes attributed to infantile autism by psychiatrists, psychologists, and other professionals in the United States and Europe.
There is an extensive literature of studies conducted in the Western world, as well as in developing countries (Erinosko and Ayonrinde, 1978); Gallagher, 1977; Graves, 1971; Jaeckel and Weiser, 1970; Leighton et al., 1963; Lemkau and Crocetti, 1962; Nunnally, 1961; Rogan et al., 1973; Townsend, 1975, 1978) on the opinions held by laymen as well as the mental health workers on the etiology of mental illness, and specifically schizophrenia, but no surveys on infantile autism have ever been conducted.
A distinction must be made here between infantile autism, as described by Kanner (1943, 1973), and childhood schizophrenia. The general view is that the illness starts so early in life that environmental factors can play only a minor role. However, during the past decade William James's notion that the baby is a "blooming, buzzing bundle of confusion" has been weakened by the studies of developmental psychologists and psychiatrists. Their research has discovered a high sensitivity in neonates soon after birth (Klaus and Kennell, 1982; Sanua, 1981b).
An intensive review of the literature revealed that there are eleven major etiological factors that could be implicated in infantile autism. To these eleven, I have added a twelfth one, the cultural factor (see Sanua, 1981a, b), which is scarcely mentioned in the literature.
Approximately 500 questionnaires were mailed to psychiatrists, psychologists, and other professionals (speech therapists, teachers, social workers) who were attached to institutions and treated autistic children or to professionals who had published within the last five years. The basic aim was to discover the relative importance that these professionals attached to the etiology of infantile autism. The questionnaire also included other items about infantile autism which have remained polemical until today, such as the socioeconomic status and the intelligence of the parents of these autistic children, whether the illness is