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Tuesday, May 03, 2005
By DAN OLMSTED
Washington, DC, May. 2 (UPI)
-- There was something similarly strange about the children who caught Leo
Kanner's attention starting in 1938. He called their behavior "autistic."
There also was something strangely similar about the families they came from.
"There is one other very interesting common denominator in the backgrounds of
these children. They all come of highly intelligent families," child
psychiatrist Kanner wrote at the end of his historic study of 11 children,
published in 1943.
He ticked off the fathers' occupations: four psychiatrists, one "brilliant
lawyer," one chemist and law school graduate, one plant pathologist, one
professor of forestry, one ad copywriter with a law degree, one mining engineer
and one businessman.
"All but three of the families," Kanner wrote, "are represented either in 'Who's
Who in America' or in 'American Men of Science,' or both."
Among the first 100 cases Kanner saw, he reported they "almost invariably came
from intelligent and sophisticated stock." Of the 100 fathers, 96 were high
school grads and, of those, 74 were college grads -- almost twice today's
percentage. They included:
--31 businessmen
--12 engineers
--11 physicians
--10 lawyers
--8 tradesmen
--5 chemists
--5 military officers
--3 with a Ph.D. in science
--2 with a Ph.D. in the humanities.
Why this amazing "intellect effect" in the parents of children whose only common
traits were language delay and deficit, "extreme aloneness" and "a desire for
the preservation of sameness?" Kanner said those traits were present from birth:
"These children had never been there."
The topic is not much discussed these days, as researchers hunt genetic causes
and debate whether autism rose tenfold during the 1990s. Yet, the effect was so
striking -- and, it turns out, so short-lived -- that surely it is a clue to the
roots and rise of autism, the subject of this ongoing series.
"It is not easy to evaluate the fact that all of our patients have come of
highly intelligent parents," Kanner acknowledged.
Theories:
--Brilliant people (read: brainiacs who were a little weird to start with) hook
up with other brilliant people and produce autistic (read: very weird) children.
Verdict: unproven, unable to explain more than a fraction of children now
affected.
--So-called refrigerator moms and dads, who obsess over their careers and their
academic abstractions, coldly ignoring their child's development. Verdict: a
damaging and discredited idea.
--Parents with the most education and money were most likely to bring their
children to a specialist like Kanner. Verdict: plausible.
--Autism started in this stratum of society. Verdict: plausible.
Let's discuss the two open verdicts.
Four of those first 11 fathers were psychiatrists, likely to realize early on
that something was clinically wrong with their children -- and likely to know
about Kanner, a renowned psychiatrist at The Johns Hopkins University in
Baltimore.
Interesting, though, one of the first autistic children appears to have been
identified, not by her psychiatrist father, but by a doctor at the institution
where she lived. Kanner disapprovingly remarked she had been "dumped in a state
school for the feebleminded." This suggests, counter-intuitively, her father's
medical career might be a risk factor for autism, not the reason she was
referred to Kanner.
Regardless, the whole approach feels dubious and has a whiff of paternalism --
only the really top-drawer crowd would notice their child had a bizarre problem
and get to the right doctor. It also is significant that Kanner, a brilliant
observer, did not dismiss the "intellect effect" that way, but continued to
puzzle over it.
Another correlation, less noticed, involves the mothers: nine of the first 10
also graduated from college, including a writer, a physician, a psychologist and
a history teacher.
The 1940 U.S. Census reported just 3.8 percent of all women over 25 had
completed four years of college. Yet, 90 percent of these mothers graduated from
college? That is at least as startling as the fathers' attainments.
Looked at this way, what really connects these first families, including the
husbands and wives, is more precise and less bizarre than an "intellect effect."
It is a college education, particularly the remarkable fact of the women's
degrees.
This education effect does a better job of reconciling Kanner's view -- that
autism was "very rare" and differed "markedly and uniquely from anything
reported so far" -- with the much higher current autism rate of 30 to 40
children out of every 10,000. It does so by defining the parents of these early
autistic children by what they did (going to college) instead of who they were (brainiacs).
It does, however, raise an unpleasant prospect: Some outside factor, unique to
that remarkably homogenous group at that time, could have triggered autism in
their children -- and then spread.
There are some early signs of exactly that spread: The one pair of parents
without college educations constitute the 11th of Kanner's original 11 families.
Their son, Charles, was born in 1938; the other 10 children were born earlier in
the decade. Kanner described the father as "a high school graduate and a
clothing merchant ... a self-made, gentle, calm and placid person." His mother,
whose education also stopped with high school, "has a successful business
record, theatrical booking office in New York, (and is) of remarkable
equanimity." (Say good night, weirdo-brainiac-refrigerator-mom theories.)
Look again at the list above of Kanner's 100 fathers, a list that incorporates
the super-educated dads from the original study. Starting with Charles' parents,
college and whatever it might imply no longer was the common thread.
Ten out of 10 of the original fathers were college graduates, followed by 64 of
the next 90 -- still impressive, but a much lower percentage, no longer
connecting all the families. Four did not even graduate from high school and
eight were described as tradesmen.
There was not one businessman among the first 10 fathers, but there were 31 in
the next 90. There were four physicians in the first 10, but just seven more in
the next 90.
Demographics are always tricky to decipher, and it is easy to make too much of
too little, but at some point all sorts of families began having autistic kids,
and that ominous pattern may well be visible in the first 100 cases.
What were the conceivable risk factors for autism among the college-educated men
and women of the 1920s and early 1930s and did they spread? We will pursue that
in future columns.
--
Next: Clues from Kanner's kids.
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