Autism Spectrum Disorders: 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, Nerv Child 2:217–250, 1943). In his description of these 11 children, Kanner noted that despite limited interest in the social world, they were highly engaged with 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 seemingly adequate cognitive and verbal skills, a condition he called autistischen psychopathen im kindesalter, which translates in English to “autistic personality disorders in childhood” (Asperger, Archive fur psychiatrie und Nervenkrankheiten 117:76–136, 1944). Asperger was apparently unaware of Kanner’s classic description of autism, 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.