EARLY INFANTILE AUTISM

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A psychotic disorder of infancy characterized by stereotyped behavior and a total lack of response or relationship to other people.The condition, which is considered the most severe mental disorder of childhood, occurs more frequently in boys than in girls, and usually becomes apparent before the end of the first year (Kanner, 1944). These children cannot form emotional ties of any kind and develop an “impenetrable aloneness.” The mothers consistently report that they cannot reach their baby: “He neverThe minute she could walk, she ran away from me,” “She never liked to be cuddled and kissed,” “He never cried or even noticed when I left the room smiled at me,” “The minute she could walk, she ran away from me,” “She never liked to be cuddled and kissed,” “He never cried or even noticed when I left the room.”The behavior patterns of these children indicate that they are enclosing themselves in a restricted world of their own. Hour after hour they play with the same toy, go through the same motions, repeat the same phrases, use strange metaphorical expressions, or appear to talk irrelevantly and nonsensically if they talk at all. They become addicted to such activities as twirling, jumping, hand-clapping, turning light switches on and off, and cannot tolerate any change in daily routine, furniture arrangement or other surroundings. In this way they limit reality to something they can manage, for the ordinary world of sensory impressions and particularly of people is apparently too complex and threatening for them to cope with. They are contented only when they are left alone.The behavior patterns of these children indicate that they are enclosing themselves in a restricted world of their own Hour after hour they play with the same toy, go through the same motions, repeat the same phrases, use strange metaphorical expressions , or appear to talk irrelevantly and nonsensically if they talk at all. They become addicted to such activities as twirling, jumping, hand-clapping, turning light switches on and off, and cannot tolerate any change in daily routine, furniture arrangement or other surroundings. In this way they limit reality to something they can manage, for the ordinary world of sensory impressions and particularly of people is apparently too complex and threatening for them to cope with. They are contented only when they are left alone.The psychoanalytic explanation of these behavior patterns is that these children have failed to establish a bridgehead to reality through their mother’s love and the normal sensory experiences of babyhood. They have also failed to go through the regular sequence of psychosexual development (oral to anal satisfaction) which helps children develop a feeling for their own bodies. Instead, they adopt “autoaggres- sive” activities, such as biting themselves or knocking their heads, in an attempt to become aware of themselves and develop a sense of identity. Interestingly, they may refer to themselves as “you” and to another person as “I.” Their confusion about their own ego leads them to relate to things but not to people.Because of their limited responsiveness and stereotyped behavior, autistic children are sometimes thought to bementally retarded. Usually, however, they are found to have average or superior intellectual capacity, and their facial expressions are generally intelligent though serious. More often than not, they come from superior homes, but in many cases the parents are preoccupied with their own interests and treat the child in a cold mechanical fashion: the “Frigidaire atmosphere.” On the other hand, it must be recognized that many autistic children have warm, accepting parents, and that their other children may be quite normal. For this reason, researchers have sought other explanations for this condition. Recently, Rimland (1964) has attributed it to a single, highly specific cognitive defect stemming from a neurological disorder. There is also the possibility that it may be, as Redlich and Freedman (1966) suggest, “A collection of different etiologically determined diseases having very similar symptomatological manifestations,” for “to date, researchers have implicated parental etiological factors, inborn constitutional factors, factors of brain damage, maturational lag, and factors of familial interaction.” In treating these children, the therapist encourages them to live through early stages of development, so that they may become aware of themselves and form an integrated ego. To enable them to relive the anal stage, for example, they are given clay and finger paint to play with and may even be permitted to soil. Though warm and permissive, the therapist shows them that they must not harm themselves or their surroundings. At the same time the children are lured out of their inner world through music and rhythmic activities, and are taught basic concepts of time and space which they missed because of their lack (1965) of communication with others. Follow-up studies show that between one third and one half of these children achieve a satisfactory social adjustment.Illustrative Case:The girl was first admitted to a child psychiatry ward of a general hospital at the age of nine years. Her history was one of lifelong developmental retardation and deviant behavior that, hitherto, had been attributed to mental subnormality. The parents reported that during the first year of life she had been quiet, passive, and unresponsive to the parents and older sister. She did not sit up by herself until the age of nine months and only started to crawl when she was fifteen months old. She was able to stand alone at eighteen months but did not walk by herself until she was thirty months old. At this time she was tested psychologically and obtained a Cattell Infant Intelligence Scale I.Q. of 58.When she was three years old the only words she spoke were “Mommie” and “Daddy,” but at the age of five she suddenly began speaking whole sentences. A Stanford-Binet test administered at the time showed her I.Q. to be 77. On this basis, she was still considered to be mentally subnormal and was placed in special classes in the public school system for several years. At the age of eight she obtained a Stanford-Binet I.Q. of 85 and her teachers became increasingly concerned about her complete preoccupation with self-directed activity and with her inability to participate in any group activities. When she was nine she was able to do the work in the basic first-level reader and workbook, despite inattentiveness during reading instruction. Her workbook exercises were sometimes completed accurately, and sometimes the page was decorated with scrolls, curves, pictures, or drawings of bugs. She appeared happiest when looking through books on or pictures of science, birds, animals, or insects. She had a remarkable memory for details which was demonstrated in a most unusual ability to cut out freehand any bird or animal in a matter of minutes.When she was admitted to the hospital, her two outstanding characteristics were selfisolation and an extreme need for sameness. Other deviant behavior that was observed or reported included: not talking aloud anywhere except in her home setting; refusing to exit through a door unless someone else opened it, and refusing to enter through a door unless she herself opened it; refusing baths because of a fear of water; fear of television, which had kept her parents from buying a set until recently; standing in one place and insisting that she was unable to move; negativism, which resulted in her doing the opposite of what was requested; responding to any physical contact with people by touching or hitting them; complete egocentricity or narcissism, with disregard for the feelings or wishes of others; interpreting any accidental hurt or discipline as a withdrawal of love; compulsive behavior, such as touching things or jumping olf the last step when descending stairs; obsessional preoccupation with the letter K (with which she replaced her middle name) and the number 8; restricted interest patterns involving animals, birds, flowers, masculinity, femininity and pregnancy; enuresis, habitual at night and occasional during the day.The patient was the second of four children; she had an older sister and two younger brothers. Her parents maintained that the pregnancy was planned and she was wanted, but it appeared that they might have preferred having had a boy and that the patient experienced some rejection following the birth of the older son. Psychological testing of the parents showed defensiveness but no gross personality disorder, and the only abnormal behavior identified in interviews with them was their excessive compliance with the patient’s demands and their inability to set limits or reward her for more normal behavior.In the hospital her deviant behavior was discouraged by ignoring it, whenever possible; every slight manifestation of social participation was reinforced and rewarded with increased attention and other means. For example, she was given second helpings of food at mealtimes only when she asked for them out loud; within three months she was talking out loud most of the time. Gradually, she learned that human relationships could be satisfying but could not always be obtained on her own terms.About four months after admission she obtained a Stanford-Binet I.Q. of 95, and a few weeks later obtained a full scale I.Q. of 116 on the Wechsler Intelligence Scale for Children (verbal score 104 and performance scale 127). She was now ready to participate far more fully in school classes held in the hospital, and worked at a grade-three level After a little more than eight months in the hospital she was discharged to her parents but continued to attend a special class in public school for the remainder of the academic year. She and her mother also continued to see a child pyschiatrist at approximately monthly intervals. During the next two years both academic performance and social participation improved. She remained at a disadvantage in her relations with other children, however, as they were inclined to tease her and ridicule her behavior. Continuing difficulties were anticipated for her during adolescence and adult life. (Rosen and Gregory, 1965)

Cite this page: N., Sam M.S., "EARLY INFANTILE AUTISM," in PsychologyDictionary.org, November 28, 2018, https://psychologydictionary.org/early-infantile-autism/ (accessed December 5, 2021).

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