В. A. Gilyarovsky spoke of autism as “a peculiar disorder of the consciousness of the self and the whole personality with a violation of normal attitudes to the environment”, stressing that such patients are withdrawn and alienated from everything else.
The beginning of a systematic approach to the study of autism in children is commonly attributed to the 1930s and 1940s, When autistic conditions were described in the clinic of childhood schizophrenia, psychoses, disorders having as their basis organic lesions or underdevelopment of the central nervous system ( M.O. Gurevich, 1925, 1927, G.E. Sukhareva 1925, T.P. Simson 1929, N.I. Ozeretsky 1938, etc.)[ ] In the 40’s autism was considered and described as a special clinical syndrome with a characteristic disorder of mental development, the main feature of which is mental loneliness that ignores everything that occurs from the outside. ( L. Kanner, Asperger, S. S. Mnuhin).
Л. Kanner singled out autism as a separate problem, as a disorder of affective communication, designating this phenomenon as “infantile autism,” appearing already in early childhood. This is how the term “early childhood autism” (ECD), also referred to as “Kanner syndrome”, came about. Л. Kanner singled out the most characteristic features of the clinical picture of early childhood autism, such as “extreme autistic loneliness” and the social development disorders associated with it: Inability to tune into appropriate behavior, delayed or deviated speech development, with echolalia and misuse of pronouns, monotonous repetition of noise or words, excellent mechanical memory, limited range of spontaneous activity, steriotypy desire to keep everything unchanged, fear of change and incompleteness, development of rituals, appearance of strange activities, strongly focused, intense hobbies and fixations, and pathological relationships with other people, preference for communication with inanimate objects. L. Kanner viewed autism as a mental disorder reflecting improper parenting, alienation of the child by the “cold” mother, describing autistic manifestations as defensive in nature.
Independently of L. Kanner, the Austrian pediatrician H. Asperger described a condition he called autistic psychopathy. He noted unusually early “unnatural” speech development (often even before walking), peculiar use of language, unusual intonation of speech, word-making, inability to create full-fledged visual contact. He pointed out poverty of facial expressions and gestures, motor clumsiness, disharmonious, angular movements, lack of formation of the simplest social skills, impulsiveness of children, without taking into account the requirements of the environment. In games and hobbies such children reflect steriotized, habitual actions. Speaking of the nature of autism, H. Asperger pointed to a biological defect of affective contact (in the prenatal or natal period) and also concluded that autistic psychopathy is hereditary. Prognostically, Asperger’s syndrome is regarded as a more benign “variant” of autism compared to Kanner’s syndrome. Asperger’s syndrome is often referred to as “high-functioning autism.
In our country, independently of L. Kanner and H. Asperger, autism syndrome was described by S. S. Mnuhin, who emphasized the organic nature of the disorder.
Currently, most authors believe that autism is a consequence of a special pathology based on central nervous system insufficiency. A number of hypotheses about the nature of this insufficiency and its possible localization have been put forward, and intensive research is being conducted to test them, but no unequivocal answers are yet available. It is only known that autistic children show signs of brain dysfunction more often than usual, and they often have disorders of biochemical metabolism. The deficits can be caused by a wide range of reasons: genetics, chromosomal abnormalities, congenital metabolic disorders, pregnancy and childbirth pathology, consequences of neuroinfections, early schizophrenic process. Thus, experts (H. Asperger, T. Peters, S. S. Mnuhin, K. S. Lebedinskaya) point out the polyetiology (multiplicity of causes) of early childhood autism syndrome, and its polynosology (manifestation within different pathologies).