Leo Kanner's attitude towards mothers

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Maybe he was one of those people who said what he thought would be a popular position with his colleagues at any particular time, blew this way and that like a leaf in the wind.

the 'refrigerator mother' diagnosis condemned thousands of autistic children to questionable therapies,

I would like to see it.

Kanner appreciated the need for biomarkers from the beginning. He noted a tendency toward autistic behaviors in some families and described autism as an ‘innateʼ disorder. He foresaw the need for research into the genetics of autism at about the same time that DNA was first identified as the bearer of genetic information. Today, genetics offers the best hope for discovery of relevant biomarkers.

It took courage to offer a hypothesis of innate determinants in 1943. The prevailing view of the day, based on Freudian psychology, had been that autism was due to poor parenting, with much of the blame placed on ‘frigidʼ mothers accused of rejecting their children.

In 1969, at a Washington D.C. meeting for the National Society for Autistic Children, Kanner gave a speech where he stated that he acquitted the parents and insisted that the condition of autism was innate.

Leo Kanner's changing views

According to the book In a Different Key: The Story of Autism (2016), Leo Kanner's original 1943 paper stated that "the child's aloneness" was evident "from the very beginning of life." Furthermore, he drew a contrast between autism and schizophrenia, in that autism was part of a child's constitution whereas schizophrenia developed later in life.[18]

This first paper drew only a handful of citations in the medical literature. The condition he described was not talked about by a single newspaper on magazine article. In addition, clinicians in other parts of the world were not confirming what Kanner had seen, so through approximately 1950, virtually all cases of autism were diagnosed by Kanner himself.[18]

Kanner engaged in lengthy conversation by mail with Louise Despert, who was a New York psychiatrist he held in high esteem. Kanner defended his theories whereas Despert maintained that he had not observed anything other than child schizophrenia. When Kanner next revised his textbook, he moved autism to the schizophrenia category although he place it in a subheading.[18]

In a 2016 paper entitled "Correcting the Record: Leo Kanner and Autism," Drs. James Harris and Joseph Piven maintains that Kanner did not go through a middle period in which he blamed parents. Instead, Kanner was describing characteristics of the parents which would later be viewed as part of the broader autism phenotype. For example, in a 1956 paper Kanner and a co-author wrote, "If one considers the personalities of the parents who have been described as successfully autistic, the possibility suggests itself that they may represent milder manifestations and that the children show the full emergence of the latent structure." In addition, the early 1940s was still a period when eugenics was held in respect, and in the United States, sterilization of people with intellectual disability was legal. Furthermore, this was a period in which psychoanalysis with its emphasis on early life experiences was the dominant view among the clinical and scientific establishment. In addition, if autism was in fact caused by negative parenting, that would seem to offer more hope for treatment of the child and/or family.[19]

In 1949 Kanner published his third major paper on autism. According to In a Different Key, he began to blame cold mothering. Whereas previously he had positive things to say about Donald Triplett's mother Mary, now he painted a picture in which Mary appeared "cold." And he portrayed parents in general as being at least partially to blame for the autistic characteristics of their children.[18]

Blaming parents, and in particular blaming mothers, seemed to resonate with broader society. For example, after Kanner blamed mothers, Time magazine wanted to write about autism. Kanner viewed 1951 as a turning point for the wider understanding of autism. Within ten years, some fifty-two articles and one book had been published by a variety of thinkers and clinicians. And autism began to be diagnosed overseas, first in Holland and then elsewhere.[18]

In the hardcover version of In a Different Key (2016), authors Donvan and Zucker state "Kanner, instead of sticking by his initial conviction about autism being inborn, had flinched." The authors further state that "the refrigerator-mother myth was set loose upon the world for many years to come."[20]

In a 1969 speech at a U.S. convention for parents with children on the autism spectrum, Kanner said, "Herewith, I officially acquit you people as parents." However, in the 1979 edition of his textbook Child Psychiatry, he states that childhood schizophrenia (a phrase often used for autism until the 1970s) was more closed correlated with parental attitudes than with a person's genetic background.[21][22]

Psychiatrist Leo Kanner used to stand up for parents. He championed them against the experts, said that it was unfair to blame the mother or father every time something went wrong with the child. Last week he told the American Ortho-psychiatric* Association in Manhattan about no parents whom he could not defend. He had examined their offspring at the children's psychiatric clinic which he heads at Johns Hopkins.

The children looked all right: Dr. Kanner called them "well-formed, well-developed, rather slender, and attractive." Many were bright, too. A two-year-old boy could identify all the pictures in Compton's Encyclopedia; a three-year-old boy could name all the Presidents and Vice Presidents of the U.S., recite 37 nursery rhymes, rattle off 25 questions & answers in the Presbyterian catechism.

Diaper-Age Schizoids. But there was something wrong with all of them: they were apathetic, withdrawn, happiest when left alone. They shrank from anything that disturbed their isolation: noises, moving objects, people, often even food. They had what Dr. Kanner calls "early infantile autism"; it is, he thinks, a diaper-age form of the mental disease called schizophrenia (split personality), which may develop before a child is a year old. How did they get that way? Dr. Kanner took a hard look at their parents.

At first glance, the parents, too, seemed fine; they were just the kind of people who, birth-controllers say, ought to have more children. Except in one case, there was no known insanity in their families. The fathers were scientists, college professors, artists, clergymen, business executives, psychologists, psychiatrists. All but five of the mothers had gone to college; all but one had been active, before or after marriage, as scientists, laboratory technicians, physicians, nurses, librarians, artists.

Cold Perfectionists. But there was something wrong with all of them. They showed a "mechanization of human relationships," described themselves and their spouses as undemonstrative. There was, Dr. Kanner found, "no glamor of romance in premarital courtship, no impetuousness in postnuptial mating." He saw only one mother hug her child warmly and bring her face close to his; many of the busy fathers hardly knew their children.

The parents wanted to do the right thing by them; but their idea of the right thing was "the mechanized service of the kind which is rendered by an over-conscientious gasoline station attendant." The children, says Dr. Kanner, were "kept neatly in a refrigerator which didn't defrost."

Were the cold parents freezing their children into schizophrenia? Dr. Kanner did not say yes or no; but he has found no case of infantile autism among children of "unsophisticated" parents. Said he of his pathetic patients: "Their withdrawal seems to be an act of turning away . . . to seek comfort in solitude."