"Asperger's Children: The Origins of Autism in Nazi Vienna"

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It has taken me a while to digest Herwig Czech’s deeply upsetting information about Hans Asperger (Revealed: how Doctor Asperger aided the Nazi project, 19 April).

When, in 1991, I translated Asperger’s seminal 1944 paper on “Autistic psychopathy in childhood”, none of this was known. Neither Lorna Wing, the instigator of the translation, nor I believed he was part of the Nazi machinery of death. My translation, footnotes and description of Asperger in the introductory chapter were based on scant sources: the paper itself, a few media sources (eg an interview he gave in the 1970s) and an interview with his daughter. As a clinical psychologist and academic, I thought highly of his clinical descriptions, which largely highlighted the positive aspects of what has become known as Asperger syndrome.

It is very saddening that he appears to have been a willing accomplice in the Nazi euthanasia programme. It seems certain now that he effectively signed the death warrants of children with severe brain damage, while at the same time providing educational therapy for the children in his clinic.

The term Asperger syndrome is not in the most recent diagnostic systems, for scientific reasons, but it will be up to the autism community to decide whether it should remain in use.
Uta Frith
Emeritus professor of cognitive development, UCL Institute of Cognitive Neuroscience


• While researching autism’s history at Oxford, I became the first openly autistic postgraduate in the UK to win the Wellcome Trust’s PhD studentship. That Asperger helped Nazis euthanise disabled children, if true, is horrifying. But it should not obscure our memory. Throughout this period, American and British psychiatrists endorsed eugenicist ideologies and sometimes heinous acts. To list but a few examples: autism’s co-discoverer in America, Leo Kanner, supported sterilisation for the mentally disabled, while Foster Kennedy, chairman of the American Psychiatric Association, advocated a US euthanasia programme to be modelled upon the Nazis’. In England, Winston Churchill endorsed the Mental Deficiency Act 1913, mandating that all “imbeciles” be separated from society and involuntarily committed to labour camps, typically for the rest of their lives. Amid often awful squalor, many deteriorated and died.

Hitler’s rationale seems less distant from even modern political rhetoric than many imagine. Nazis spoke of “useless eaters”, those “hereditary defectives” certain to cost the government thousands of marks per year.

The real lesson of Czech’s study, it seems, is not that Asperger was a monster – even if he was – but that we must understand his ideological mistake if we are never to repeat it. Asperger associated autism with capacity for brilliance. But even when it isn’t, even when a disability entails no such thing, the life of the disabled person – their security, their freedom, their individual potential – becomes not a shred less valuable.
Sahil Singh Gujral

If what is said about the upcoming Edith Scheffer book above is true it will confirm fears I have had about this information being revealed going back to "In A Different Key". That this information is going to be a gift to those that think those of us in the milder/higher functioning/aspie end of the spectrum are not really autistic but frauds diverting attention from "real autism". I can envision causation equals correlation arguments like you were so wrong with identifying with Aspergers whatever you say about autism has no credibility, stop being a lazy bum and just try harder.

The above does not mean we should do the same thing and say because we disagree with her apparent agenda her findings are wrong. While those of who bought into Asperger as a heroic ally need to do soul searching does not mean we should stop advocating for other autism things we believe in.

The other thing about Frith which I consider misleading, (perhaps a deliberate move on her part) was her emphatic denial that HA could have been guilty of these horrors - sending AS children to their deaths (and worse, some were used as medical objects, they were flayed and their mutilated bodies used to illustrate medical books on anatomy, they were "killed for purpose") - oh no, Frith said, HA would never have done these things because he was a "good catholic man". Given her intelligence, I don't believe her whitewash was an innocent error. The Catholic church in Germany and in Italy colluded greatly with the Nazis to protect Nazis and what they were doing (and to help their escape after the war, on Vatican passports and via the "ratlines" that the Pope set up to assist their escape from justice).

Frith will say what advantages her, and I don't believe her primary motivation was ever the well being of AS people. Conversely, I think Lorna Wing did truly care and prioritised that well being. Her challenges to Kanner's ideas and ideology were definitely motivated by service to AS people, and she undid a lot of his mistakes, though she was pretty much a voice in the wilderness for a long time because of this. The AS professional community does not particularly like the priorities Wing chose, with the underlying themes of the humanisation of AS people.

At least no one ever put up a prominent statue to Hans Asperger, so we are spared the scene where they bring in the crane to drag another historical figure down from his pedestal. But essentially, that is what has just happened to Asperger, the Austrian pediatrician who lent his name to the syndrome that recognized autistic traits in verbally fluent individuals who demonstrate superior intelligence and creativity.

The new, novella-length study by the medical historian Herwig Czech answers many of the questions that have dogged Asperger for decades, except for one: why it took so long for the story to come out in full.

Two things have protected Asperger’s reputation up till now. The first was a geographical and language barrier. Asperger, who lived between 1906 and 1980, never published in English, and spent almost no part of his professional life outside of Austria. This mundane fact proved critical. Starting at the conclusion of World War I—when scientists from Belgium, France, and the United Kingdom shut out their German and Austrian peers from Western European conferences, journals, and the like—the German language began to lose its position as a lingua franca of science and research. English started to take over. Moreover, following World War II, there was a taint to virtually all Nazi-era medical scholarship, owing to the disgusting and well-documented ethical breaches associated with some of the research conducted. This unquestionably dampened international discussion of Asperger’s ground-breaking 1944 paper, in which he wrote about four intellectually capable but socially struggling Austrian boys and for the first time described the syndrome that he called “autistic psychopathy.”

For the next four decades, that paper went virtually unnoticed and was minimally cited in the main centers researching autism, which were located in Britain and the United States. It was only in 1981 that the influential British psychiatrist Lorna Wing drew attention to it. Wing was just then beginning to develop the now familiar concept of the autism spectrum, and saw Asperger’s account of autistic psychopathy as an important demonstration of autistic traits in a wider range of individuals than previously documented. Historically, the autism label had been used more narrowly, applied to individuals profoundly challenged in areas like learning, communication, or self-care. For the sake of discussion around the Austrian’s work, she also urged adoption of a less jarring name for it: Asperger’s syndrome.

Thus did the syndrome become famous, but not the man, who died the year before Wing told a wider world about his work, and about whom that wider world knew essentially nothing. In that vacuum, just a few people in the English-speaking world began asking questions.

One of the earliest was Eric Schopler, a psychologist at the University of North Carolina who had been running an innovative education program there for autistic people since 1971. Schopler was an immigrant, having fled Europe as a child with his Jewish family, and among the first English speakers to raise suspicions about Asperger—though he never made a compelling case for them. In the late 1980s, he was openly maligning the quality of Asperger’s work, while making cloaked suggestions that Asperger was, at a minimum, a Nazi sympathizer. Influential among autism experts into the early 2000s, Schopler apparently never made any real effort to substantiate his suspicions. Yet his comments stirred up a cloud of rumors, and others started asking questions.

Following Schopler was the Yale psychologist Fred Volkmar, another major figure in the autism field. In 1993, he was on the committee appointed to investigate whether Asperger’s syndrome merited inclusion in the Diagnostic and Statistical Manual—the main reference book used for coding mental diagnoses. The committee was trying to judge the syndrome’s clinical validity. But Volkmar told me in an interview that he was also concerned about the reputation question, since there was honor attached to being named in the DSM. He made a transatlantic phone call to the only person he knew who had ever met Asperger—Lorna Wing—and asked her point blank whether she knew anything about Asperger being a Nazi. Wing was shocked at the question, and, although she had only met Asperger once, for tea and conversation, she apparently felt compelled to vouch for him. She, too, did not actually have much information, but she knew him to be a religious man, and shared that with Volkmar. As exculpating evidence, it was thin, but there was no known evidence on the other side. In 1994, when a new edition of the DSM appeared, Asperger’s syndrome was listed in it.

A few years later, a second Yale psychologist, Ami Klin—who now leads the Marcus Autism Center at Children’s Healthcare of Atlanta and Emory University School of Medicine—attempted a more comprehensive investigation, ahead of copublishing an academic book to be titled Asperger Syndrome. Klin went as far as reaching out to various archives and research centers in Germany and Austria, and shared that correspondence with me for my research. “We would like to be able to write that he was a benevolent doctor,” he wrote to one historian. “But we are not sure of that.” The answer that came back from that same historian was ambivalent: Records were hard to come by, and while Asperger certainly worked and survived in a Nazi-dominated professional environment—which should be grounds for caution—he never joined the Nazi party, and there was no evidence implying he’d been personally involved in its immoral enterprise. Klin went with the benefit of the doubt, and published a book whose foreword, written by Asperger’s daughter, described Asperger’s “lifelong interest in and his curiosity about all living creatures,” and his opposition to Nazi determinism.

In 2016, along with my coauthor Caren Zucker, I published a social history of autism that laid out the story of people asking these questions, and the lack of clear answers. But we also explored a corollary development: the growing popularity of a version of Asperger that was the complete opposite of the possible Nazi sympathizer Eric Schopler had been whispering about. This story asserted that Asperger, far from working with Nazis, was secretly working against them, and was actively saving vulnerable children’s lives. This narrative, which proved amazingly durable in the absence of confirmable facts to back it up, was the second thing shielding Asperger’s reputation.

This version of Asperger was built with just a few available data points. Those included comments made about Asperger’s virtue by his children as adults; praise for his character by people who worked with him long after the war years; a line from a talk he once gave concerning challenged children, in which he asserted that “not everything that falls out of line” need be considered “inferior”; and, most critically, Asperger’s own testimony in a 1974 interview, in which he said that he twice had close calls with gestapo.

But making this narrative work also required a certain selective memory. In some early public statements Asperger made, he sounded unmistakably enthusiastic about what was going on in Nazi medicine and genetics. In 1938, months after Austria was welded to Hitler’s Germany, Asperger gave a public talk in which he hailed the new era, and embraced the principle that “the Volk is more important than any single individual”—the central tenet of fascism. Further, he expressed support for the regime’s goal “to prevent the passing on of diseased heredity,” which was how the Nazis justified euthanasia of disabled people.

These statements alone might seem fatal to the hero story, but some argued that Asperger was only saying those things to throw the Gestapo off the scent. This transformation of a Vienna pediatrician into a wily resistance figure—credited by one writer with making “deft chess moves” against the Nazis—was enormously appealing. It gave professionals working in the autism field an inspiring forebear, and was also an attractive characterization for people given the Asperger’s diagnosis, many of whom, since the late 1990s, had been building a kind of pride movement in response to lifetimes of rejection, bullying, and isolation. The Asperger resistance story wasn’t crucial to fighting the condition’s stigma, but it didn’t hurt—it was a nice add-on for those who sometimes spoke of their “Aspie pride.”

I found it appealing too, and in the first draft of my book’s short chapter on Asperger’s past I described the resistance narrative as standing up to “a fair-minded analysis,” in the absence of solid countervailing evidence.

Then, in the spring of 2014, six or so months before my deadline, I got a call from Jeremiah Riemer, the freelance translator I’d asked to check the English translation I was using to quote Asperger’s writing in German. Reimer asked me if I’d ever heard of Herwig Czech—the historian whose work has just appeared in Molecular Autism. It seems my friend, frankly suspicious of the hero narrative (which he said had a great deal to do with being a Jew well acquainted with the history of postwar patterns of Austrian denial of responsibility), he had googled around in German, and come across an interview Czech gave to an Austrian newspaper raising questions. I had never heard of Czech, but we were to become well acquainted over the next two years, as he gradually shared with my coauthor and me most of the details that he has now made public in full.

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At the start, I found it difficult to accept what he was telling us over email and Skype calls: that Asperger, after examining numerous disabled children, had signed documents recommending their placement in the pseudo-hospital called Am Spiegelgrund, where, his follow-up work showed, they had been murdered. With my coauthor, I flew to Vienna, where Czech laid out the documents, showed us Asperger’s signature, and walked us around the grounds of Am Speigelgrund and into the building where the marked children waited to die—a place that was the more chilling for actually looking like an ordinary ward.

Here, at last, was a researcher who bridged the language barrier, and knew his way around an archive. Czech was able to provide what had been missing before: minute, documentable detail, which made clear that the hero story was a fantasy.

Zucker and I included Czech’s findings on Asperger in our book, but it did not deal a lethal blow to the myth. Out on press tour, we found that most reviewers and interviewers representing general audiences were far more interested in other aspects of autism’s history than the character of one distant Austrian, and unfamiliar with the resistance narrative anyway. Among those more directly connected to autism, we encountered some who were stunned and dismayed, but we also got pushback from people who charged us with sensationalism, fabrication, and Nazi baiting. Quite reasonably, some thought it better to withhold judgement until Czech’s work was peer-reviewed and fully published.

Now that it has been, this does appear to be, at long last, Hans Asperger’s crane moment. But the disgrace of the man’s actions does not negate the value of his clinical insights, nor does it reflect negatively, in the slightest way, on individuals who were at one time given the Asperger’s diagnosis.

If a child receives a medical diagnosis, it’s natural for a parent to jump into research. If the parent is a historian, perhaps the urge is magnified — so when my son was diagnosed with autism at 17 months old, I read widely about the condition, including its historical origins.

This fact brought a strange confluence of interests, since I am a specialist in 20th century Germany and central Europe. I was amazed to find that, though just this month a study in the journal Molecular Austism did address the topic, at the time there was no in-depth research on Asperger’s Nazi-era activities. The little written about Asperger, in parent manuals and online blurbs, depicted him as a resister of Nazism and compassionate with his patients. Some speculated that Asperger tried to protect them from Nazi killings by emphasizing their special abilities and potential value to the state, using the autism diagnosis as a way to save them from the extermination that could face those seen as disabled.

I was excited to write a positive book about autism and the Third Reich. My first day in the Austrian National Archives in Vienna, however, dispelled any notion of a heroic tale.

It came down to one’s label. The Third Reich was a diagnosis regime, obsessed with sorting the population into categories, cataloging people by race, religion, politics, sexuality, criminality and purported biological, mental and behavioral defects. Nazi officials created massive population indexes that compiled individuals’ medical, financial, educational, criminal and welfare records — even sports club files. By 1942, Reich Health Leader Leonardo Conti estimated that ten million Reich citizens had been indexed — 12% of the total population. These files, then, established the grounds for sterilization, deportation and extermination.

Having now finished my book, it is ironic that my research took me to the opposite perspective from where I started. I wish I had been able to tell a heroic story about Asperger. But it is more important that the full history of Asperger and his work in Nazi Vienna becomes known, and not only for discussions about autism and Asperger’s syndrome. His is a cautionary tale about the power and proliferation of labels — as science, state and society seek to order the human condition.

Maybe it is for the best Dr. Sukareva does not get reconized, there must be some connection with Stalinism there.

...the "Joint Session" of the USSR Academy of Medical Sciences and the Board of the All-Union Neurological and Psychiatric Association took place from 10 to 15 October 1951. The event was dedicated, supposedly, to the great Russian physiologist Ivan Pavlov and alleged that several of the USSR's leading neuroscientists and psychiatrists of the time (among them Grunya Sukhareva, Vasily Gilyarovsky, Raisa Golant, Aleksandr Shmaryan, and Mikhail Gurevich) were guilty of practicing "anti-Pavlovian, anti-Marxist, idealistic [and] reactionary" science, and this was damaging to Soviet psychiatry.

The Austrian paediatrician Hans Asperger has long been recognized as a pioneer in the study of autism. He was even seen as a hero, saving children with the condition from the Nazi killing programme by emphasizing their intelligence. However, it is now indisputable that Asperger collaborated in the murder of children with disabilities under the Third Reich.

Historian Herwig Czech fully documented this in the April 2018 issue of Molecular Autism (a journal I co-edit; see H. Czech Mol. Autism 9, 29; 2018). Now, historian Edith Sheffer’s remarkable book Asperger’s Children builds on Czech’s study with her own original scholarship. She makes a compelling case that the foundational ideas of autism emerged in a society that strove for the opposite of neurodiversity.

These findings cast a shadow on the history of autism, already a long struggle towards accurate diagnosis, societal acceptance and support. The revelations are also causing debate among autistic people, their families, researchers and clinicians over whether the diagnostic label of Asperger’s syndrome should be abandoned.

In digging anew into the deeper historical context of Asperger’s work, Sheffer fills in parts of the story anticipated in John Donvan and Caren Zucker’s history of autism, In a Different Key (2016; see B. Kiser Nature 530, 159; 2016), which referred to Czech’s early findings. Sheffer reveals how the Nazi aim of engineering a society they deemed ‘pure’, by killing people they saw as unworthy of life, led directly to the Holocaust.

With insight and careful historical research, Sheffer uncovers how, under Hitler’s regime, psychiatry — previously based on compassion and empathy — became part of an effort to classify the population of Germany, Austria and beyond as ‘genetically’ fit or unfit. In the context of the ‘euthanasia’ killing programmes, psychiatrists and other physicians had to determine who would live and who would be murdered. It is in this context that diagnostic labels such as ‘autistic psychopathy’ (coined by Asperger) were created.

Sheffer lays out the evidence, from sources such as medical records and referral letters, showing that Asperger was complicit in this Nazi killing machine. He protected children he deemed intelligent. But he also referred several children to Vienna’s Am Spiegelgrund clinic, which he undoubtedly knew was a centre of ‘child euthanasia’, part of what was later called Aktion T4.

This was where the children whom Nazi practitioners labelled ‘genetically inferior’ were murdered, because they were seen as incapable of social conformity, or had physical or psychological conditions judged undesirable. Some were starved, others given lethal injections. Their deaths were recorded as due to factors such as pneumonia.

Sheffer argues that Asperger supported the Nazi goal of eliminating children who could not fit in with the Volk: the fascist ideal of a homogeneous Aryan people.

Both Czech and Sheffer include details on two unrelated children, Herta Schreiber and Elisabeth Schreiber, and their referral letters, signed by Asperger. In these, the paediatrician justifies Herta’s referral to Am Spiegelgrund because she “must be an unbearable burden to the mother”; and Elisabeth’s, because “in the family, the child is without a doubt a hardly bearable burden”. These provide proof that he effectively signed their death warrants.

Nearly 800 children were killed in Am Spiegelgrund. Asperger went on to enjoy a long academic career, dying in 1980.

Both Asperger’s Children and Czech’s paper converge on the same conclusion. Personally, I no longer feel comfortable with naming the diagnosis after Hans Asperger. In any case, this is a category rendered moot in the most recent edition of the DSM (used in the United States). European nations will follow this diagnostic lead in 2019, with the 11th edition of the International Classification of Diseases.

The future use of the term, of course, is a discussion that must incorporate the views of autistic people. Many take pride in the term Asperger’s syndrome as part of their identity, feeling it refers to their personality and cognitive style, which obviously do not change simply because of historical revelations. They might not, therefore, want a change. Others have already written about switching to using ‘autism’ (or autism spectrum disorder, or autism spectrum condition) to describe their diagnosis.

For brevity and neutrality, I favour the single term autism.

When Wing coined the term Asperger’s syndrome, none of us was aware of Hans Asperger’s active support of the Nazi programme. As a result of the historical research by Sheffer and Czech, we now need to revise our views, and probably also our language. Asperger’s Children should be read by any student of psychology, psychiatry or medicine, so that we learn from history and do not repeat its terrifying mistakes. The revelations in this book are a chilling reminder that the highest priority in both clinical research and practice must be compassion.

Edith Sheffer has written a book that defies easy categorization — an appropriate, if perhaps inadvertent, response to her fascinating and terrible subject matter. In “Asperger’s Children: The Origins of Autism in Nazi Vienna,” she shows how the Third Reich’s obsession with categories and labels was inextricable from its murderousness; what at first seems to be a book about Dr. Hans Asperger and the children he treated ends up tracing the sprawling documentary record of a monstrous machine.

Sheffer’s stake is personal as well as professional. A historian of Germany and Central Europe, she’s also the mother of an autistic son. Her previous book, “Burned Bridge,” examined how Cold War divisions in a German town were not so much imposed on ordinary people as they were actively — and sometimes enthusiastically — propagated by them. “Asperger’s Children” similarly explores how people deal with their political environment through their daily routines.

“Caught in the swirl of life,” Sheffer writes, “one might conform, resist and even commit harm all in the same afternoon.”

That sentence, which comes toward the end of Sheffer’s book, makes it sound as if the Hans Asperger she presents is a complex figure, full of ambiguities and contradictions, hard to characterize with any certainty and impossible to pin down. For most of “Asperger’s Children,” however, she seems interested less in a complex biographical portrait than an indictment, as she methodically marshals her evidence and lays out her argument.

She acknowledges Asperger’s “well-known support for children with disabilities” and the “two-sided nature to his actions,” but the overall sense you get is that Sheffer judges Asperger’s ambivalence woefully insufficient. If anything, his mixed record suggests to her that he knew better, rendering him ultimately responsible for the ignominious decisions he made.

Sheffer has built an impressive case, though certain questions remain. Did Asperger’s pleas on behalf of at least some of his patients save their lives? Or by emphasizing the potential for “social integration” into the Volk, was he consigning those who didn’t fit into that privileged category to their deaths? Under the brutal boundaries drawn by the Nazi regime, both could be true. Sheffer seems to go back and forth herself, condemning Asperger in the severest terms on one page and slipping in a few caveats about his “drift into complicity” on another.

“It can be misleading to classify people too neatly,” Sheffer writes, trying to explain where historians draw the lines of culpability. It’s a fitting conclusion to a book that raises unsettling questions about who someone was, and what he did.

we’ve been seeing rumors to this effect trickle in for quite some time now. I don’t have the credentials to tell you whether the evidence is true or false, but my gut says it’s true. I studied the Holocaust a great deal as an undergrad, and the chances of someone conducting high-level work under the auspices of that government, without engaging in atrocities…and living? The odds are awful. I don’t doubt Ms. Sheffer’s scholarly work whatsoever.

However, in Sheffer’s op-ed, she writes, “Moreover, the name (Asperger) remains in common usage. It is an archetype in popular culture, a term we apply to loved ones and an identity many people with autism adopt for themselves. Most of us never think about the man behind the name. But we should.” Herein, I doubt Ms. Sheffer tremendously.

Most of us, for instance, were diagnosed with Asperger’s Syndrome by a clinician. The condition was not “adopted for ourselves” or “applied to loved ones” as a throwaway, comedic remark. A recognized clinical diagnosis, Ms.Sheffer should know, is not a “fad.” That assumption is not objectionable on ethical grounds, it’s just stupid.

At greater issue is her dictum at the end, “But we should,” that implies a wish on Sheffer’s part that people with the diagnosis need to feel worse than they might already do, given the stigmatic consequences of living life with any disability, or that our worth can be measured by some total stranger’s long ago life, i.e. that which we have no control over.

,No, Ms. Sheffer, we don’t need to care. Perhaps the association with the word will obtain, a new, negative layer, given the new information we now have about the choices he made, and we will have to deal with that. But the meaning in our lives that the diagnosis brought was based on finally having answers to why we were so out of sorts with the majority. It was based on finding out that our behavioral differences were the result of our wiring, and not our character. We might have been grateful to him, and this gratitude now must be tempered. But it was not based on some fantasy that Asperger was this benevolent, warm and fuzzy man whose concern for vulnerable children rivaled that of Janusz Korczak (and brilliant scientists, in general, are…brilliant…but they are not warm and fuzzy). We loved the gold, not the gold miner; Ty Cobb’s base-stealing approach, not Ty Cobb; Wagner’s music, not Wagner. It’s sad perhaps, but do we really mind tearing down imaginary statues of Hans Asperger along with the confederate flags, or the careers of Hollywood rapists? I don’t mind, and I think it’s the right thing to do. Hans Asperger was not our Dr. Frankenstein, nor our father. I think it safe to say that if he hadn't figured this stuff out, someone else, eventually, would have. We are seeking value in ourselves; not in any reputed, neurotypical saviors.


Finally, Ms. Sheffer; some advice? Those three words ("But we should") could be interpreted as your telling spectrum people what to feel. I know it's just three words out of a whole Op-Ed but...just don't. We've been down that road before.