The most tragic, and in some ways most mysterious, form of mental illness in children is infantile autism. Autistic* children live in a lonely and unbreakable trance. As babies, they seldom look into their mothers' eyes, they never reach out to be picked up and cuddled. By the age of about two, they have withdrawn completely from the world, ignoring the people around them in favor of the Teddy bears or dolls to which they become fanatically attached. The smallest departure in routine can send them into screaming paroxysms; some must wear tiny football helmets to prevent them from smashing their heads against a wall.
Unlike children afflicted with brain damage, the victims of autism often display tantalizing flashes of intelligence. Some can memorize long, complicated stories with flawless accuracy; many have perfect pitch. Psychiatrists differ widely in their views on the cause of autism, and real cures have been rare. In Washington last week, discussions at the annual meeting of the National Society for Autistic Children indicated that research and treatment are beginning to move along some new paths.
No Blame. Parents of autistic children have never had much reason for hope. Until Dr. Leo Kanner of Johns Hopkins University identified and defined the disease in 1943, most doctors concluded that autistic children were mentally retarded, and could recommend nothing more than packing them off to a vegetable-like existence in a custodial institution. Kanner, taking more careful note of their mental abilities, concluded that the disease was a psychosis. He felt that the condition was innate, but noted that many parents of autistic children were highly intellectual and emotionally cold—"refrigerator parents," as he called them. Other experts in autism, including Chicago Psychoanalyst Bruno Bettelheim, accept the theory that parental rejection is the basic cause of the children's problems.
The specialists who belong to the National Society—and the parents who founded the organization 3¢ years ago —strongly disagree. They point out that the symptoms of autism usually develop in a baby's first weeks, seemingly well before strong parental influence is possible. Moreover, studies indicate that the other offspring of parents with an autistic child are almost invariably normal. Some researchers hope that autism will turn out to be similar to cretinism and phenylketonuria (or P.K.U.)—products of some defective chemistry affecting the nervous system. Meanwhile, a growing number of experts would like to sidestep the question of parental blame and concentrate on teaching autistic children acceptable substitutes for their difficult and harmful behavior. Says Dr. Leon Eisenberg, chief of psychiatry at Boston's Massachusetts General Hospital: "Guilt is the most useless commodity available."