How did contemporaries justify the separation and disconnection between Kanner’s “early infantile autism” and Asperger’s “autistic psychopathy”? They said, with Van Krevelen, that the latter was a static “personality trait” while the former a “psychotic process” with a course (1971, 83, 84; see also Rutter 1978, 145). This was the key difference Van Krevelen used as the basis for his argument that they were “two entirely different nosological syndromes” (1971, 84).
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This is good evidence that the distinction between personality trait and psychotic process was the decisive element separating the two syndromes within a discursive economy quite different from our own. Change the terms a little bit in Van Krevelen’s formulation, and you can turn it into a sentence that looks to our twenty-first-century eyes like an unproblematic spectrum statement: “low and high functioning autistic spectrum disorder share a common genetic basis, as shown by their co- occurrence within families. The children with low functioning ASD may suffer from additional injury.” Yet in Van Krevelen’s work the same statement sits comfortably within a text geared to explain that the two are not merely “quantitative variants” of the same thing, but rather qualitatively different. What’s in a name? Why is it important that one condition is described as a personality trait and the other as psychotic process? The most obvious point is that the two terms indicate different levels of severity.
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If Asperger would have been translated into English in the 1950s, perhaps his cases would have been assimilated to the category of “children with circumscribed interests,” but in 1981 there was a place for him on the spectrum, and [Lorna] Wing could use the idea of a spectrum to dissolve any difficulties posed in the past by the differences between Kanner’s and Asperger’s descriptions. She used her own epidemiological findings to support the concept of an autistic continuum (Wing and Gould 1979).
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Her real ingenuity lay in the invention of the autism spectrum as a device for translating and aligning the multiple interests of members of this network: autism researchers, clinicians, therapists, parents of severely afflicted autistic children, and parents of near normal autistic adolescents, and ultimately also these adolescents and children themselves.
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From the perspective of looping, [Temple] Grandin is a bridging figure (Hacking 2007). As a child, she approximated the prototype of Kanner’s infantile autism enough to become associated with the label, but she grew into something that was previously unthinkable to many people, an independent living, self-reflexive, highly articulate if idiosyncratic autistic adult.18 In becoming a public figure, she stretched the autism prototype, making room on the spectrum for others who may not have shown such classic autistic traits as children but identified with her circumscribed interests, visual thinking, or particular sensory experience of the world.
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Now, alongside parents, and often in direct and open conflict with them, people diagnosed on the spectrum inserted themselves into networks of information and knowledge production. Boards and committees, like the Autism Coordinating Committee, now stipulate that there be a person with autism among the group. Following the disability rights movement of the 1980s and 1990s, these self- advocates come bearing the slogan “nothing about us without us,” and they demand respect for “neurodiversity” (“diversity of human wiring”) as one axis of human difference among others, like race, class, or gender.
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First, contrary to what one might think, this image of neurodiversity and the technologies of behavior management are not mutually exclusive. Rather, they coexist and hybridize. Within the same home, one finds a room for structured discrete trial ABA and a bookshelf housing biographies by Grandin and other self- advocates. Parents move seamlessly between talk of their child’s “perseveration” and her “sensory sensitivities.” ABA-based schools allow students to work to earn “sensory breaks,” or they teach them to request a “sensory toy” instead of lashing out when they feel uncomfortable or become stressed. Second, parents did not need to wait for the self- advocates to provide them with this “thick” image of their child. Recall Wing’s 1972 comment that autistics do not lack emotional experiences but simply express them differently, and that parents come to learn the “special language” of their own child. Or consider Clara Claiborne Park’s thick portrait of her daughter in The Siege or Rimland’s son who became a successful artist. The point is that some parents could reach the conclusion that their child had a rich emotional and intellectual life before the autobiographies that described them in that way. Nonetheless, the accounts of the self advocates provide parents with a language with which to imagine and interpret their children’s actions and they expand the prototype of autism in the public imagination so that these interpretations can appear plausible or defensible to others.

The Autism Matrix Reviewed by Dr. Stephen Haswell-Todd (The Turn of the Self: A History of Autism, 2015)

The Autism Matrix, by the sociologist Gil Eyal and a team of secondary authors, stands out among extant publications in addressing itself not to the families or caregivers of autistic children, in order to help them understand and cope with their charges, but rather to anyone seeking a fuller understanding of how the current autism crisis arose. Its overall argument is that the “epidemic” of autism that has gathered strength since the 1980s can be explained without reference to the actual rate of incidence of autism in the population, entirely on the basis of “diagnostic substitution”: autism has come to be the preferred diagnosis for conditions that previously were lumped into other categories. The most important factor driving the shift in diagnoses was deinstitutionalization, or the emptying of American mental asylums in the 1960s.

Large numbers of atypical children who would otherwise have been labeled as generically “feebleminded” and put into institutional care instead had to be dealt with in school and society. This opened up a new market for targeted therapies, and concomitantly a kind of “market” for diagnoses driven by the combined interests of therapists, researchers, teachers, and parents. This was a market on which autism performed exceptionally well. The Autism Matrix makes this argument in painstaking detail and rigorous sociological terms; and along the way it lends many insights into how the diagnosis of autism has changed since Kanner and Asperger.

Eyal and his team acknowledge what they call “the riddle of simultaneous discovery”: the question of how Asperger in Vienna and Kanner in Baltimore, their respective countries at war with one another in the early 1940s, could have apparently had the same thought—that there was a group of children, more or less the same group of children, waiting for the label “autistic” to be applied to them. Because there had never been any known channel by which they could have heard of each other’s work, this has always been thought to be a coincidence, an example of genuine dual discovery like Newton and Leibniz’s independent arrival at the calculus. But for the sociologist Eyal, very little in this picture is truly coincidental. He sets out to “dissolve” the riddle by explaining why modern autism was ripe for discovery in both Europe and the United States at this time. To this end he points out the “similar intellectual and clinical milieus” in which Asperger and Kanner—a lifelong Viennese and an Austrian by birth who emigrated to the United States, respectively—were formed, and the similar “institutional location of the two men” at the time of their autism research, “their similarly interstitial position between disciplines” (the disciplines of child psychiatry and special education). The coincidence of these two factors—intellectual milieu and institutional location—made the two of them highly likely both to come across the same kind of case material and to interpret it in the same terms.24