Dr Hans Asperger (18 February 1906 - 21 October 1980) was an Austrian pediatrician who took a particular interest in solipsistic children whom he called "little professors" for their propensity to expound, to the exclusion of almost everything else, on their subjects of interest which could often be quite obscure.
Dr Asperger was greatly influenced by the work of the Swiss psychiatrist Eugen Bleuler (30 April 1857 - 9 February 1940) who identified and named the brain disorder known as schizophrenia. In the course of his practise, Dr Bleuler had noticed these strange, solitary children and provisionally concluded that they, too, had a variant of schizophrenia which he called "autistic psychopathy". This was also the conclusion reached by Dr Asperger and although he does not seem ever to have accepted any connection between the behaviour of these people and schizophrenia, at no time during his professional career did he change his view that they had a psychopathy. Autistic is a word derived from the Greek for self and psychopathy derives from a Greek compound meaning mind disease.
If you consult any psychiatric text on psychopathy, you'll find that they all say that you can't change the behaviour of a psychopath. Psychopaths may sometimes modify their behaviour in their own interests, assuming that they can perceive, or care to perceive, what those interests might be (something psychopaths are said to find difficult), but you can't write programs that will, of themselves, modify their behaviour in childhood or at any other time. This was certainly the view held by the psychiatric profession in Austria and Germany during the first half of the twentieth century.
In fact, identified psychopaths were considered to be "mad" and held in institutions. Almost anyone who was considered different was also considered to be potentially dangerous or even mad and consequently fit only to be institutionalised. This view still predominates in most of the world. I mean that literally: Russia, all of Asia, the entire African continent except the Republic of South Africa, and all the American continent south of the US border. This view can still be found, on occasion, even in the United States. (I have personally encountered, in the US, children who have been institutionalised for no better reason than that they were autistic and having difficulty coming to terms with just exactly what that meant.) Consequently, most children who today would be diagnosed as being somewhere on the autism spectrum were, in the 1940s and before, in Germany and Austria, held in psychiatric institutions along with people with physical disabilities and those who had brain disorders which made them truly delusional.
I mention the 1940s for a particular reason: in the first part of that decade Austria was politically connected to Germany and consequently had the same Nazi government. What was the Nazi policy relating to those with disabilities or considered mad? To kill them all off. There was no place for them in the greater German Reich, the empire that was to be "purified of all antisocial and Jewish elements".
How was this accomplished? We've all heard of Auschwitz and other unspeakable places, which still exist and which will poison the earth for generations to come, but those with disabilities could be difficult to move. Some of them couldn't move of their own accord very far, if at all, while others would just fly into a panic if any attempt were made to move them. Yet others, who could walk and talk and sound absolutely normal, and who additionally were children and non-Jewish, had the potential to excite compassion in the population and thus it was better off, from a Nazi perspective, not to move them at all.
Enter the gaswagen. About the size and shape of a refrigerator truck and modified so that its exhaust could be switched to emit inside the container, and with a pressure valve set high enough so that those locked inside would die of carbon monoxide poisoning but not enough to cause the container to explode. A masterpiece of German engineering! Carbon monoxide poisoning is supposed to be a pleasant way to die. Would you care to try it? Right now? I thought not.
Gaswagens were driven into an institution's carpark and, over the course of a day or so, all the patients were killed. Dr Asperger was not in private practise, he worked for the Institute for Childhood Diseases, an offshoot of the University of Vienna.
Many cities throughout the world have brain banks. These are places in which brains taken from the dead have been studied and stored. Their very existence is proof that they advance humankind's knowledge of how exactly our brains work, how they can malfunction and how those malfunctions might be cured. There will be no map of the brain until every one of its billions of neurons is identified, a process which will take many centuries at the present rate. But you have to start somewhere.
Vienna has such a brain bank. It began when a pediatrician there suggested that the brains of 400 children with "brain disorders" who had been murdered in gaswagens be taken for study. Dr Asperger was not that person but I think I can be pretty sure that as a pediatrician specialising in child behaviours he would have been very interested in working on those brains. I also ask you to consider just what it took to work as a doctor in Nazi-controlled territory. In a word: complicity. Did Dr Asperger speak out against the murder of children at any time? No, because he would have lost his job and perhaps been sent to a concentration camp. He kept his job until he retired in the 1970s.
And last, let's be very clear about his legacy. Was it Asperger syndrome? Not at all. This syndrome, as currently described in the Diagnostic and Statistical Manual of the American Psychiatric Association, which is optional for a diagnosis on the autism spectrum in the US but compulsory in many other countries, including the UK, Australia and New Zealand, bears hardly any resemblance to Dr Asperger's stated positions. In fact, it's fair to say that he would most certainly have been wondering how this dog's breakfast of criteria could possibly ever have been attributed to him. There are currently at least five different widely-circulated definitions of Asperger syndrome, in addition to those provided by DSM-IV and ICD-10. (Ghazzuiddin, Tsai and Ghazzuiddin, 1992; Leekam, Libby, Wing, Gould & Gillberg, 2000; Klin & Volkmar, 1997; Wing, 1981; Szatmari, Bryson, Boyle, Streiner & Duku, 2003; Tsai, 1994.) I keep hearing that in view of this diagnostic insanity, the next revision of the DSM will eliminate Asperger syndrome altogether, and place Rhett's Syndrome and Childhood Disintegrative Disorder on a different axis so that the autism spectrum will at last be as it always should have been, identifying only low, mid-range and high-functioning autism.
Dr Asperger published two major papers: Die Autistischen Psychopathen im Kindesalter ("Autistic Psychopaths in Childhood"), 1944 and Zur Differentialdiagnose des Kindlichen Autismus ("On the Differential Diagnosis of Childhood Autism") in 1968. The problem is that Dr Asperger's differential diagnosis is not the same as that in the current version of the DSM. (To start with, the criteria used by Leo Kanner and others in the US, which are pretty much the criteria used by the DSM today, and by Dr Asperger in Austria to diagnose autism itself in 1968 were different.)
We need to come to terms with the fact that infantile autism presents in two main ways: that which is covered by the criteria currently used by the DSM for autistic disorder/Asperger syndrome and the etiology of which is genetic; and that in which a small number of children progress normally for some eighteen months or so and then regress, usually to quite a low level of functioning, for reasons we can still only guess at (everyone has a view: is it MMR or something in the environment? Genetic? Or what? No-one actually knows.).
There are some Asperger associations around the world which celebrate Dr Asperger's birthday. If I had to celebrate anything about him it would be his demise but can I suggest this to you............? Let's just forget him.
Postscript: Thanks for the emails. Some of you have suggested that the definition of "psychopath" has changed since the time of Bleuler and Kräpelin and that it changed, specifically, in the 1970s. My answer to this is that there has been no change. If you read the early definitions of psychopathy, in either (or preferably both) English and German, you won't see any significant difference.
Lindsay Weekes
Melbourne, Australia 2006
Vianden, Luxemburg 2008