Studies in the childhood psychoses. V. Cerebral dysfunction and childhood psychoses

A series of recent papers (Creak, 1961, 1963; Rutter, 1966; Brown, 1963; Lotter, 1967; Schain and Yannet, 1960) have provided evidence of degrees of cerebral dysfunction in infantile autism (Kanner, 1943) and other infantile psychoses. They have demonstrated that groups of cases of infantile psychoses satisfying broadly similar diagnostic criteria have in their backgrounds a variable frequency of cerebral insult and abnormal discharge in the EEC The diagnostic criteria in such series are of crucial importance. Imprecision and vagueness hamper comparisons between series. In childhood psychoses some investigators have excluded those cases in which there was any history or clinical evidence of organic features in an attempt to obtain a ‘pure’ group. This technique, while valid in delineating a syndrome, is handicapping to subsequent etiological study. For these reasons the present authors have used only age of onset and behavioural features as their ascertainment criteria it was a behavioural rather than an aetiological diagnosis.

Thyroid dysfunction

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Childhood autism: an investigation of aetiological factors in twenty-five cases

In 1943 Kanner described a disease entity which he referred to as ‘Infantile Autism’. Creak and Ini (1960) found no evidence of psychogenic aetiology in a study of 200 parents of autistic children. Bender (1955) retrospectively studied children seen at Bellevue Hospital for behavioural or developmental disorders and who had been diagnosed as schizophrenic before seven years of age. No preponderance of the sophisticated, intelligent, well-to-do parents as described by Kanner was found; every racial and religious group was represented, Jews predominating slightly. A strong genetic predisposing factor was indicated—40 per cent of the parents were schizophrenic. Stroh (1962) insists that the child's condition cannot be attributed to maternal mishandling, and Wing (1966) has said ‘It is possible to interpret the data to support both environmental and biological theories of primary causation, but on the whole the former argument is very difficult to sustain.’