A five to fifteen year follow-up study of infantile psychosis. II. Social and behavioural outcome

On the organic nature of some forms of schizoid or autistic psychopathy

Representative case histories are presented to illustrate the typical clinical features of autistic psychopathy. These patients showed several clinical features compatible with organic encephalopathy. Physical signs suggesting the presence of an underlying cerebral dysgenesis were particularly frequent. These patients superficially resembled schizophrenics but differed in their delayed and peculiar intellectual development, the response of their behavior to external stimuli, and their frequent and severe motoric defects. From these observations and a review of the pertinent literature, we conclude that the patients described in this report have an organic deficiency of brain function, determined congenitally or in the early postnatal period.

A comparative study of infantile autism and specific development receptive language disorder. I. The children

There is now extensive evidence that autistic children manifest a specific cognitive defect involving language impairment (Rutter, 1974). The presence of such a deficit is demonstrated by the pattern of clinical findings (Rutter, 1968; Rutter, Bartak and Newman, 1971), the long term course of the disorder (Rutter, 1970), and the results of systematic experimental studies (Hermelin and O'Connor, 1970). Nevertheless, basic questions remain concerning the meaning of this deficit for theories on the nature and causation of infantile autism. First, what are the boundaries of the cognitive deficit and in particular does it extend outside language? Second, does it constitute the primary handicap which gives rise to other symptoms? Thirdly, if it does, does the cognitive deficit lead directly to the behavioural syndrome or must there be an interaction with a particular set of environmental or other circumstances for the syndrome to develop?

Autism and attention: theoretical considerations and a pilot study using set reaction time

We have presented an attentional model that may have value in the pathophysiology of autism. We have presented data that suggest attentional dysfunction and an attentional hypothesis that may explain autism's multisensory clinical appearance and natural history. Only further studies will be able to evaluate this hypothesis and hopefully provide us with something more promising to offer parent and child in the way of therapy.

The development of infantile autism

An account is given of how research over the last 30 years has led to progress in the delineation of the mechanisms involved in the genesis of the behaviour covered by the term ‘infantile autism’. The validity, nature, and basis of the syndrome are discussed with reference to treatment.

Histidinaemia. Study of relation between clinical and biological findings in 7 subjects

Seven subjects with raised plasma histidine and low skin histidase levels (histidinaemia) are described: 4 were severely retarded, 2 showing in addition features of an early infantile psychosis (autism); 3 were of normal intelligence. There were no biochemical differences between the two groups. In view of these findings and a study of patients reported in the literature, attention is drawn to the difficulty in making a decision about treatment of a neonate detected by screening and shown to have the biochemical features of histidinaemia. The natural history of the condition is further examined, particularly the question of deterioration at time of seizures or infection.

A five- to fifteen-year follow-up study of infantile psychosis

Surprisingly little is known about the course of intellectual development in children with infantile psychosis. Kanner (1943; Kanner and Lesser, 1958) has stated explicitly in several papers that “even though most of these children are initially considered feeble-minded, they are all unquestionably endowed with good cognitive potentialities, which are masked by the basic disorder” (original italics—Kanner and Lesser, 1958). The expectation would seem to be that the child's IQ, should fluctuate with the course of the psychosis, particularly the autistic aspects, but this has not been tested. It has been suggested (Anthony, 1958) that an intelligence test result in a young child with infantile psychosis is most unreliable and virtually meaningless if the child is without speech. Perhaps because most investigators have shared this view, neither of the two major follow-up studies of children with infantile psychosis, that of Kanner's cases (Eisenberg, 1956; Eisenberg and Kanner, 1956; Kanner, 1943 and 1949; Kanner and Eisenberg, 1955; Kanner and Lesser, 1958) and that of psychotic children seen by Creak (1962, 1963a and b) has included information on IQ changes.