Leo Kanner

Before working at the Henry Phipps Psychiatric Clinic at the Johns Hopkins Hospital, Kanner practiced as a physician in Germany and South Dakota.

In 1943, Kanner published his landmark paper Autistic Disturbances of Affective Contact, describing 11 children who displayed "a powerful desire for aloneness" and "an obsessive insistence on persistent sameness.

[3] The Charité, situated in the middle of Berlin, attracted students, physicians and scientists from all over the world, resulting in a group of outstanding personalities and renowned clinicians.

[5] Motivated by the post-war hyperinflation and poor economic conditions of Weimar Germany, Kanner immigrated to the United States in 1924.

Beyond his revolutionary clinical research, Kanner's concern for the mentally ill manifested as social activism for which he is also remembered today.

In the 1930s, a group of lawyers and judges arranged for 166 state-institutionalized, mentally ill residents to be released and assigned as unpaid domestic servants for affluent families around Baltimore.

[9] Out of his own concern, Kanner decided to track down the 166 patients and found them plagued with a variety of dreadful outcomes such as STDs, tuberculosis, prostitution, imprisonment, institutionalization, and even death.

[4] Kanner's report on these patients, "Scheme to Get Morons to Work in Homes Free Charged", made the headlines of The Baltimore Sun and The Washington Post in 1938.

[8] Beginning in 1938, Kanner observed eleven of his patients and chronicled the lives and behavioral characteristics of the children in his seminal paper, "Autistic Disturbances of Affective Contact", published in 1943.

Published in the journal Nervous Child, "Autistic Disturbances of Affective Contact" was one of the most cited papers on autism in the twentieth century.

[12] From 1938, Kanner began to study a group of eleven young children (eight boys and three girls) who came to see him at his clinic at the Johns Hopkins Hospital.

For each of the cases, Kanner provides a detailed account of the symptoms, health, results of diagnostic tests, familial background, and future development and progression of the children.

Adding to his own observations, Kanner further contextualized the lives of his patients by including typically epistolary inputs from family members and other individuals with whom the children interacted.

[1] The following are summaries of each of the eleven cases: After profiling each of the patients, in the "Discussion" and "Comment" portions of the paper, Kanner stated that the common characteristics observed in the children formed a "unique syndrome" that may have been more frequent than what was reported at the time given the small sample size in the study.

[14] The notion of the innate nature of what Kanner called "extreme aloneness" was evident by recurrent reports of the failure of the children to "assume at any time an anticipatory posture" and adjust their bodies upon being picked up by their parents.

[1] The preferences the children had towards solitude manifested in complete disregard and ignorance of any external outputs that may interfere with them, such as direct physical contact, sound, or motion.

[15] Additionally, Kanner observed that the children's behavior was governed by an anxious and obsessive desire for sameness, and that this resulted in their repetitions of actions, such as their verbal utterances, as well as limited spontaneous activity.

[14] A related cognitive attribute noted by Kanner was that many of the children had an excellent rote memory, which led their parents to "stuff" them with verse, lists of animal and botanical names, favorite songs, and random facts.

However, Kanner believed that with time, the white race could also gain a similar resistance to general paralysis like that of the Native Americans.

Kanner explored the issues surrounding "early infantile autism" as it moved from having a well-defined symptomatology to being ready for a place in psychiatric nosology.

Kanner focused on how early infantile autism was related and unrelated to the "intrinsic nature" of other conditions such as dementia infantilis and childhood schizophrenia.

While early infantile autism and childhood schizophrenia have virtually identical symptoms, Kanner argued that they differ in onset.

Kanner reported that the babies with early infantile autism were unusually apathetic, did not respond normally to people, did not assume proper posture to be picked up, startled at anything that disrupts their isolation, and lacked responsiveness.

His concise and cogent clinical descriptions of children with autism continues to inform, and is the standard against which current diagnostic criteria are measured.

Yankton State Hospital in Yankton, South Dakota
The Henry Phipps Psychiatric Clinic at the Johns Hopkins Hospital