***TAKING THE MYTH AND MYSTERY OUT OF THE HISTORY: Part Two: ASD in the 19th Century

The 19th century too seems to have had its fair share of children who might fit the criteria for ASD today: children who,  in keeping with those times, and depending on the severity of their problems were often classified as fools, idiots or imbeciles.

As ever some survived in the community whilst others were incarcerated in what were variously termed psychiatric hospitals or lunatic asylums.  Progress was in the air though and so some of the more fortunate found themselves in asylums set up by philanthropists, social reformers or educationalists; places where they were cared for and ofttimes given access to education or vocational training.

In France  Edouard Séguin, a physician, neurologist and educator, continued Dr Itard's educational revolution.  He came to believe that idiocy was caused by a degeneration of the central nervous system and identified a number of things that might cause 'accidental idiocy',  including a poor diet, sunstroke, hydrocephalus, measles, whooping-cough, intermittent fever and even seizures. 

With his positive outlook he also believed that the cognitive abilities of such children could often be increased through physical exercises and sensory development.  Séguin put his ideas into practice when he set up the first (?) residential school for such children and would eventually emigrate to the USA where he continued his work.  

Meanwhile over in the UK the prominent philanthropist and social reformer Reverend Andrew Reed had begun to set up institutions to care for people with a variety of learning disabilities:  one being Essex Hall in Colchester, another the Earlswood Asylum for Idiots in Surrey (later known as the Royal Earlswood Hospital).  And it is there that we find the savant James Henry Pullen who, like his brother William, was apparently deaf and nearly mute. 

Although considered ineducable,  James was obsessed by boats and from an early age had made ships from firewood, cotton and pins.  Aged thirteen he was sent to Essex Hall and some two years later went to live at Royal Earlswood, which was to be his home for the rest of his lengthy life.

On admittance – around 1850 – it was noted that James was nearly deaf and dumb, could neither read nor write but had a slight idea of drawing. He was also said to be unsociable, passionate and self-willed - with an explosive temper which stayed with him throughout his life;  although it was said that in time he responded to 'judicious training' and became 'nicely behaved and sweetly confiding'. 

James came to excel artistically and was given two workshops in which he worked all day, doing carpentry, cabinet making and carving and then spending his evenings drawing.  Indeed, so impressive were his artistic and mechanical skills that he became a national celebrity, known as the Genius of Earlswood Asylum. Even the Prince of Wales (later King Edward VII) sent him some ivory tusks to use for his carvings and one of his drawings was accepted by the Queen, who sent him a gift in return.

His abilities and life are well documented and so we know that he had great  powers of observation, comparison, attention and memory but was also thought to be too childish,  emotional and unstable to survive on his own.  Even so the doctors who knew him best disagreed about his basic disability. Thus whilst one concluded he had a 'secondary mental deficiency' due to his deafness, another believed that the problem ran much deeper. 

We shall never really know of course but whatever the cause it certainly seems possible that today he would find a place somewhere on the spectrum.

Of course many other children with various problems lived at Earlswood over the years alongside a number of doctors whose work was – and still is – extremely informative.   And it is there in the 1850s that John Landon Down (best known for identifying Down's syndrome) became Medical Superintendent; where he also acted as psychiatrist, psychologist, social worker, supervisor, counsellor and administrator.  
    
Under his leadership Earlswood gained a world-wide reputation as a center of excellence where children got good food,  physical exercise and were even involved in using role-play to learn social activities like shopping.  Most importantly Dr Down also spent much time observing the children and adults there and that  enabled him to build up a  detailed picture of each patient. 

Fortunately he also left some detailed accounts of his work and so we know that there were other savants there too - all boys - who were 'feeble-minded' but  exhibited special faculties such as artistic, musical and numerical skills and 'extraordinary' memories.  Thus one could repeat the Rise and Fall of the Roman Empire verbatim  –  including a mistake and the correction he made the first time he had read it.  Another could 'tell the tune, words and number of nearly every hymn in Hymns Ancient and Modern' while others had amazing recall or powers of calculation.     

Dr Down divided his patients into classes according to the cause of their disorder, some inherited, others linked to accident or illness;  many having epilepsy.  He also noted a number of different causes including stress during pregnancy; problems during birth and subsequent illness.

Those groups?  One contained children of 5 or 6 who, on entering Earlswood,  all had echo-like speech. 

Another hetermed 'developmental' because many of the children had initially seemed  normal until, often when teething,  their progress seemed to stop.  At which point he says they lost their brightness and their speech, became less responsive and developed a number of strange traits - e.g. strange rhythmical movements.  Thus, after such a deterioration, one boy was said to have .' . . heard everything . . . but never replied to a question and even after regaining some speech 'always spoke of himself in the third person'.  Sounds familiar doesn't it? 

Meanwhile another group of children showed no physical signs of retardation, but, in contrast to those in the 'developmental' group, had never reached their developmental milestones in the first place: echoing what we know today as early onset autism. 

Then there were a group of children whose problems seemed 'accidental'.  They too lacked any of the physical aspects of feeble-mindedness,  leading him to suggest that they were:
. . . born, or ready to be born, with all the potentiality of intelligence, but whose brain become damaged by traumatic lesions, by medications, or by inflammatory disease.

Dr Down even identified a possible culprit - meningitis - which he thought probably resulted from illnesses such as scarletina, measles or smallpox and also noted that, although recovery was  rare, a few of them had been affected by TB meningitis. 

However Drs Séguin and Down were not the only people to make such observations as the next article will show.

Adapted from The Cracks in the Code - the first book in new series The Autism Code.