Leo Kanner

Leo Kanner

Leo Kanner ca. 1955.
Born June 13, 1894
Klekotow, Austria-Hungary
Died April 3, 1981(1981-04-03) (aged 86)
Sykesville, Maryland, U.S.

Leo Kanner (pronounced "Kahner"; June 13, 1894 – April 3, 1981) was an Austrian-American psychiatrist and physician known for his work related to autism. In 1943, Kanner published a landmark paper, "Autistic Disturbances of Affective Contact" describing 11 children who were highly intelligent but displayed "a powerful desire for aloneness" and "an obsessive insistence on persistent sameness".[1] He later names their condition "early infantile autism." This is now known as autism. Because of this he is referred as the "father of child psychiatry". He is considered to be one of the most influential American clinical psychiatrists of the 20th century.

His known life and career

Life in Berlin

Kanner was born in 1894 in the small town of Klekotów, Austro-Hungary (nowadays Ukraine). In this area the proportion of people of Jewish descent was about 70% of the total population.[2] His parents were Jewish and he received both a religious as well as a secular education.[3] Kanner spent the first years of his life in Klekotów with his family and was brought up according to Jewish tradition and custom.[3] As a young boy he moved to Berlin in 1906 to live with his uncle.[3] Kanner passed his final examinations from Sophien Gymnasium and decided to go to medical school.

With the outbreak of World War I while he was 20 years old, Kanner – because of his Austrian origin – was recruited to serve in the Austro-Hungarian Army, and was in the medical service of the 10th Infantry Regiment.[4] After his military service he continued medical school and passed his medical exams in 1916. He officially became a physician in 1921. As a physician he worked as a cardiologist in Charité Hospital. Kanner began doing work with normal heart sound to the relationship of the electrocardiogram.[3] At that time, the atmosphere at the Charité clinics and institutes inspired rapid progress in science, teaching and patient care.[2] 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.[3]

An American physician persuaded him to immigrate to the United States. At the time economic conditions in Weimar Germany were not favorable due to the post-war hyperinflation.[2] This was an auspicious move; if he had stayed in Austria his fate would have been similar to other Jewish professionals who lost their lives during the war.[4] He stated: "Little did I know, if I had remained in Germany I would have been perished by Hitler in the holocaust”.[1] He would later find out that moving to the USA was one of his best decisions.

Life in the United States

He finally moved to the United States in 1924. In America, Kanner immediately received a position as assistant doctor at the state hospital of South Dakota. As he did not have any experience in pediatrics and psychiatry, he acquired it here, in practice, studying the subtleties of these spheres of medicine at night.[2] Later, in 1930, Adolf Meyer and Edward Park selected him to found the first children's psychiatric department at the pediatric hospital of Johns Hopkins Hospital in Baltimore.[4] Kanner accepted the offer and three years later became a professor of psychiatry. In 1935 the first edition of his textbook, Child Psychiatry was published. This was the first English language textbook for child psychiatry.

Studies of Autism

Kanner expressed a great deal of concern about the usual mistreatment of mentally disabled children. He expressed concern about a society that causes the intellectual haves to look down on the intellectual have-nots, which led many to look down on the mentally deficient child as an object of adult manipulations rather than as a human being who reacts to affection and hostility, to acceptance and rejection, to approval and disapproval, to patience and irritability as any other child would.[5] This led to his major work in 1943, "Autistic Disturbances of Affective Contact," published in 1943. In this article, Kanner characterizes eleven cases, 3 girls and 8 boys, and would later call his observations 'autism'.

Kanner indicated that the fundamental issue of this disorder is the children's inability to relate to people and objects in an ordinary way.[6] Kanner called this "extreme aloneness". He spoke of these preferences of being alone also applying to loud and noisy objects.[6] Regarding the children’s lack of interest towards people, Kanner stated that ‘it would be best to get these interferences over with, the sooner to be able to return to the still much desired aloneness’.[1] Kanner (1943)[1] noted that many of the children had been diagnosed with schizophrenia at one point. He differentiated the two disorders, however, stating that a person with schizophrenia steps outside his or her world and departs from already existing relationships, whereas the children he described had never established such relationships, experiencing an extreme aloneness from very early on.[6] Kanner[1] further noted the centrality of speech disturbances in this disorder, observing that many of the children were delayed in their speech, and that those who were verbal often used speech in peculiar ways (e.g., echolalic repetition of phrases and/or inflexible use of language as seen in the exact repetition of pronouns).[7] Kanner (1943)[1] also 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, as well as limited spontaneous activity.[6] 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.[7] Kanner (1943)[1] indicated that 4 of the children had been considered deaf or hard of hearing early on. He also reported early difficulties with eating and suggested that eating may have represented the first intrusion into the children's extreme aloneness.[6] He noted that the children had no particular health difficulties and that their EEG results were normal. He did, however, observe that 5 of the 11 children had relatively large heads, and a few were somewhat clumsy in their gait.[8] Kanner also recounted his observations of the children’s families: he noted the high level of intelligence characterizing parents and relatives, while at the same time asserting that there were few warm-hearted parents among the families he observed.[6] He suggested that parenting might contribute to the development of autism, but he also balanced this suggestion with the observation that the aloneness of these children was present very early on, making it unlikely that the whole picture of the disorder was the result of parenting.[7]

Kanner's 1943 paper eventually had a profound impact on the fields of psychology, education, and developmental disability.[6] In his "discovery" of autism, Kanner focused on the clinical presentation of a group of individuals and then inferred the common features of the disorder.[6] Although he gave some insight into possible pathways through which the disorder might emerge, Kanner’s description of autism was largely theoretical.[5]

Legacy

Kanner was the first physician in the United States to be identified as a child psychiatrist. His textbook, "Child Psychiatry" (1935) was the first English language textbook to focus on the psychiatric problems on children. In 1943, Kanner first described the syndrome of infantile autism. His concise and cogent clinical descriptions of children with autism continues to inform, and is the standard against which current diagnostic criteria are measured.[9] Leo Kanner was a man of many firsts. His research on autism paved the way for many researchers today and still has a huge impact and meaning today.

It has been more than 70 years since Leo Kanner's 1943 paper, and research on autism continues to be an area of increasing interest. Although much progress has been made, this field is still in its infancy, and many avenues of research are just beginning to be pursued.[6] Despite the time that has passed, the syndrome Kanner identified and his comments about the children he observed continue to have meaning today, and although some of his suggestions about the etiology and presentation of autism were grounded in the thinking of his day, many of his observations were quite prescient.[6]

Papers

Books

Obituaries for Leo Kanner

References

  1. 1 2 3 4 5 6 7 Kanner, Leo (1943). "Autistic Disturbances of Affective Contact" (PDF). Nervous Child.
  2. 1 2 3 4 Bender, L (1981). ""In memoriam Leo Kanner, M. D. June 13, 1894--April 4, 1981."". Am Acad Child Psychiatry.
  3. 1 2 3 4 5 Neumarker, KJ (2003). "Leo Kanner: his years in Berlin, 1906-24. The roots of autistic disorder.". Hist Psychiatry. 14: 205–18. doi:10.1177/0957154x030142005. PMID 14518490.
  4. 1 2 3 Sanua, VD (1990). "Leo Kanner (1894-1981): the man and the scientist.". Child Psychiatry Hum Dev. 21: 3–23. doi:10.1007/bf00709924. PMID 2204518.
  5. 1 2 Bird, David (April 7, 1981). "DR. LEO KANNER, 86, CHILD PSYCHOLOGIST". The New York Times. Retrieved March 6, 2012.
  6. 1 2 3 4 5 6 7 8 9 10 Blacher and Christensen, J, L (2011). "Sowing the seeds of the autism field: Leo Kanner (1943).". Intellect Dev Disabil. 49: 172–91. doi:10.1352/1934-9556-49.3.172. PMID 21639744.
  7. 1 2 3 Cohmer, Sean (2014). "Leo Kanner and the Psychobiology of Autism" (PDF). Arizona State University.
  8. ↑ Eisenberg, L (1981). "Leo Kanner, M.D. 1894--1981.". J Child Psychol Psychiatry. 22: 317–22. PMID 7026583.
  9. ↑ "Leo Kanner's Legacy at Johns Hopkins Hospital". www.hopkinsmedicine.org. Retrieved 2015-12-11.
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