Kanner Syndrome

front page. All of these headlines from seven about how the world was really starting to come apart, British soldiers being Sheldon Shanghai, Italy walking out of a peace conference, and a new law passed in Germany making it illegal for Jews to go into business with non Jews, all of this foreshadowing of World War two coming. And then right here on the same front page this little headline

doctor Mrs Death. Well, you know, the story of autism could have turned out very differently if what happened in Halifax had a different ending too. September A brisk afternoon by the harbor in Halifax, Nova Scotia. So close to the water you can almost taste the salt in the air. Dr leo'connor, who likes to walk, sets off on a stroll along the train tracks that trace the shoreline. Connor is forty three years old and about a year away from starting the research on autism that today defines his

career for most of us. But at this point he's already well known as the world's leading authority on child psychiatry. His book on the topic is the standard text. He heads the clinical Department of Child Psychiatry at Johns Hopkins, the first of its kind in the world. He's up in Canada for a conference. During a break, he takes a ferry across Halifax Harbor to have lunch at the home of an old friend. Afterwards, Connor decides to walk back to the ferry landing. It's a gorgeous walk along

a set of railroad tracks. But at a certain point these tracks cut out across a stretch of water, a little inlet called Dartmouth Cove. So now the tracks are running on top of this rickety wooden bridge. It's a train trestle about twenty ft above the water, and it's really narrow, just wide enough for a single set of railroad tracks. So there's really no shoulder there and there are no guardrails, but getting across it looks like it

should take a minute or two. It most so. Connor continues on steps onto the trestle and starts stepping carefully from railroad tie to railroad tie. He's out near the middle of the bridge when he sees the train coming at him. The train is moving fast. He's already too late to run back. His only option jump, but he doesn't jump. Instead, he attempts this sort of weird maneuver where he steps out as far as he can on one of the railroad ties, and he tries to make

himself as small as he can. I guess in the hope that there would be enough rule him for this oncoming locomotive to just squeezed by without hitting him. It doesn't work. The train hits him. It just clips him. Connor falls, his overcoat flapping up around him, his arms flailing, and then he hits the water. He's terrified, and not just because he's just been hit by a train. It's for the same reason that he chose not to jump. He can't swim. It is definitely not looking good for

the doctor from Baltimore. Question, what do I feel about retirement of Well, for one thing, I so far, I haven't retired. Here's Connor years later in an interview. The quality is kind of rough here and there, so we brought in a voice actor to recreate Connor's words verbatim. What do I feel about retirement and dead? Well, for one thing, so I haven't retired. Second, as to debt,

that is something that comes to everybody. I was near death when I had my accident in Nova Scotia, and since then it has given me a great deal of satisfaction to know that at that time I wasn't panicking. The only thought I had then was a good thing. My insurance policies are all paid up. Dead comes to everybody, it will come to me. So just when it looks

like he's going to drown, Connor gets really lucky. A member of the train crew named Murray Hanes, according to the newspaper story, sees the doctor hit the water and Haynes dives into the cold waters. He gets to Connor and pulls him to shore. A passerby runs for help from a doctor who lives nearby. Connor is badly shaken up and he has a broken hip, but he's alive, and Connie recovered pretty quickly. He was out of his plaster cast within him better of months, and never even

had a limp after everything that happened. He does complain, however, that the accident left him unable to dance, which of course was a joke, because Connor could never dance to begin with. Connor may have made light of what happened, but when John and I were researching the origins of the autism diagnosis, we always wondered what would the world be like if that guy hadn't jumped in to save him.

How would we be thinking about kids with autism? Would we still be locking kids away for life, euthanizing them, sterilizing them. Would autism as we understand it today even have been recognized by now? Your question is an extremely important one, probably an unanswerable one. That's Dr Leon Eisenberg. He worked under Connor as a young doctor, and then he went on to become a huge figure himself in

child psychiatry. It's a question that's raised in physics so all the time, and you get these wonderful stories about the guy who goes to sleep and see the six carbon atoms holding their hands, and when he wakes up in the morning says, that's it, that's it, that's it. Well, what capacity to take an abstract problem and to make it visual to see the the atoms holding onto each other, and then RAMI faded back towards is a question I think we have a really successfully answered. So your question

is important. It's probably unanswerable. From my Heart radio, this is autism's first child. I'm Karen Zucker and I'm John Dunvin. In our last episode, we met Beamon and Mary Triplet of Forest, Mississippi their determination to unlock the meaning of their little boy, Donald's unexpected behavior. We'll change history in this episode, Donald meets the father of child, said Kietry.

Episode two Connor Syndrome, a young couple from a town called Forest, Mississippi, Beamon and Mary Triplet brought their three year old boy, who was acting and speaking in ways they didn't understand, to an institution about an hour and a half from their home to live there without them. They arrived at the institution, checked him in, and then

they drove home. There's no way for us to know how painful this was for Mary and Beaman, but they were doing what parents in that error were told to do by almost the entire medical establishment whenever a child in the family presented as mentally defective. Those two words just sounds so horrible, but in that era, that's how doctors talked about kids like Donald who were different. The idea was to remove those kids from their families, like they were not fully human and even posed a danger

to society. And then the families were told to move on with their lives, as though these kids didn't even exist. To get on with their lives, that was the phrase they used. Have more kids, that kind of thing. Mary and Beaman did that. They had another son, Oliver, with Donald away, so they were kind of playing by the roles. But there was a part of them that we sing didn't feel right about that. And here's what we know

happened next. They wanted basically to get another opinion about Donald, and they wanted to get it not just from another doctor, but from the top child psychiatrist in the country, if not the world, who was none other than the man who nearly perished in that train accident less than a year earlier. Dr leo'connor. Now Connor is a fascinating and singular character. Here's Dr Leon Eisenberg again reflecting on his

mentors personnel pity. He who was an unusual child, who is an unusual capacity for memory aver seeing patterns where they were not fel Evidently, he was born in Austria and he went to med school in Berlin. Well, I might say briefly in the internroduction that I had originally had my medical training in Berlin medical school. That's from

an interview with Dr Connor in two. It's one of three long interviews recently discovered by the archivist at the American Psychiatric Association, and these tapes have probably only ever been heard by a handful of scholars. I had some excellent teachers that included a classical student of organic psychosis and would later be punished after going against Tyler and his son was killed by Nazis. I specialized first in

internal medicine. I came in on the ground for of electric cardiography and published my thesis on electric cardiographic work and also my first paper. Connor was thirty years old and had a growing medical practice in Berlin when he moved to Yankton, South Dakota on a whim. An American physician he had grown close to helped Connor land a position at the South Dakota State Hospital for the Insane. Connor was fluent in seven languages when he arrived in Yankton. Unfortunately,

English wasn't one of them. He worked at changing that, just as he worked hard at becoming culturally American, buying a Chevy, taking up golf, joining a weekly poker game. Back then, the field of psychiatry was still new and not really professionalized like it is today. Basically there was Freud and a lot of Germans and Austrians theorizing about neuroses, and then there were just regular doctors working in mental hospitals figuring out how to help patients just using their instincts.

They were basically self taught, and that's how Connor learned psychiatry. Also, working in Yankton, he developed his own values and philosophies about how mental patients should be treated them. One of them was he thought we should avoid pigeonholing people and getting to know them as individuals, as people with their own stories that needed to be listened to, and doing that became one of the hallmarks of his life's work.

Here's the late doctor James Harris, another of Connor's protegees from Hopkins, in an interview with the BBC, he was a wise man, a scholar, a compassionate clinician. Although he was retired, he would drop by the clinic and encourage staff members in their work. But I think most importantly was his rapport with children. Children talked to him, he listened. His timing was exceptional. He was particularly concerned the children

be treated as individuals. They tell the stories if you let them, if you don't use the aha reaction, you know what they mean by that. Some people look at drawing and say, Aha, this means this, and this means that to home to the interpreter. But if you're going to give a chance to talk about it, you'd get their story and not your biases and preoccupations. Connor got restless and yanked in and he left to work on

a three year fellowship at Johns Hopkins in Baltimore. When the fellowship was finished, Hopkins gave Connor the job of setting up the first psychiatric department within a pediatric hospital in the United States. In short order, he became the field's most prominent figure. But at the start, the hospital provided Connor with just a small room that had a washstand and a desk. The little acorn from which the oak of the Children's Psychiatric Service at Yarns Hopkins Hospital

grew was not much to look at. I was installed in an abandoned annex and the Harrott Lynn Home, which was once used as an isolation ward for children with infectious diseases. The room assigned to me had a shaky white table, there was no waiting room, and there was nobody to look after the children when I interviewed the parents. Occasionally an adventurous rodent found its way up from the cellar and enabled at the sandwich which I had brought

for lunch. But it grew from there as Connor became a major figure in the United States and eventually around the world, whose textbook called Child Psychiatry became the standard in the field, and Hopkins itself became the training ground for dozens of young doctors who would go on to forever change our understanding of pediatric psychiatry. And it's where one day in the summer of Connor received a letter from the father of Donald Triplet. Now John and I

knew something about the backstory of this letter. We know that back in forest, Beaman triplet dictated to his secretary while she filled her notepad with shorthand then she typed it all up. Beamon wasn't just a successful lawyer. He was a man with first rate observational skill, and he was determined to compose a really full, complete, comprehensive biography of this four year old child that he and his wife had sent away. And this letter he wrote would

turn out to be a game changer. In time. His words would travel far and wide around the world. They would be quoted in scholarly research, They would be discussed in university classrooms. They would be translated into many many languages. But on that human day and forest, it was just one father speaking from his heart about his boy. You seem to be self satisfied. He is never glad to say father or mother. He has no apparent affection when petted,

it does not observe the fact that anyone combs or goes. It. Never seemed glad to say father or mother or any playmate. He seems to draw into his shell and live within himself. He seldom comes to anyone when called, but actually picked up and carried or led wherever he ought to go. Beamon described Donald's eating habits, his verbal patterns, the age of which he learned to walk and count and hum

and sane. And here's the thing, Little Donald showed glimmers of real brilliance for a young child, and has just tantalized his parents to see how he dialed in on activities that captivated him in such an intense way at the age of two, that will memorize the words of many songs and the melodies that went with them, the names of all of the presidents of the United States. But here's the other thing. According to his father, Donald could do little with these facts beyond reciting them rotely.

He said that conversation with his son was impossible because Donald seemed to have no interest in people, and he wasn't learning to ask or answer questions. In fact, he said, his son seemed unreachable by any of the usual ways that parents connect with their kids. He appears to always be thinking and thinking, and to get his attention almost requires wanted to break down a mental barrier between his inner consciousness in the outside world. Beaman's letter went on

and on like this. By the time as secretary finished typing the letter, it ran to thirty three single space pages, and it's historic because it would be the basis of a landmark account of a child with autism, a term and diagnosis that did not yet exist. When we return Beaman and Mary Triplets stage a rescue for their little boy. So Beaman sent the letter off to Baltimore, and Connor received it and he read it, and he wanted to

see Donald. A date was set, and in those days far As, Mississippi was a long way away from Baltimore, Maryland, but that's where Donald was heading now for an in person meeting with Dr Connor during the first week of October. Beamon triplets letter describing Donald is a hugely important document because it's just so influential. But sadly for us, for everyone,

most of what he wrote has been lost. We have excerpts quotations from it that Connor published, but the original it's gone and there don't seem to be any copies, so we've never been able to read the full text, not that we didn't try. In fact, we searched for that letter a long long time. We pastor Johns Hopkins to look through their archives and they never turned it up, although we did find some of Donald's initial medical records. There, we went through every page of the Connor archive at

the American Psychiatric Association. Then we went down to Forest and visited Beamon's old law office, where there was a room stuffed with old, rusting metal file cabinets stuffed with papers, but nothing there of that letter. We went to an old bank vault in Forest that his family used to store the overflow from Beamon's law practice and went through

all of those filing cabinets. Nothing there. Then Donald let us go through all of the cupboards and closets and drawers and a x in the house where he grew up. His family had saved everything. In fact up in the attic. We found love letters between Mary and Beeman in the early nineteen twenties, perfectly preserved after a century. But we just didn't find what we were looking for, that famous letter. So writing that letter was just one step Donald's parents stuff.

The next one was even more important in Donald's life. They had sent him away because they were told it was the right thing to do. Now they decided it wasn't the right thing at all. Here's Donald's nephew, Oh B. Triplett. I think one day. So she said, you know what, I'm not doing this. I am not doing this. It doesn't you know, doesn't pay all right or whatever. And then you know, we're going to turn the page and started to know the chapter in the life of Don.

So they drove back down to that institution and they told the director they were taking Donald out and taking him back home. And here's the amazing thing. They got pushed back. Okay, the director insisted, and this is a quote. Donald is getting along nicely now, and he said they should leave him alone, which meant leave him there. But Mary's mind was made up. She dressed Donald and clothes she had brought him from home, and then the three of them got in the car and they drove home

together and now to Baltimore. Donald had just turned five a few days earlier when he and his parents boarded the train in Meridian, Mississippi. The train journey took two days across seven states, and for Donald, we imagine this trip must have been one of those bewildering, maybe mesmerizing explosions of new sensory experiences. I mean, don't we all have that experience in a train at night, staring out the windows, watching the lights, sling through the blackness outside.

Their journey ended in Baltimore at the Harriet Lane Home for Invalid Children. After a physical exam, Donald was led into a hospital library and presented to a group of roughly thirty physicians. Donald blocked eyes on some alphabet blocks in one of the doctor's hands. He grabbed them and started spinning them, seemingly completely oblivious to anything else going on. And a little later he walked up to one of the older doctors and reached up to stroke his beard.

Our research on Donald's story brought us to the library at the American Psychiatric Association in Arlington, Virginia. He spent a lot of time there and found, amongst many other things,

that Leo Connor had written an unpublished autobiography. More recently, a series of audio recordings of long interviews Connor sat for in the late nineteen sixties and nineteen seventies was discovered, and Karen, you made a really interesting find in the Hopkins archives, the intake notes on Donald for when he first got to Hopkins. Yeah, they were only a few pages long, but no journalists had ever seen them before. In October nine hundred and thirty eight, a five year

old boy was brought to me from Forest, Mississippi. I was struck by the uniqueness of the peculiarities which Donald exhibited. He could, since the age of two and a half years, tell the names of all presidents and vice presidents, recite the letters of the alphabet forwards and backwards, and flawlessly, with good enunciation, rattle off the twenty third song. Yet he was unable to carry on an ordinary conversation. He was out of contact with people. What he could handle

objects skillfully, His memory was phenomenal. The few times when he addressed someone, largely to satisfy his wants, he referred to himself as you and to the person a desk as I. He didn't respond to any form of intelligence testing, but manipulated intricate form boards jointly. Donald remained in Baltimore for two weeks observation and study at the Child Study Center, on whose the directors I was a member, and of course Connor and his colleagues remarked on all of the

ways that Donald appeared to isolate himself. Connor observed that Donald showed disappointment when he didn't get his way, and it seemed that he did like getting praise. That's all stuff a typical child would do. But Connor also noted Donald doing some really unusual things. For example, he would walk around drawing letters in the air with his fingers and speaking out random words like semicolon and capital and

twelve twelve. He chewed on paper, he put food in his hair, he threw books into the toilet, he put a key down the water drain, he threw temper tantrums, he climbed all over the furniture. So Donald spent two weeks being observed in Baltimore, and after that the family went back home to Mississippi, and from that point on, Mary started sending almost monthly letters to Connor describing how he was doing at home, and some of what she

wrote showed some real development going on. He learned to read fluently and to play simple tunes on the piano. He began responding to yes or no questions. He started building things with his blocks, watering flowers with his hose, playing store with the household groceries. Yet it was clear that Donald still had some serious challenges, and he made several more visits to Baltimore over the next few years,

kind of becoming one of Connor's favorite patients. The truth is Donald fascinated le O'Connor and made him want to figure out exactly how this boy was different and why, and Donald's parents wanted to know the same thing. We found some correspondence between Connor and Mary where she admitted to being worried that she had quote a hopelessly insane child. Connor took these feelings seriously, and he wanted her to be more optimistic. In his next letter, he urged her

to quote refrain from that type of gloom. Many times he wrote to reassure her that our efforts to help Donald were splendid and often heroic. Donald, he insisted, was fortunate in having you for a mother. Important things were happening in Donald's life during these years. In the fall of nineteen thirty nine, he began the first grade. Mary wrote Connor about that also October nineteen thirty nine. The first day was very trying for him, but each succeeding

day he's improved very much. Dawn is much more independent. He wants to do many things for herself. He marches in line nicely, answers when called upon, and is more bidable and obedient. In March of nineteen forty, in the middle of the first grade year, Mary noted to Connor, the greatest improvement I noticed is in his awareness of things about him. He talks very much more and asked a good many questions. Not often does he voluntarily tell me things at school, but if I asked leading questions,

he answers them correctly. He really enters into the gangs with other children. One day he enlisted the family in one game he had just learned, telling each of us just what to do. Donald paid another visit to Connor. In one he was inexhaustible and bringing up variations like how many days in a week, years in a century, hours in a day, hours and a half day, weeks in a century, centuries and a half a millennium. So it's now four years since Connor and Donald met, and

Mary starting to get impatient for something. She wants a solid explanation, a diagnosis. She writes to Connor, complaining that he had given her only generalities. The truth was, he confessed that he still simply could not match Donald with any familiar or standard label, nothing that was in the textbooks, nor could he predict Donald's future prospects. Donald's behaviors comprised the syndrome. Connor was still struggling to see in full.

But then he told her some news that he was beginning to realize that Donald had a novel kind of syndrome. He said, he is putting together a paper detailing the outlines of this new diagnosis. He kept this news to himself, he said, because he wanted to have sufficient time to observe the children and follow their development. Soon, however, he intended to go public with these findings and to give his discovery a name. In Dr Leo O'Connor published his

landmark paper Autistic Disturbances of Effective Contact. For here we seem to have pure cultural examples of inborn artistic disturbances of effective conduct. The way Connor describes autism, the way he wrote about it, and the language he used, was remarkable in itself. What he did made autism, you know, sort of a thing because it was so clear and accessible to the reader. That's Dr Joseph Pivet. I'm a psychiatrist with training and child menolyist and psychiatry and adult psychiatry.

I've done a number of different things in my research career. Now is looking at infants at high familiar risk for autism and following them over time, looking at how their brains develop and their behavior, and have kind of connected with leo'connor in that area. Dr Piven is a big

fan of Leo connor's. I give a lot of talks to trainees and students and particularly those that don't know about autism, maybe graduate students in neuroscience, and and I asked the students to read that first paper because while it's not synonymous with the breath and of the way we think about autism today, it's just so rich and it's description. I often talk about how you could you could read the d s M all day and sit on the bus next to somebody with autism and not

realize that they have autism. But if you read Lee O'Connor's accounts, it just as you say, leaps off the page. You know, not only was he institute observer in general and a great writer, but he was able to kind of distill some of the essential features out that are

still with us today. And we're still sort of wrestling with terms that really kind of have persisted in our conversation, like insistence on sameness, something that's important to understand the term autistic wasn't something that Connor came up with on his own. It had been quite a few decades earlier to describe a behavior that was thought to be unique to schizophrenia, where people sometimes withdraw for a while socially

and appear to lose contact with the outer world. So back in the nineteen thirties and nineties, psychiatrists who described somebody as autistic or displaying autism meant only that the person was behaving that way, that socially withdrawn way for the moment. It described one symptom, not a syndrome, and definitely it did not yet describe the diagnosis we know today.

Various psychiatrists applied it to various people with various constellations of behaviors, and now Connor was using it to characterize something about the complex set of behaviors he saw Donald and the other children that together he believed constituted a single, never before recognized diagnosis. Here's Connor again, in in my search find appropriate designation, I decided on the term early infantile autism, thus accentuating the time of the first manifestations

and the children's limited accessibility. Years later, Dr Connor claimed that identifying autism was serendipity. He didn't discover this syndrome, he said, because it was always there. Connor, however, news that in psychiatry the obvious often went unrecognized until someone looked at it with the right set of eyes. And that's what leo'connor had meeting Donald. Thinking about Donald gave him the right set of eyes to recognize what today

we call autism. Today we call it autism, but there was a time and you can still find this in the medical literature from the nineteen fifties when the syndrome that Leo Connor wrote about was called by many professionals Connor's syndrome. In the mid twentieth century, having a syndrome named for you is considered a great honor, but Connor

didn't really go for it. I'm identified little too closely with one particular thing that I did, and that I consider a vignette of my activities rather than the main principle. But now autism is identified with me, and I with it. I think it just speaks to the fact that he was an incredible human being, and incredible human beings don't try and sell themselves on one thing they accomplished, that's

Dr Piven. If you train at Hopkins and Child Psychiatry, interacting with Leo Connor is on a warble, you know. So he clearly was the first director of child psychiatry Hopkins. That's not a small thing in those days. He wrote the first textbook on child psychiatry, so he essentially established the field of child psychiatry. But he also used his stature and position in some of the cultural wars of his era. Remember he was working when ideas like eugenic

still had a huge following among important people. Well, here's a clip of Connor describing an argument he started at the American Psychiatric Association meeting in twenty five years ago. At the meeting of the a p A in Richmond in nineteen forty one, then famous neurologists from New York gave a talk on euthanasia for the feeble minded, with the general feeling they are dragon society off with their

heads too much money. I rarely get real angry, but they did at the time, and there was no discussion anticipated, but I got up and had my say, whereupon I was asked to give a talk the next year at the two meeting in Boston, which I did, and which

I called Exoneration of the feeble Minded. You know, Connor's use of the term feeble minded reminds us that he was still very much a man of his time, But the fact that he was doing battle with the eugenicists also shows us how he was ahead of his time too, and that he pioneered the entire field of child psychiatry, which took that special ability to listen and to empathize. It really helped to open the door to a lot

of progress and growth and killing. And yes, if he hadn't survived being hit by that train, who knows where we'd be. But we know Connor would never have met Donald, and Donald would never have met Connor. And in this version of how autism came to be known to the world at large, well the two of them meeting, it's how it did happen, and it really was everything. I'm

John don Vent and I'm Karen Zuker. Autism's First Child is a production of School of Humans and I Heart Podcasts, and it's based on our book and our documentary film in a different Key. Autism's First Child is produced by Alexander Ritchie our story. Editors are Matt Riddle and Alex French, senior staff writer at I Heeart Originals. Original score composed and mixed by Alice McCoy. Additional scoring, mixing and mastering

by Alexander Ritchie. Executive producers are Virginia Prescott, Brandon Barr, Elsie Crowley and Jason English. Special thanks to Ray Conley, Ernie, Indra Doot and Will Pearson. Editing an assembly by Kareem ben Yagoub. Voice worked by Louis Carloso, Ben Ritchie and Missy Ritchie for the recordings of Dr Lee O'Connor. Special thanks to Dina Goreland of the American Psychiatric Association Foundation, Melvin Saption, Empty Librarian Archives, and A p A Foundation School of Humans m