Hans Asperger

Johann Friedrich Karl Asperger (, ; 18 February 1906 – 21 October 1980) was an Austrian psychiatrist. He is remembered for his pioneering studies of autism, specifically in children. His name was given to Asperger syndrome, a form of autism defined in 1981 by Lorna Wing, which is now referred to as Autism spectrum disorder - level 1 as per the DSM-5. He wrote more than 300 publications on psychological disorders that posthumously acquired international renown in the 1980s. He had previously termed the diagnosis, "autistic psychopathy", which garnered controversy. Further controversy arose during the late 2010s over allegations that Asperger referred children to a Nazi German clinic responsible for murdering disabled patients, although his knowledge and involvement remains unknown.

His role in Austria annexed by the Nazis remained unknown for a long time, until the study of archival documents. These show that Hans Asperger, who worked under the direction of his friend Franz Hamburger, collaborated with the Government of Nazi Germany, benefited from career advancement due to the flight of Jewish doctors, and participated in the selection of children sent to Am Spiegelgrund clinic, where some of them were murdered. The question of his personal adherence to Nazi ideology remains controversial, particularly because of his Catholic religious convictions.

Personal life

Hans Asperger was born in Hausbrunn, Austria, on February 18th 1906, and raised on a farm not far from the city. The eldest of three sons, his younger brother died shortly after birth. His younger brother, Karl, who is four year younger than him, died on the Soviet front of World War II. Hans describes his mother as pious and loving, while his father, Johann Asperger, who worked as an accountant but came from a farming family, was very strict. He grew up Catholic.

He was talented in language; in particular, he was interested in the Austrian poet Franz Grillparzer, whose poetry he would frequently quote to his uninterested classmates. He also liked to quote himself and often referred to himself from a third-person perspective. Hans had difficulty finding friends and was considered a lonely, remote child. This information is contradicted by Sheffer who emphasizes his regular attendance in youth movements.

As a youth, he joined the Wandering Scholars of the Bund Neuland(in the group of ''Fahrende Scholaren'', which organized outdoor activities such as hiking and mountaineering), a conservative Catholic organization within the German Youth Movement that he supported throughout his life. He considered this a formative experience, later stating: "I was molded by the spirit of the German youth movement, which was one of the noblest blossoms of the German spirit.". This movement maintained close links with the Hitler Youth from the 1930s onwards. Asperger married in 1935 and had five children.

Education

Hans Asperger claimed to have discovered his future vocation as a doctor by dissecting the liver of a mouse during his final year of high school.. He passed his secondary school final examination on May 20, 1925, with a distinction and the grade "very good" in all subjects.

According to his daughter, from 1916 to 1928, he followed an education oriented towards humanism, learning western philosophy, Latin and ancient Greek. Asperger studied medicine at the University of Vienna under Franz Hamburger and practiced at the University Children's Hospital in Vienna. Asperger earned his medical degree in 1931 and became director of the special education section at the university children's clinic in Vienna in 1932. He joined the Austrofascist Fatherland Front on 10 May 1934, nine days after Chancellor Engelbert Dollfuss passed a new constitution making himself dictator.

Career

1930-1938

According to Czech, "with the appointment of Hamburger as president in 1930, the Vienna pediatric clinic became a beacon of anti-Jewish policy, long before the Nazi takeover".

After the death of Clemens von Pirquet in 1929, Franz Hamburger expelled the Jewish doctors from the clinic, and also tried to remove the women. Hans Asperger thus obtained his first post in May 1931, thanks to the "purge" of Jewish doctors, as Hamburger's assistant at the University Paediatric Clinic in Vienna. He then worked for different departments. Czech points out the changes in leadership: "The political orientation of Hamburger's assistants is illustrated by the fact that among those who obtained the highest academic qualification (habilitation), all, with the exception of Hans Asperger, were rejected in 1945 as Nazis". Under the influence of Franz Chvostek junior, the Vienna clinic became a "hotbed of pan-Germanist and Nazi agitation".

Erwin Lazar died in 1932 , and Hans Asperger took over in May 1934 or 1935, as head of the department of ''Heilpadagogik'' (or: ''Heilpadagogische'' curative pedagogy) at the pediatric clinic in Vienna. He joined an experienced team, consisting of psychiatrist George Frankl (who was Jewish), psychologist Josef Feldner and a nun, Sister Viktorine Zak. Asperger's very rapid rise to head a pediatric ward, despite his few publications and the existence of more qualified candidates, was facilitated by the anti-Jewish policy. The team also included, from August 1933 to February 1936, a young doctor specializing in gastrointestinal disorders, Erwin Jekelius, who later became a major architect of the Nazi extermination. The pedagogy employed in ''Heilpadagogik'' was inspired by Erwin Lazar, the founder of the clinic; Asperger continues and develops this approach. He was influenced by two pedagogues, Jan-Daniel Georgens and Johann Heinrich Deinhardt, who founded a specialized institute in 1856. He is particularly interested in the "psychically abnormal child".

In addition to Hamburger and Jekelius, Asperger frequented other Nazi ideologues, including Erwin Risak, who studied with him in 1931 and with whom he co-authored an article the following year. There is, however, no documented evidence that Asperger joined groups of Nazi sympathizers before 1938,.

His career was spent entirely in Vienna, with two brief exceptions. In 1934 he was invited to work for some time at the psychiatric clinic in Leipzig, with Paul Schröder. He was also invited for three months, during the summer of 1934, to the psychiatric hospital in Vienna, directed by Otto Pötzl (whom he would later describe as a "terrifying exterminator"). He joined the nationalist and anti-Semitic German Medical Association in Austria the same year.

1939-1945

During World War II, Asperger was a medical officer, serving in the Axis Powers, Axis occupation of Yugoslavia; his younger brother died at Battle of Stalingrad, Stalingrad. Near the end of the war, Asperger opened a school for children with Sister Viktorine Zak. The school was bombed and destroyed, Viktorine was killed, and much of Asperger's early work was lost.

Asperger published a definition of autistic psychopathy in 1944 that resembled the definition published earlier by a Russian neurologist named Grunya Sukhareva in 1926. Asperger identified in four boys a pattern of behavior and abilities that included “a lack of empathy, little ability to form friendships, one-sided conversations, intense absorption in a special interest, and clumsy movements”. Asperger noticed that some of the children he identified as being autistic used their special talents in adulthood and had successful careers. One of them became a professor of astronomy and solved an error in Newton's work he had originally noticed as a student. Another one of Asperger's patients was the Austrian writer and Nobel Prize in Literature laureate, Elfriede Jelinek.

In 1944, after the publication of his landmark paper describing autistic symptoms, Asperger found a permanent tenured post at the University of Vienna. Shortly after the war ended, he became director of a children's clinic in the city. It was there that he was appointed chair of pediatrics at the University of Vienna, a post he held for twenty years. He later held a post at Innsbruck. Beginning in 1964, he headed the SOS-Kinderdorf in Hinterbrühl. He became professor emeritus in 1977, and died three years later. AS was named after Hans Asperger and officially recognized in the fourth edition of the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM) in 1994; it was removed from DSM-5 and subsumed into autism spectrum disorder in 2013.

Posthumous adoption of Asperger syndrome diagnosis

Asperger died before his identification of this pattern of behaviour became widely recognised. This was in part due to his work being exclusively in German and as such it was little-translated; medical academics, then as now, also disregarded Asperger's work based on its merits or lack thereof. English researcher Lorna Wing proposed the condition Asperger's syndrome in a 1981 paper, ''Asperger's syndrome: a clinical account'', that challenged the previously accepted model of autism presented by Leo Kanner in 1943. It was not until 1991 that an authoritative translation of Asperger's work was made by Uta Frith; before this, AS had still been "virtually unknown". Frith said that fundamental questions regarding the diagnosis had not been answered, and the necessary scientific data to address this did not exist.

In the early 1990s, Asperger's work gained some notice due to Wing's research on the subject and Frith's recent translation, leading to the inclusion of the eponymous condition in the International Statistical Classification of Diseases and Related Health Problems 10th revision (ICD-10) in 1993, and the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders 4th revision (DSM-IV) in 1994, some half a century after Asperger's original research.

Despite this brief resurgence of interest in his work in the 1990s, AS remains a controversial and contentious diagnosis due to its unclear relationship to the autism spectrum. In 2010 there was a majority consensus to subsume AS into the diagnosis "Autistic Spectrum Disorder" in the 2013 DSM-5 diagnostic manual. The World Health Organization's ICD-10 Version 2015 describes AS as “a disorder of uncertain nosological validity”.

In his 1944 paper, as Uta Frith translated from the German in 1991, Asperger wrote: "We are convinced, then, that autistic people have their place in the organism of the social community. They fulfill their role well, perhaps better than anyone else could, and we are talking of people who as children had the greatest difficulties and caused untold worries to their care-givers." Based on Frith's translation, however, Asperger initially stated: "Unfortunately, in the majority of cases the positive aspects of autism do not outweigh the negative ones." Psychologist Eric Schopler wrote in 1998:

Asperger's own publications did not inspire research, replication, or scientific interest prior to 1980. Instead, he laid the fertile groundwork for the diagnostic confusion that has grown since 1980.

Since 2009, Asperger's birthday, 18 February, has been declared International Asperger's Day by various governments.

Nazi involvement

Edith Sheffer, a modern European history scholar, wrote in 2018 that Asperger cooperated with the Nazi regime, including sending children to the Am Spiegelgrund clinic which participated in the euthanasia program. Sheffer wrote a book called ''Asperger's Children: The Origins of Autism in Nazi Vienna'' (2018), elaborating on her research.

Herwig Czech, another scholar and historian from the Medical University of Vienna, concluded in a 2017 article in the journal '' Molecular Autism'', which was published in April 2018:

Asperger managed to accommodate himself to the Nazi regime and was rewarded for his affirmations of loyalty with career opportunities. He joined several organizations affiliated with the NSDAP (although not the Nazi party itself), publicly legitimized 'race hygiene' policies including forced sterilizations and, on several occasions, actively cooperated with the child 'euthanasia' program.

Dean Falk, an American anthropologist from Florida State University, questioned Czech and Sheffer's allegations against Hans Asperger in a paper in ''Journal of Autism and Developmental Disorders''. Czech's reply was published in the same journal. Falk defended her paper against Czech's reply in a second paper.

Norwegian doctor and historical scholar Ketil Slagstad added his interpretation of both Sheffer's and Czech's work in his 2019 article "Asperger, the Nazis and the children - the history of the birth of a diagnosis", in which he describes the nuances of the situation. He offers an alternative explanation of Asperger's involvement: citing the challenges of war, a desire to protect his career, and protection of the children for whom he was caring. Slagstad concluded:

The story of Hans Asperger, Nazism, murdered children, post-war oblivion, the birth of the diagnosis in the 1980s, the gradual expansion of the diagnostic criteria and the huge recent interest in autism spectrum disorders exemplify the historical and volatile nature of diagnoses: they are historic constructs that reflect the times and societies where they exert their effect.

Slagstad wrote, "Historical research has now shown that he spergerwas...a well-adapted cog in the machine of a deadly regime. He deliberately referred disabled children to the clinic Am Spiegelgrund, where he knew that they were at risk of being killed. The eponym Asperger’s syndrome ought to be used with awareness of its historical origin".

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{{DEFAULTSORT:Asperger, Hans
1906 births
1980 deaths
20th-century Austrian physicians
20th-century Austrian scientists
Austrian Nazis
Austrian pediatricians
Autism researchers
Combat medics
German Army officers of World War II
Nazi eugenics
University of Vienna alumni