In a Different Key: The Story of Autism (82 page)

“a desirable procedure”:
Leo Kanner, “Exoneration of the Feebleminded,”
American Journal of Psychiatry
99, no. 1 (July 1942): 17–22.

filled her notepad with shorthand:
Author interview with Oliver Triplett.

“He never seems glad”:
The contents of Beamon Triplett’s letter are preserved only in the form of excerpts quoted by Leo Kanner in “Autistic Disturbances of Affective Contact,”
Nervous Child
2 (1943), 217–22.

experiment was deemed a failure:
Jimmy was not, after all, returned to the orphanage. He was adopted by acquaintances of the Tripletts, who bonded with him immediately upon seeing him. He lived in Forest the rest of his life.

“let him alone”:
Leo Kanner, “Follow-up Study of Eleven Autistic Children Originally Reported in 1943,”
Journal of Autism and Childhood Schizophrenia
1, no. 2 (1971): 120.

“glandular disease”:
Ibid., 121.

“referring to the foot on the block as ‘umbrella’ ”:
Kanner, “Autistic Disturbances,” 220.

“He wandered about smiling”:
Ibid., 219.

“a hopelessly insane child”:
Letter from Leo Kanner to Mary Triplett, September 17, 1939, Johns Hopkins Hospital medical archives. The records were given to the Triplett family in December 2007.

“the good sense you are using”:
Ibid.

Kanner wrote back to reassure her:
Letter from Leo Kanner to Mary Triplett, September 28, 1942, Johns Hopkins Hospital medical archives.

Kanner’s first recorded use of “autistic”:
As this book was nearing publication, journalist Steve Silberman published his book
Neurotribes
. In it he reported his original finding that a Czech diagnostician named Georg Frankl, who worked under Kanner in Baltimore in this period, had previously worked alongside the Austrian pediatrician Hans Asperger in Vienna. Silberman contends that through Frankl, and through Kanner’s own reading of German-language medical journals, Kanner would have known that Asperger had already used the term
autistic
as early as 1938. We find Silberman’s discovery of Frankl’s connection to both men intriguing. Moreover, his theory that Kanner built aspects of Asperger’s thinking into his own model of autism, without
crediting him, cannot be ruled out as a possibility. However, it seems just as plausible that Kanner, like Asperger, borrowed the term
autistic
from Swiss psychiatrist Eugen Bleuler, who famously used it in 1911 to describe behaviors he saw in schizophrenia. In a 1965 lecture, Kanner said exactly that. In addition, while both men called the cases they studied “autistic,” they focused on different populations of children, and the conditions they described diverged in several important respects.

In either case, it was Kanner’s use of the term
autistic
—not Asperger’s, which was little known outside the German-speaking world—that set off the complex chain of events that comprise the story of autism as it was lived and understood by thousands of families for decades to come. That is the story we tell.

In addition, as will become clear in
chapters 31
and
32
, our assessment of Asperger’s work and character differs from Silberman’s in significant ways.

CHAPTER 4: WILD CHILDREN AND HOLY FOOLS

“It was there before”:
Leo Kanner, speech given at the annual National Society for Autism Meeting, Washington, DC, July 17, 1969. A transcription is available from the American Psychiatric Association.

Around 1910, Bleuler:
Uta Frith, ed.,
Autism and Asperger Syndrome
(Cambridge, UK: Cambridge University Press, 1991), 38.

Half a millennium ago:
Natalia Challis and Horace W. Dewey,
The Blessed Fools of Old Russia
(Ann Arbor: University of Michigan; Franz Steiner Verlag, 1974), 1–11.

a pair of Russian-speaking scholars:
Natalia Challis and Horace W. Dewey, “Basil the Blessed. Holy Fool of Moscow,”
Russian History
14, no. 1 (1987): 47–59.

Hugh Blair of Borgue:
Rab Houston and Uta Frith,
Autism in History: The Case of Hugh Blair of Borgue
(Oxford: Blackwell, 2000).

“The available evidence”:
Ibid., 149.

The so-called Wild Boy:
Jean-Marc-Gaspard Itard,
The Wild Boy of Aveyron
, trans. George and Muriel Humphrey (Englewood Cliffs, NJ: Prentice-Hall, 1962).

“Seeing that my efforts”:
Ibid.

“to respect humanity in every form”:
Samuel Gridley Howe,
The Servant of Humanity
(Boston: Dana Estes & Co., 1909), 204.

“its moral character”:
Ibid., 204.

The result of Howe’s outrage:
Samuel G. Howe,
Report Made to the Legislature of Massachusetts upon Idiocy
(Boston, 1848), 8–17, 51–53.

“Science has not yet”:
Ibid., 7.

the Idiot’s Cage:
Catherine Slater, “Idiots, Imbeciles and Intellectual Impairment,” Langdon Down Museum of Learning Disability,
http://langdondownmuseum.org.uk/the-history-of-learning-disability/idiots-imbeciles-and-intellectual-impairment/
.

CHAPTER 5: DOUBLY LOVED AND PROTECTED

In the late summer of 1939:
Except where otherwise specified, the details of Donald’s life during the years 1939–1945 are from Leo Kanner, “Autistic Disturbances of Affective Contact,”
Nervous Child
2 (1943), and Leo Kanner, “Follow-up Study of Eleven Autistic Children Originally Reported in 1943,”
Journal of Autism and Childhood Schizophrenia
1, no. 2 (1971).

publication dates of
Time
magazine:
Author interview with Donald and Oliver Triplett.

an obsession with calendars:
Author interview with James Rushing.

It was not an institution:
Authors’ visit to Lewis home; interview with Oliver Triplett.

“Mr. & Mrs. Lewis are”:
Letter from Donald Triplett’s grandfather, William McCravey, June 22, 1943, provided to the authors by Oliver Triplett.

CHAPTER 6: SOME KIND OF GENIUS

When Donald was fourteen:
In 2005, a UPI journalist named Don Olmsted, later a founder of the website
AgeofAutism.com
, theorized that mercury was the cause of Donald’s autism. He built his case partly on the fact that Donald seemed to have improved after doctors at the Campbell Clinic gave him a compound known as “gold salts,” which was then a standard treatment for rheumatoid arthritis. Olmsted proposed that the gold salts had accelerated the removal of mercury from Donald’s body. In a book arguing that autistic behaviors in a child may often be the result of an environment contaminated by mercury, Olmsted elaborated on how mercury might have reached Donald’s developing brain. The lumber used in the construction of the Triplett home, he suggested, might have been treated with a mercury-based fungicide, which might in turn have leached into the air inside the house, where Mary Triplett would have inhaled it while pregnant with Donald.

In his initial reporting, Olmsted went so far as to suggest gold salts had cured Donald’s autism. He quoted Donald’s brother, Oliver Triplett, saying that Donald’s “proclivity to excitability and extreme nervousness had all but cleared up.” He also quoted a doctor—clearly one who had not examined Donald—who said, “It sounds like he moved right off the spectrum.”

The theory has several weaknesses, most notably the lack of any evidence that the wood in the walls of the Triplett home contained mercury, or that Mary Triplett was ever exposed to toxic levels of mercury. Also, as is clear to anyone who has ever met Donald, he continues to this day to be a person with autism. He did not “move off the spectrum.” Moreover, a 1956 write-up on Donald by Kanner’s deputy, Leon Eisenberg (“The Autistic Child in Adolescence,”
American Journal of Psychiatry
112, 8 [Feb. 1956]: 607–12), reported that the moderation of his autistic behaviors had started
before
he became sick. True, Eisenberg noted that Donald’s improvement had apparently continued
during the illness and afterward, when it even accelerated, but this perception could easily have been the natural result of watching a boy in terrible pain returning to himself as the pain receded.

In a 2007 interview, his brother Oliver told us that neither of Donald’s parents traced the lessening of his “nervousness” to the gold salts he was given at Campbell. Rather, according to Oliver, his mother believed that it was the high fevers Donald experienced that had improved his behavior. While her hunch is just as speculative as Olmsted’s gold salts theory, it dovetails intriguingly with recent research indicating that high fevers have a moderating effect on certain autistic behaviors. See, for example, Curran et al., “Behaviors Associated with Fever in Children with Autism Spectrum Disorders,”
Pediatrics
120, no. 6 (December 1, 2007): e1386–e1392.

about the bricks:
Author interview with Oliver and Donald Triplett.

They simply let him be:
Author interviews with Janelle Brown, John Rushing, and Celeste Graham.

and piano recitals:
Mary Triplett’s activities were often noted in the
Scott County Times
, the local newspaper, published in Forest, Mississippi, from 1950 to 1951.

Fortunately for Donald:
Janelle Brown interview.

blend in themselves:
Celeste Graham interview.

Donald
was
a numbers whiz:
Author interview with Buddy Lovett.

then a senior, approached her:
Janelle Brown interview.

Donald continued doing this:
Buddy Lovett interview.

One classmate, John:
John Rushing interview.

This was a landmark:
Scott County History Book Committee,
History of Scott County, Missouri: History & Families
(Paducah, KY: Turner, 2003).

“Billy Bob Hefferfield”:
Author interviews with Donald and Oliver Triplett.

When he graduated:
Donald Triplett shared his Forest High School yearbooks with the authors.

CHAPTER 7: THE REFRIGERATOR MOTHER

“You have a major problem”:
This and other details about Rita Tepper’s experience from an author interview with Tepper.

“diaper-aged schizoids”:
“Medicine: Frosted Children,”
Time
, April 26, 1948.

“kept neatly in a refrigerator”:
Ibid.

CHAPTER 8: PRISONER 15209

He was called
Dr
. Bruno Bettelheim:
Except where otherwise specified, details of Bruno Bettelheim’s life are from Richard Pollak,
The Creation of Doctor B: A Biography of Bruno Bettelheim
(New York: Simon & Schuster, 1997), and Bruno Bettelheim, “Individual and Mass Behavior in Extreme Situations,”
Journal of Abnormal and Social Psychology
38, no. 4 (1943): 417–52.

Bettelheim, upon his release:
Theron Raines,
Rising to the Light: A Portrait of Bruno Bettelheim
(New York: Knopf, 2002), 124.

“From these children”:
Grant application to Ford Foundation submitted by the Shankman Orthogenic School of the University of Chicago and Bruno Bettelheim, August 9, 1955, 4, Rockefeller Archive Center, Sleepy Hollow, NY. The files include Bruno Bettelheim’s proposals and responses to the Ford Foundation.

“From what we know”:
Bruno Bettelheim,
The Empty Fortress: Infantile Autism and the Birth of the Self
(Glencoe, NY: Free Press, 1976), 60.

Critics were awed:
Robert Coles, “A Hero of Our Time,”
New Republic
, March 4, 1967.

“as much a philosophical”:
Eliot Fremont-Smith, “Children Without an I,”
New York Times Book Review
, March 10, 1967.

“She studied it with intense”:
Bettelheim,
Empty Fortress
, 163.

“completely ignored”:
Bruno Bettelheim, “Joey, a Mechanical Boy,”
Scientific American
, March 1959, 131.

“This is essentially the same”:
Bettelheim,
Empty Fortress
, 67.

CHAPTER 9: KANNER’S FAULT

In 1949, Leo Kanner:
Leo Kanner, “Problems of Nosology and Psychodynamics in Early Infantile Autism,”
American Journal of Orthopsychiatry
19, no. 3 (1949): 416–26.