Leo Kanner

Leo Kanner introduced the label early infantile autism in 1943.

Leo Kanner, (pronounced “Conner”), (June 13, 1894 – April 3, 1981), was an Austrian psychiatrist and physician known for his work related to autism. Kanner’s work formed the foundation of child and adolescent psychiatry in the U.S. and worldwide.
Kanner was born in Klekotow (now Klekotiv), a small village north of Brody in the Ukraine. He studied at the University of Berlin from1913, his studies broken by service with the Austrian Army in World War One, finally receiving his M.D. in1921. He emigrated to the United States in 1924 to take a position as an Assistant Physician at the State Hospital in Yankton County, South Dakota. In 1930 he was selected by Adolf Meyer and Edward Park to develop the first child psychiatry service in a paediatric hospital at JohnsHopkins Hospital,Baltimore. He became Associate Professor of Psychiatryin1933..
In academical means, he was the first physician in the world to be identified as a child psychiatrist, founder of the first academical child psychiatry department at Johns Hopkins University Hospital and his first textbook, Child Psychiatry in1935, was the first English language textbook to focus on the psychiatric problems of children. His seminal 1943paper, “Autistic Disturbances of Affective Contact”, together with the work of Hans Asperger, forms the basis of the modern study of autism.
He became Director of Child Psychiatry at The Johns Hopkins Hospital in1930. He retired in 1959 and was replaced as Chief of Child Psychiatry by Leon Eisenberg.
Leo Kanner was the Editor for the Journal of Autism and Developmental Disorders, then called Journal of Autism and Childhood Schizophrenia, from 1971 till 1974.
Kanner remained active until his death at the age of 86, two months short of his 87th birthday.
When Doctor Kanner took his first job as a psychiatrist in the United States, he had to go to an asylum. There was little else he could do. Almost all psychiatric work was done in big institutions, many of them warehouses for the “chronically insane.” During Kanner’s medical school years, the American Psychiatric Association was still called the Association of Medical Superintendents of American Institutions for the Insane.
Most of these institutions were less than thirty years old but, by 1904, 2 in every 1,000 Americans lived in one. By mid-century, more than 500,000 Americans lived in mental institutions, more than 3 in every 1,000. The patients, many of them violent and with signs of psychosis, were often locked in barren cells, strait-jacketed. Not surprisingly, they usually got worse the longer they were there. Most asylums were depressing and inhospitable, unsanitary and with poor ventilation. And the psychiatrists, working in miserable conditions and having little hope of actually helping anyone improve, questioned the goals of their discipline. Was it simply to decide who was abnormal and then separate them from society, or was it to treat people and make them productive members of society? They were demoralized and found themselves denigrated by the medical establishment as second-rate caretakers. In 1928, the psychiatrist Werner Heinz poked fun at himself and his colleagues, saying that those doctors who decided to become psychiatrists were “afraid of failing,” “physically and intellectually inadequate.” They enjoy the asylums, he joked, because “they stand out there less.”
This was the same period during which Roy R. Grinker, Sr., became a psychiatrist. His career spanned most of the 20th century, from the early 1930s to his death in 1992, and for much of that time he was, like Heinz, cynical and pessimistic about psychiatry’s future. For a time, he thought the only hope for psychiatry was psychoanalysis. At least psychoanalysts treated patients, usually fairly healthy patients, people who were capable of making real progress. Psychoanalysts listened too, rather than shut their patients away in silent cells, believing the patients had something important to say. In 1935, Roy Grinker Sr founded the Department of Psychiatry at the University of Chicago, with an annual salary of less than $10,000, just weeks after he returned from Vienna and his expensive analysis with Sigmund Freud ($25 an hour, equivalent to $330 in today’s money, all paid for by the Rockefeller Foundation).
But there wasn’t much they could do for the most severely ill patients, other than sedate them, and little would change until May, 1954, the month Smith, Kline, and French introduced Thorazine, the first antipsychotic medicine. Before that time, doctors used hypnotics, like chloral hydrate and paraldehyde, or mixed them together in a colorful concoction many doctors called the “Green River.” It wasn’t metabolized by the liver, so the patients exhaled it, and, because it had a fruity odor, it attracted insects. “You would always know the patients with schizophrenia,” Roy Grinker Sr would say, “because they’d be the ones with flies buzzing around their faces.”
Leo Kanner was born Chaskel Leib Kanner, at home, to orthodox Jewish parents in a small Austrian village called Klekotow, in 1894 and he would struggle with these names for the rest of his life. He hated the sound of the name Chaskel, a Yiddish version of Ezekiel. Nor did he like Leib, so he changed it to Leo. And in the United States, despite telling people that Kanner should be pronounced “Connor,” only one person ever got it consistently right, a long-time Irish patient of the Phipps asylum in Baltimore who consistently called him Father O’Connor and said he was ready to give confession. In his retirement, Kanner would often ask himself whether all the fuss over names and naming in the world was really worth it.
Kanner described his father as abnormally short, socially awkward, obsessively dedicated to Talmudic studies, but also eager to absorb large amounts of useless information on just about anything in the world. Had his father lived in the 21st century, he might very well have been diagnosed with Asperger Syndrome. Kanner recalled that his mother played with his father’s unusual skills as if he was a toy, getting great pleasure by having him perform his amazing memory in public. If she had a skill, it was the art of opposition. She strayed from Jewish tradition often, and would eventually place Kanner in a public, non-Jewish high school where he felt isolated and unusual.
He was the only Jew in the school. Kanner, his four other siblings, and their parents—especially his mother—knew that for the children to get anywhere in life, they had to leave Klekotow. So at the age of 12 Kanner went to live with his uncle in Berlin, soon followed by the rest of his family. The Kanners lived simply, managing a small hotel while Leo’s father became a middleman in the rag business, and living in a small ghetto occupied by Galician immigrants. Kanner was one of the top students in the school, but he was isolated and lonely as the sole Jewish boy.
Now that Kanner didn’t live near his paternal grandparents he visited them as often as possible. He never understood why he liked them so much but it could be because they were as socially awkward as he and his father. They were both emotionally flat to a fault, matter of fact, seemingly incapable of showing much emotion. In later years, Kanner would remember how odd it was that their personalities and emotions seemed unchanged during and after tragedies, as when their son was called to military duty during World War I, or when their seventeen year-old daughter died from Typhoid. When his grandfather died, Kanner didn’t shed a tear. He wrote in his unpublished papers, now lodged at the American Psychiatric Association, that both grandparents were “paradigms rather than real people of flesh and blood.” How can you love or mourn people, he reflected, who were almost shadows of real human beings, people whose feelings never break the surface?
So Kanner was a lonely boy raised by bizarre, unexpressive people. And he often felt himself to be on the margins of society. Is it any wonder, then, that as an adult, he would be so sensitive to the needs of the handicapped, and so acutely aware of the social deficits that would become the hallmark of autism diagnoses?