Hans Asperger

Hans Asperger married Hanna Kalmon in 1935,[14] whom he met during a mountain hike, and with whom he had five children; four daughters and a son:[15][16] Gertrud (born 1936), Hans (born 1938), Hedwig (born 1940), Maria (born 1946) and Brigitte (born 1948).[17] In 1961, Gertrud Asperger completed her doctorate at Innsbruck.[18] Another daughter, Maria Asperger Felder, became a renowned child psychiatrist.[16][18] Hans Asperger and his daughter were also "socially well-connected".[19]

Hans Asperger was a devout Christian, a practicing Catholic [7],[20] but without the political tendencies generally associated with Catholicism at the time.[21] His faith was initially considered a disadvantage in his evaluation after the Anschluss.[22] He was a member of the Sankt-Lukas Guild, which, according to Sheffer and Czech, "advocated for Catholic eugenics," [23] including support for "positive eugenics" (the multiplication of individuals considered desirable) rather than "negative eugenics" (the limitation of individuals considered undesirable).[23][24]

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.[9] He passed his secondary school final examination on 20 May 1925, with distinction and the grade of "very good" in all subjects.[25]

According to his daughter, from 1916 to 1928, he followed an education oriented towards humanism, learning western philosophy, Latin and ancient Greek.[16] Asperger studied medicine at the University of Vienna under Franz Hamburger and practiced at the University Children's Hospital in Vienna.[26] Asperger earned his medical degree in 1931 and became director of the special education section at the university's children's clinic in Vienna in 1932.[1] He joined the Austrofascist Fatherland Front on 10 May 1934, nine days after Chancellor Engelbert Dollfuss passed a new constitution making himself dictator. [27]

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"[7]

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.[28][7] Hans Asperger thus obtained his first post in May 1931, thanks to the "purge" of Jewish doctors,[29][7][30] as Hamburger's assistant at the University Paediatric Clinic in Vienna.[30] He then worked for different departments.[16] 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".[31] Under the influence of Franz Chvostek junior, the Vienna clinic became a "hotbed of pan-Germanist and Nazi agitation".[7]

When Erwin Lazar, the head of the curative pedagogy department died in 1932,[14][30][32] Hans Asperger took over in May 1934[30] or 1935,[7] as head of the department of Heilpädagogik (or: Heilpädagogische curative pedagogy) at the pediatric clinic in Vienna. He joined an experienced team, consisting of psychiatrist Georg Frankl (who was Jewish), psychologist Josef Feldner and a nun, Sister Viktorine Zak. [33] Asperger's very rapid rise to head of the pediatric ward, despite his few publications and the existence of more qualified candidates, was facilitated by the anti-Jewish policy.[7] 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.[34][7] The pedagogy employed in Heilpädagogik was inspired by Erwin Lazar, the founder of the clinic;[34] Asperger continued and developed this approach.[16] He was influenced by two pedagogues, Jan-Daniel Georgens and Johann Heinrich Deinhardt, who founded a specialized institute in 1856.[35] He is particularly interested in the "psychically abnormal child".[14]

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.[7] There is, however, no documented evidence that Asperger joined groups of Nazi sympathizers before 1938.[36][28]

His career was spent entirely in Vienna, with two brief exceptions.[16] In 1934 he was invited to work for some time at the psychiatric clinic in Leipzig, with Paul Schröder.[16][32] He was also invited for three months, during the summer of 1934, to the psychiatric hospital in Vienna, directed by Otto Pötzl[32] (whom he would later describe as a "terrifying exterminator"[16][30]). He joined the nationalist and anti-Semitic German Medical Association in Austria the same year.[37]

During World War II, Asperger was a medical officer, serving in the Axis occupation of Yugoslavia; his younger brother died at 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.[38]

Asperger published a definition of "autistic psychopathy" in 1944 that resembled the definition published earlier by Russian neurologist Grunya Sukhareva in 1926.[39][40] Asperger identified four boys with 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”. [38] Asperger noticed that some of the children he identified as being autistic used their special talents in adulthood and had successful careers: one became a professor of astronomy and solved an error in Newton's work that he had originally noticed as a student,[41][42]^: 89 and another was Austrian writer and Nobel Prize in Literature laureate, Elfriede Jelinek.[43]

Under the Third Reich, with his position as a doctor in Vienna, Hans Asperger was a decision-maker in the context of examinations of minors: he could defend them if he thought they would integrate into Volk (the national community of Nazi Germany), or the contrary, sending to Spiegelgrund the minors he thought were too deficit, and therefore unfit for integration.[30] Am Spiegelgrund clinic, created in July 1940 on the premises of the Steinhof psychiatric hospital in Vienna, was directed by Erwin Jekelius, a former colleague of Asperger's at the university clinic who became a major architect of the extermination policy, from June 1940 until the end of 1941[44].

During the last two years of the Second World War, from April 1943, Asperger was a doctor for the Wehrmacht.[45] He underwent nine months of training in Vienna and Brünn, then was sent with the 392nd Infantry Division to Croatia in December 1943 as part of a "mission of protection" of the occupied territories in Yugoslavia and the struggle against the "partisans".[2] The Heilpädagogik, in which Asperger worked before his military service, was destroyed in 1944 by a bombing, in which sister Viktorine Zak was killed.[46]

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. There, 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.

Hans Asperger resumed his academic career after the war,[47] in 1945, returning to the department he was directing, which had been destroyed by a bombardment.[46] His authorization to teach was confirmed on February 9, 1946, because he was not a member of the NSDAP.[48]

Between 1946[14] and 1949, he was deputy director of the pediatric clinic in Vienna.[46] In 1948, he co-founded the pediatric clinic, Österreichische Arbeitsgemeinschaft für Heilpädagogik (now the Heilpädagogische Gesellschaft Österreichs) in Innsbruck, Austria, for 5 years,[49] succeeding Richard Priesel, who died suddenly on 18 November 1955.[50] Documentation of this part of his life is scarce.[49] Hans Asperger's name is the last one mentioned on the list of recommendations, after those of three other doctors.[49] Asperger took up his new position on 31 March 1957, with an inaugural lecture devoted to problems in modern pediatrics.[51] According to the Innsbruck historian Franz Huter (1899-1997), Hans Asperger "quickly created a circle of friends and colleagues".[52] His wife Hanna preferred to stay in Vienna.[52] He was generally appreciated there for his pedagogy.[19]

Asperger was then appointed to the chair of pediatrics at the Vienna hospital on 26 June 1962,[52] and was its director until his official retirement in 1977.[46] In 1964 he was in charge of SOS-Kinderdorf in Hinterbrüh.[53] In the same year he was appointed president of the Internationalen Gesellschaft für Heilpädagogik.

On 8 May 1971, he was appointed vice-president of the newly founded Austrian Society for Allergy and Immunology (Österreichische Gesellschaft für Allergologie und Immunologie).

He became professor emeritus in 1977, and died three years later on 20 October 1980, after a short illness.[46]

According to his statement in 1962, the Gestapo attempted to arrest Hans Asperger because of his remarks during his 1938 lecture.[54] However, the only known source for this claim is Hans Asperger, who mentions this incident during the inauguration of his chair of pediatrics, and then claims to have been "saved from the Gestapo" by his mentor Franz Hamburger, during an interview in 1974,[55].[56] During the same interview, he claimed to have "volunteered for the army to escape Gestapo reprisals because he had refused to cooperate with Nazi racial hygiene policies" [57]. There is no evidence in the archives of any attempted arrest by the Gestapo [57].

"Other facts speak against Asperger's self-portrayal as a man persecuted by the Gestapo for his resistance to Nazi racial hygiene, who had to flee into military service to avoid further problems. On several occasions, he published approving comments on racial hygiene measures such as forced sterilizations." - Herwig Czech[57], Hans Asperger, National Socialism, and "race hygiene" in Nazi-era Vienna

There is no archival evidence that Asperger's publications were perceived to be opposed to the new regime[55]. In November 1940, the Vienna Gestapo responded that it had "nothing on him" to a request for a political evaluation of Asperger[55]: this is the only documented interaction between Asperger and the Gestapo[55],[56]. Czech believes that this Gestapo investigation is the source of Asperger's subsequent claim that he was being persecuted, and that his Nazi party (NSDAP) mentor, Franz Hamburger, most likely vouched for his assistant while asking him to cooperate with the ruling regime, which would explain Asperger's statement during his 1974 interview[55].

Doorstep of Am Spiegelgrund clinic

In 1940, Asperger obtained a position as a medical expert in Vienna, for which he was responsible for diagnosing "hereditary diseases" and proposing forced sterilization in the interest of the Nazi eugenics program.[29] Even at that time, the excess mortality in Vienna's psychiatric hospitals was well known to the population, which protested against this situation, especially in September and November 1940.[80] According to Czech's analysis of Hans Asperger's written diagnoses, he was not "more benevolent towards his patients than his peers in labelling children with diagnoses that could have an enormous impact on their future - quite the contrary ";[81] in the majority of cases, Asperger made a harsher judgment than other doctors towards the children and adolescents he examined.[82]

He described one of the children he recommended for Am Spiegelgrund on 27 June 1941, Herta Schreiber, as follows:[83]

"Severe personality disorder (post-encephalic?): very severe motor retardation; erethic idiocy; epileptic seizures. The child is an unbearable burden at home for her mother, who has five healthy children to care for. A permanent placement in seems absolutely necessary" - Dr. Asperger, WStLA file, 1.3.2.209.10, Herta Schreiber, Heilpädagogische Abteilung der Universitäts-Kinderklinik Vienna, 27 June 1941

Sent to the hospital on 1 July as Asperger had requested, Herta Schreiber died there two months later, on 2 September, officially of "pneumonia".[84]

In 1942, following a request addressed to his superior Franz Hamburger,[85] Asperger took part in a selection of patients aimed at separating the "uneducable" from those who could become German citizens.[85] Although he was not directly responsible for their death, he chose 35 children whom he considered to be "uneducable ".[86]

While he did not cooperate with the forced sterilization programs according to the records,[85] he also did not oppose them.[87] According to Czech, "what emerges from the available sources is that Asperger's approach to the forced sterilization program was ambivalent ".[85] He quotes passages written by Hans Asperger demonstrating his support for this aspect of racial hygiene policy:

"In the new Germany, we took on new responsibilities in addition to our old ones. To the task of helping the individual patient is added the great obligation to promote the health of the people [], which is more than the well-being of the individual. I need not add to the enormous amount of dedicated work done in terms of affirmative action and support. But we all know that we must also take restrictive measures. Just as the physician must often make painful incisions during the treatment of individuals, we must also make incisions in the national body [], out of a sense of responsibility: we must make sure that those patients who would pass on their diseases to distant generations, to the detriment of the individual and the , are prevented from passing on their diseased hereditary material" - Hans Asperger, Pädagogische Therapie bei abnormen Kindern[88]

There is a possible protective case of a patient, Aurel I., whom Hans Asperger examined in the autumn of 1939 and exempted from group education.[85] His family sent him to the countryside, where he survived the war under his parents' care.[85] In 1962, a member of Asperger's family believed that he had saved Aurel from "castration" and possibly worse.[85] Asperger wrote his report a few days before the introduction of the sterilization law in Austria.[85]

The Heilpädagogik Vienna department, where Asperger worked, is known to have taken in Hansi Busztin from September 1942, a Jewish patient in hiding until the end of the war, who states that about a hundred people knew of his existence, and that this department housed "a group of opponents of National Socialism".[57] However, Busztin does not mention Hans Asperger's name, and Asperger makes no reference to this episode even after the war, even though it could have helped him establish anti-Nazi credentials.[57] According to Czech, Asperger may have been aware of this Jewish patient, but he did not take an active role in protecting him, and more importantly, joined the Wehrmacht only six months after Busztin's admission.[57] Czech considers it likely that Asperger joined the Wehrmacht to protect himself in case Busztin's presence in his ward was discovered, rather than because of "persecution by the Gestapo", which is not proven.[57] However, he also did not denounce the presence of this Jewish child.[89]

Hans Asperger established in 1943 the description of an "autistic psychopathy of childhood".[92] He identified in over 200 children (including 4 cases of young boys described in detail [93]) a pattern of behavior and skills including "lack of empathy, poor ability to make friends, unidirectional conversation, strong preoccupation with special interests, and awkward movements." [14] Asperger calls these four boys his "little teachers" because of their ability to talk about their favourite subject in great detail.[14] His article was not published until 1944 in the journal:[94]

• (de) "Die 'Autistischen Psychopathen' im Kindesalter", Archiv für Psychiatrie und Nervenkrankheiten, no 117, 1944, pp. 76-136 — the article appeared in 1938 in Wiener Klinische Wochenschrift.

• "Leucin und Tyrosin im Ham bei Lungengeschwülsten". Klin WSCHR (in German). Wien. 2: 1281–1284. 1930.
• Siegl (1934). "Zur Behandlung der Enuresis". Archiv für Kinderheilkunde (in German): 88–102.
• "Das psychisch abnorme Kind". Wiener Klinische Wochenschrift (in German). 49: 1314–1317. 1938.
• ""Jugendpsychiatrie" und "Heilpädagogik"". Münch med WSCHR (in German). Munchen, Berlin. 89: 352–356. 1942.
• "Kataloge der Universitäten Graz, Linz, Bratislava und Innsbruck". webapp.uibk.ac.at (in German). Retrieved 20 November 2020.
• "Postencephalitische Persönlichkeitsstörungen". Münch med WSCHR (in German). München, Berlin. 91: 114–117. 1944.
• "Encephalitis im Kindesalter und Folgezustände". Wien Klin WSCHR (in German). 64 (H. 10): 171. 1952.
• Asperger, Hans (1954). "Heilpädagogische Problematik der organischen Hirnstörungen". Acta Psychother Psychosom Orthopedagog (in German). 2 (2): 115–126. doi:10.1159/000278416.
• "Heilpädagogik: Eine Einführung in die Psychopathologie des Kindes für Ärzte, Lehrer, Psychologen, Richter und Fürsorgerinnen" (in German) (2 ed.). Wien: Springer Verlag. 1956.
• "Die Jugendgemeinschaften als Erziehungsfaktor: Jugend in Not. Schriften zur Volksbildung des Bundesministeriums für Unterricht" (in German). Vienna. 1959.
• Laireiter, Matthias (1966). Die Fremdversorgung der Jugend (in German). Salzburg.{{cite book}}: CS1 maint: location missing publisher (link)
• "Zur Differentialdiagnose des frühkindlichen Autismus". Acta Paedopsychiatrica (in German). 35: 136–145. 1968.
• Schmid, F (1969). Springer Verlag (ed.). "Neurologie-Psychologie-Psychiatrie" (in German). New York.
• "Kurze Geschichte der Internationalen Gesellschaft für Heilpädagogik". Heilpädagogik, Fachzeitschr. D. Österr. Ges. F. Heilpäd (in German). 4: 50–55. 1971.
• Österr. Bundesverl. für Unterricht, Wissenschaft und Kunst, ed. (1974). "Das Werden sozialer Einstellungen in Familie, Schule und anderen Sozialformen" (in German). Vienna.
• Asperger, H; Haider, F (1975). Österreichischer Bundesverlag (ed.). Leben heute - Eine Herausforderung an die Pädagogik - Tagungsbericht der 23. internationalen pädagogischen Werktagung (in German). pp. 60–70.
• Österreichische Gesellschaft für Heilpädagogik, ed. (1978). Neue Impulse in der Heilpädagogik. Bericht des 2. Österreichischen Heilpädagogischen Kongresses (in German).
• "Problems of infantile autism". Communication. 13: 45–52. 1979.
• "50th anniversary of the death of Clemens von Pirquet". Pädiatrie und Pädologie. 14 (2): 1–2. 1979.
• Asperger, H; Haider, F (1979). Selbstverlag der internationalen pädagogischen Werktagung (ed.). Kinderprobleme - Problemkinder - Tagungsbericht der 27.Werktagung 1978. Bd. 33 (in German). Salzburg. pp. 14–24.{{cite book}}: CS1 maint: location missing publisher (link)
• Selbstverlag der internationalen pädagogischen Werktagung, ed. (1980). Mit Konflikten umgehen - Tagungsbericht der 28. internationalen pädagogischen Werktagung. Bd. 34 (in German). Salzburg. p. 56-66.{{cite book}}: CS1 maint: location missing publisher (link)
• Asperger, H; Rothbucher, M (1981). Selbstverlag der Internationalen Pädagogischen Werktagung (ed.). Das rechte Mass - Hilfen zur Lebensorientierung - Tagungsbericht der 29. Werktagung 1980 (in German). Salzburg. pp. 61–71.{{cite book}}: CS1 maint: location missing publisher (link)
• Asperger, H; Wurst, F (1982). Urban & Schwarzenberg (ed.). "Psychotherapie und Heilpädagogik bei Kindern" (in German). München, Wien, Baltimore.;
• Chapters:
  • "Schwierigkeiten Hochbegabter". Psychotherapie und... pp. 242–248.
  • "Frühkindlicher Autismus, Typ Kanner". Psychotherapie und... pp. 286–292.
  • "Kindlicher Autismus Typ Asperger". Psychotherapie und... pp. 293–301.

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.[108] It was not until 1991 that an authoritative translation of Asperger's work was made by Uta Frith;[109] before this, Asperger's syndrome had still been "virtually unknown".[110] Frith says that fundamental questions regarding the diagnosis had not been answered, and the necessary scientific data to address this did not exist.[111]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. In Asperger's 1944 paper, as Frith translated in 1991, he 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 caregivers."[112] 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.[112] Psychologist Eric Schopler wrote in 1998: "Asperger's publications did not inspire research, replication, or scientific interest before 1980. Instead, he laid the fertile groundwork for the diagnostic confusion that has grown since 1980."[113]

Despite this brief resurgence of interest in his work in the 1990s, Asperger's syndrome remained a controversial and contentious diagnosis due to its unclear relationship to the autism spectrum.

In 2010, there was a majority consensus to subsume Asperger's syndrome into the diagnosis "Autistic Spectrum Disorder" in the 2013 DSM-5 diagnostic manual.[114] The World Health Organization's ICD-10 Version 2015 describes Asperger's syndrome as “a disorder of uncertain nosological validity”.[115]

Czech was the first to study the issue of Hans Asperger's Jewish patients. While Asperger did not express overtly anti-Semitic ideas, his public statements and Asperger's treatment of his Jewish patients show an indifference to the persecution suffered by this population.[116] He also seems to have internalized at least some of the anti-Jewish stereotypes of his time.[116]

Czech[117] and Sheffer[118] believe that Hans Asperger's diagnoses are sexist, while Dean Falk refutes that Hans Asperger was sexist.[72]

Sheffer devotes a chapter of her book to the differences between the diagnoses of boys and girls.[119] According to Claude Grimal's review in the journal, it should not be considered surprising that Asperger's diagnoses contain "all the gender biases of the time ".[119]

Czech notes that Hans Asperger's gender bias leads to "disadvantaging girls in terms of sexual abuse and precociousness",[120] adding that he blames victims of sexual abuse.[75] Czech cites, in particular, the example of the diagnosis of a 12-year-old Jewish girl, who, according to Asperger, "acted like a madwoman, talked about anti-Jewish persecution, was afraid." Asperger interpreted these signs of distress as symptoms of schizophrenia, and concluded his report, "for her age and race, sexual development is visibly retarded".[116]

In Steve Silberman's first edition of his book, in 2015, before the publication of the archives studied by Czech, Silberman openly supports Asperger's work, postulating that, if Asperger's syndrome had been used as the basis for defining autism in the twentieth century, rather than Leo Kanner's infantile autism, individuals with autism and their families would have avoided a great deal of suffering, positive criteria would have been used for diagnosis rather than deficits, and financial resources would have been allocated more quickly to supporting individuals with autism themselves rather than to seeking therapies and cures.[121]

According to Czech, it is from April 2018 onwards that Hans Asperger's legacy is seriously questioned, notably through an editorial and press release distributed by, widely reported in the media, and then by the publication of Edith Sheffer's book a few weeks later.[96] This gave rise to some sensationalist media exaggerations concerning the true role of Asperger's.[122] Silberman reconsidered his position, pointing out that people with autism who once saw Hans Asperger as an ally probably felt betrayed, and updated new editions of his book.[123]

In Asperger's Children, historian Edith Scheffer argues for the abandonment of the notion of "Asperger's syndrome". After reading this book, Judy Sasha Rubinsztein says she is "convinced not to use the term 'Asperger's Syndrome' because it raises the spectre of that barbaric time when medical values were distorted to support Nazi ideology."[29] Professor Simon Baron-Cohen states that, in light of Czech and Sheffer's findings, "we now need to revise our views, and probably our language as well", by no longer referring to "Asperger's syndrome" but only to "autism".[47] In contrast, the American journalist Seth Mnookin does not agree with Sheffer's conclusion, which he analyzes as an attempt to deconstruct the notion of autism by falsely making it sound like a "Nazi invention".[124]

The reactions of autistic people to the revelations about Hans Asperger's past are varied: some are attached to the terminology of "Asperger's syndrome", while others testify in favour of abandoning this name.[47] This is notably the case of the doctor of philosophy Josef Schovanec,[125] who states:

"Even more than his links with Nazism, it is what must have been Dr. Asperger's strong point that will seal his doom, namely his ability to sort out children among humans."

- Josef Schovanec [126]

In 2007, Viktoria Lyons and Michael Fitzgerald (a controversial expert in retrospective diagnosis) hypothesized that Hans Asperger himself had Asperger's syndrome, as they believed that as a child he exhibited features of the very disorder that later received his name.[127] The article is based on a German newsletter[127] and on the book by Uta Frith, published in 1991.[127]

This hypothesis was taken up by the investigative journalist Steve Silberman[128] and by Élisabeth Roudinesco, who asserted that Hans Asperger was affected during his childhood by the syndrome he later described.[129] It is refuted by Sheffer, who believes that the diagnostic criteria for Asperger's syndrome are irrelevant (and even less so in retrospect), but also that Asperger's "severe criticism" of "autistic psychopaths" precludes the possibility that he would have considered applying a diagnosis that he judged so negatively to himself.[130]

Czech points out that "the potential obstacles to his [Hans Asperger's] support for National Socialism were his religious convictions, his humanistic background, and his elitist and cultured habitus. He adds that "Asperger's political socialization at the time probably blinded him to the destructiveness of National Socialism because of an affinity with its ideological core elements."[69]