Paulas Journal: Surviving Autism
It is clear that such a spirit had to be diametrically opposed to National Socialism. He acted accordingly. There are episodes—confrontations with the Gestapo, the hiding over years of a Jewish student whose family had been exterminated—which could have been taken from an adventure novel [ 53 ]. This episode could help explain why Asperger joined the military in March While this is contradicted by the favorable assessments he continued to receive from Nazi officials for example during the vetting for his Habilitation , the cited evidence and the timeline of events suggest a direct connection—namely, that he wanted to get away from the Vienna clinic in case Busztin were discovered.
He also mentioned that he had committed himself to working for the Hitler Youth. These memberships should be seen against the backdrop of the heavy Nazi influence at the clinic see [ 4 ]: —1. Most likely, Asperger took these decisions in order to protect and further his career. By foregoing NSDAP membership, he chose a middle path between keeping his distance to the regime and outright alignment. It is important to note that Asperger had all the political protection he needed through his mentor Franz Hamburger.
In all, they demonstrate how after an initial phase of distrust the party authorities came to see Asperger in an increasingly positive light. It was noted positively that he had not taken any stance against the Nazi takeover in Austria.
In response to your enquiry from 25 October I declare that Dr. Asperger is a faithful Catholic, but without supporting the political tendencies of Catholicism. Regarding questions of the racial and sterilization laws he conforms to National Socialist ideas. With respect to his character and in political terms he is considered unobjectionable. Asperger hails from Catholic circles and his orientation during the period of the [previous Austrian] system was strictly Catholic.
He has never taken active steps of any kind against National Socialists, although it would have been easy for him to procure incriminating evidence at the Pediatric Clinic, which was staffed exclusively with Nazi physicians. In terms of his character, Dr. After the Anschluss, Asperger tried to prove his loyalty to the new regime in various ways. Maybe you can make something of it. How they were diagnosed and what decisions about their future were taken at the clinic had an important impact on their chances of survival. A number of these children—like Alfred—were Jews living with non-Jewish families.
When the Nazis took over the city administration, this came to be regarded as a problem, and Jewish foster children were separated from their caretakers and segregated in Jewish orphanages, which for many became death traps during the Holocaust. The diagnostic report itself is rather benevolent in tone; Asperger considered Alfred capable of functioning among adults, who would feel less provoked by his behavior than children. His fate is unknown.
Walter Brucker was admitted to the clinic on 14 March , the day following the Anschluss, because of extreme agitation. On 15 March, amidst cheering youngsters, Walter had to listen to a triumphant speech by Hitler. Despite the fact that as a Jew Walter had every reason to panic, his fearful reaction was held against him. He was very agitated; when a child broke out in cheers he opened his eyes wide and turned pale.
In his diagnosis, Asperger omitted the fact that Walter was Jewish and that his life was under threat from the Nazi regime. As it turns out, Walter indeed had every reason to be fearful. As far as the written record is concerned, there is no indication that Asperger was guided by personal animosity towards Jews, but there is a notable absence of empathy for their plight under Nazi rule. Racial stereotyping became—not surprisingly—more frequent following the Anschluss.
When she spoke of the violent abuse she had suffered at the asylum, this was taken as an indication of her dishonesty rather than an explanation for the changes in her behavior. She thought a Jewish acquaintance had died from hanging, but could be convinced that this was not true. This leads to the broader question whether Asperger held anti-Semitic views. Apart from the case files quoted above, there is scant direct evidence.
On the one hand, hostility towards Jews and their alleged corrupting influence was a common ideological denominator of the groups Asperger associated with. Until the end of his life, as far as his public statements are concerned, he never distanced himself from the racialized anti-Semitism that pervaded Austrian and German political life during the twentieth century nor did he comment on the destruction this had brought down on the Jews of Europe during the Holocaust. I will show that Asperger on several occasions supported tenets of Nazi race hygiene and medicine, contributing to their legitimization.
We stand in the midst of a massive reorganization of our intellectual and spiritual life, which has seized all areas of this life—not least in medicine. You know by what means one strives to prevent the transmission of diseased hereditary material—many cases that belong here are hereditary disorders—and to promote hereditary health. We physicians have to take on the tasks that accrue to us in this area with full responsibility [ 1 ] We will see shortly what these tasks entailed and how he handled them in the context of his own work.
These children are intellectually below average including to the degree of feeble-mindedness —whereby with intelligence we mean abstract intelligence—whereas practical reason, in short everything that has to do with instinct, including the practical usefulness and the values of character, are much better developed in relative terms. These cases are important—or at least they will be as soon as the Law for the Prevention of Hereditarily Diseased Offspring comes into force here. If the physician has to take a decision in such a case, he will not be allowed to do so based solely on a questionnaire or the intelligence quotient.
This passage has been quoted as evidence that Asperger tried to publicly protect his patients from forced sterilizations [ 8 ]: ; more cautiously [ 9 ]: —7. Why did these comments then not hurt his standing in the eyes of the Nazi hierarchy, which came to the conclusion that he was in conformity with Nazi race hygiene policies? It is important to note that Asperger focused on skills, where others were primarily concerned with defects.
In the new Germany, we physicians have assumed an abundance of 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 Volk , which is more than the welfare of the individual. I do not need to elaborate on the enormous dedicated work being performed in terms of positive, supporting measures. But we all know that we also have to carry out restrictive measures. Therefore we are called more than others to contribute decisively to what is probably the most important area of research on human heredity, namely the questions concerning the inheritance of mental traits and mental abnormalities.
We must also lead the way in the practical tasks of eugenics, especially with regards to the problems relating to the Law for the Prevention of Hereditarily Diseased Offspring—and not just the physicians, but also the special school teachers we work with. Although many race hygienists were more dogmatic in terms of a one-sided genetic determinism, Nazi ideology was not monolithic.
A key element in the established narrative of Asperger as a principled opponent of Nazi policies derives from his repeated appeals to treat troubled children with the utmost dedication to help them overcome their challenges [ 20 ]: 17, [ 21 ]: —9. One of the most significant passages in this regard is contained in his paper on autism:. We think that such individuals have their own place in the organism of the social community, which they fully occupy, some of them maybe in ways nobody else could. Often, in the course of development, possibilities for social integration arise which one would not have expected before.
This is in line with his speech, in which he also expressed his determination to side with his patients:. But let me discuss this problem today not from the standpoint of the Volk as a totality—in this case one would have to primarily focus on the Law for the Prevention of Hereditarily Diseased Offspring—but from the standpoint of the abnormal children.
How much can we accomplish for these children shall be the question [ 1 ] Again the question is whether this approach put Asperger at odds with the regime or even made him vulnerable to reprisals, which is a central claim in the narrative of his resistance to the Nazis. The evidence, however, does not support this. Due to increasing labor shortages, it became a political and military imperative to rehabilitate as many potential workers as possible, even those considered of inferior hereditary quality. And if we help them [the abnormal children] with all our dedication, we also render the best service to our Volk ; not only by avoiding that they burden the Volksgemeinschaft with their dissocial and criminal acts, but also by trying to ensure that they fulfill their duties as productive individuals in the living organism of the Volk [ 1 ] He made sure that local authorities and hospitals cooperated and that the operation ran smoothly.
From June to the end of , Jekelius directed the child killing facility Am Spiegelgrund, where hundreds of disabled children were murdered. The two men maintained professional contacts during the Nazi period. In , when Jekelius became the first chairman of the newly established Viennese Association for Therapeutic Pedagogy, Asperger represented the Pediatric Clinic along with Hamburger [ 4 ]: —3.
Erwin Jekelius represents Nazi medicine in its most inhumane extremes: a fanatical Nazi and a murderer responsible for the deaths of thousands of patients. Had Asperger deviated from the party line, Jekelius would certainly have reined him in. Instead, this is what Jekelius had to say about Asperger and his therapeutic approach:.
At this opportunity, I would like to remind you of the substantial lecture on therapeutic pedagogy which our Dr. Asperger gave last year in this same place. To be sure, when their writings are set side by side, there is an enormous divide between the two men in tone. I wanted to emphasize this from the beginning, when I talk today about our Aesculapian obligation specifically towards the psychologically abnormal individual, as I see this obligation. Our time has brought revolutionary changes in the field of education: Whereas in earlier times a number of philosophical, political, and religious orientations stipulated their pedagogic goals and consequently were in competition with each other, today National Socialism has established its pedagogic goal and demands that it be the only valid one.
As much as this development is to be approved, we nevertheless have to stress: This one goal, the integration into the National Socialist state, can only be achieved with these children by using different means. This is how we know that the success of our work is worth the effort [ 67 ]. This paper was originally presented in September at a prominent pediatric conference in Vienna. Asperger was one of only three speakers from Vienna. This argument is problematic for several reasons. While this position anticipated later advances in autism research, the question arises whether under the circumstances it was prudent to put such an emphasis on heredity.
Had protecting his autistic patients been his primary goal, he could have taken a more flexible position, one less likely to draw the attention of race hygienists to his patients [ 2 ]: — Fritz had for his age outstanding abilities in mathematics, but was incapable of attending regular school, having passed the first three school years by homeschooling.
These latter cases, according to Asperger, were often very similar to conditions caused by organic brain damage such as birth trauma. Nevertheless, the argument that Asperger focused on the better-functioning cases in order to protect all of his patients presumably, by deflecting attention from the less well-functioning is questionable given that Asperger by no means withheld from his readers the severe impairments of some of the boys. Third, there is a fundamental flaw in the assumption that highlighting the potential of some of his patients would benefit all of them.
Focusing on the higher functioning children did nothing to lift the boat for all of them; those on the lower end still risked being left to drown. Highlighting the potential of some patients should not then be mistaken for the defense of all children with disabilities. Asperger, who had begun his career under Hamburger, shared many of these views, including a staunch opposition to psychoanalysis [ 76 ].
This increased demand, together with the exclusion of Jewish doctors, 78 led to additional career opportunities for Asperger, for example, his appointment as an expert witness in May to the Vienna Juvenile Court. In some cases, however, he demonstrably cooperated in such matters. In two of these cases, both Asperger and the Spiegelgrund staff suggested a hereditary etiology.
In two other cases, Asperger included a reference to heredity in his report, but the Spiegelgrund staff did not. This raises the question whether this non-cooperation by omission should be considered a form of resistance. It is important to note that the sterilization program in Nazi Austria was never implemented on a scale comparable to Nazi Germany between and and that children were not its primary targets. In Vienna, the Hereditary Health Court decreed a total of sterilization cases. There is one case in which documents suggest that Asperger may have helped shield a patient from possible persecution.
In the fall of , he examined Aurel I. His family then moved him to the countryside, where he spent the war in the care of relatives.
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His role in this context is the topic of the next section. In his wartime publications, Asperger appears as someone who declared his willingness to cooperate with the Nazi state, propagated—albeit less enthusiastically than others—elements of Nazi race hygiene, and tried to argue that his discipline had an important role to play within the new political order.
His professed pedagogical optimism reached its limits, however, in children with greater degrees of mental disability. In this regard, as we will see, his record was mixed. Severe personality disorder post-encephalitic? At home the child must be an unbearable burden to the mother, who has to care for five healthy children. Permanent placement at Spiegelgrund seems absolutely necessary.
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Mother asks to be notified if the condition of the child should get worse. The husband should not be informed, he would be too upset. She says in tears that she can see for herself that the child is mentally not well. If she cannot be helped, it would be better if she died. She would not have anything in this world, she would only be ridiculed by others.
As the mother of so many other children she would not want that for her, so it would be better if she died. Or did he decide independently what he thought best, based on the information she provided? From the available documents, we cannot know with certainty. As previously mentioned, he repeatedly called for giving people with mental anomalies the best available care in order to develop their potential as far as possible. However, he never addressed the question of what should happen in cases without hope of improvement. The children Asperger advocated for were those who promised some future benefit to society.
Erethic imbecility, probably on a post-encephalitic basis. In the family, the child is without a doubt a hardly bearable burden, especially under their crowded living conditions, and due to her aggressions she endangers the small siblings. Therefore it is understandable that the mother pushes for institutionalization. Spiegelgrund would be the best possibility. What can be said with a degree of certainty is that she sought institutional care for her daughter and that Asperger recommended transferal to the killing facility.
However, Elisabeth was not immediately transferred to Spiegelgrund, probably because there was no bed available. Instead, she was sent to another institution for children with mental defects, where she stayed for a few months. In March , she was transferred to Spiegelgrund. Was Asperger aware that Elisabeth would have almost no chance of survival at Spiegelgrund, that he was sending Herta to her death?
Significantly, the extermination of the mentally ill was never explicitly referred to in written documents, at least not outside the smallest circles of the initiated. In documents not protected as state secrets, it would have been a grave breach to even mention the possibility of killing patients. I point out that my clinic [Spiegelgrund] was always overcrowded, since other clinics […], including the University Pediatric Clinic, transferred—or wanted to transfer—such hopeless cases, evidently because they believed that in my clinic euthanasia was possible on account of the mentioned circular, while they were not allowed to practice euthanasia.
I am absolutely convinced that the directors of the mentioned institutions were aware of euthanasia and the mentioned circulars. Illing had every reason to diminish his own responsibility, but there is further evidence for the close ties between Spiegelgrund and the university clinic. After the experiments, the children were sent to Spiegelgrund, where they were murdered so that the vaccine results could be compared with the pathological findings. Staff at the pediatric clinic were not only aware of what happened at Spiegelgrund but exploited the research opportunities created by the murders [ 85 ].
Even abroad, the killings at Spiegelgrund became known. In light of this evidence, it seems extremely implausible that Asperger—a longtime colleague of Erwin Jekelius and a well-connected player in his professional field—was unaware of the activities at Spiegelgrund. In the cases of Herta and Elisabeth, were there alternatives to sending them to Spiegelgrund? Could he have saved their lives? Nevertheless, Asperger was under no obligation to send children directly to the killing facility, even if they suffered from severe disabilities.
He could, without any risk to himself, have transferred them elsewhere, and in a number of other cases, he did just that. The evidence in these two cases suggests that at least under the given circumstances he accepted the killing of disabled children as a last resort. Jekelius as soon as possible. Due to overlapping jurisdictions the Gugging hospital was on Viennese territory and property of the city, but leased to the Niederdonau administration , the committee consisted of seven members from both provinces.
After children had been transported in March and May to the killing center in Hartheim, at the end of that year, patients remained on the ward. All of them were dead within a few months. By the end of that year, another 20 children 9 girls and 11 boys followed, only to meet the same fate. During , 12 children 8 boys and 4 girls were taken to Spiegelgrund, none of whom survived. The commission relied on suggestions prepared by Schicker but examined the children individually and took a decision in each case. Among a group of 50 children whom the director deemed unfit for school and wanted to keep in Gugging, the committee found 18 who in their opinion warranted further pedagogical efforts.
In all, 59 of children evaluated by the commission died at Spiegelgrund before the end of the war, a death rate of Was the commission in a position to save at least some of the children had they wanted to? Due to the limited sources available, this question cannot be answered conclusively. What can be shown, however, is that at least in some cases their families wanted to take them into their care but were not permitted to do so by the authorities.
He was deaf-mute from his birth in His case file mentions hydrocephaly and severe mental disability. Although he could not attend school, there was hope he might be able to improve his physical abilities to perform simple tasks. He was described as lively and sociable. The requests were denied on all three occasions, the last under the pretext that further examinations were necessary. On 20 May , Engelbert was transferred to Spiegelgrund, where he died on 8 November. In this case, it seems that Asperger was a well-functioning cog in a deadly machine.
In his publications, Asperger projected an image of himself as benevolent, optimistic, and affectionate towards the children in his care—a characterization echoed in the biographical literature. While there is little doubt that he was passionate about his work and genuinely cared about many of his patients, in the context of this paper, we must ask whether this positive attitude extended to those children who did not offer hopes of future development or who defied attempts to educate or discipline them.
The following analysis focuses on the remaining 40 children 12 girls, 28 boys , who survived Spiegelgrund and were later transferred to other institutions or discharged. Unlike with Herta and Elisabeth Schreiber, in the 14 cases in question, there is no indication that Asperger expected the children he recommended for transferal to Spiegelgrund explicitly or by suggestion to be killed there. The conditions of these 14 children appear not to have been so severe as to make them targets for extermination, although sending them to Spiegelgrund nevertheless put them at considerable risk.
The senior staff at Spiegelgrund who were the authors or signatories of the medical reports analyzed here were committed Nazis and race hygienists. Against this background, any systematic bias Asperger might have had in favor of his patients would have to be visible in this sample. And yet, out of these 30 cases, there are only 2 in which Asperger appears to judge the children less harshly than his peers at Spiegelgrund. In 16 or just over half of the cases, Asperger and the diagnosticians at Spiegelgrund came to comparable conclusions.
In the remaining 12, Asperger took a more negative and in some instances an outright disparaging view of his patients. Gerald St. Gross now described the boy as emotionally responsive, cheerful, and excitable. Gerald was initially described in similar terms by Asperger and at Spiegelgrund. Leo A. Born in April to a single mother, Leo was placed in foster care immediately after his birth.
At age four, Leo was an intelligent but difficult child. He suffered from fits of rage and was accused of cruelty towards animals. The case of year-old Johann K. As mentioned, of these 30 cases, there are only 2 in which Asperger appears to have taken a more positive position than his peers at Spiegelgrund: In November , he saw 6-year-old Johann T. It is hardly surprising then that Johann did not make much progress over the next years. The second case is similarly inconclusive. In October , Asperger saw the year-old Hildegard P.
For Hildegard, it meant the difference between freedom and confinement to a reformatory. In one regard, however, Asperger did show a certain restraint. Apart from this qualification, the sample yields no evidence that Asperger proved more benevolent towards his patients than his peers at Spiegelgrund when labeling children with diagnoses that could have an enormous impact on their future—quite the opposite. Like many of his colleagues, Asperger had a marked tendency to separate children from their families—which he often considered dysfunctional—and to commit them to closed institutions.
Of course, many children were exposed to violence or neglect at home, and institutional education in principle could have been a means of protecting them. In practice, though perhaps despite his best intentions, this meant that he regularly sent minors to institutions ripe with abuse and violence [ 89 ]. Asperger briefly mentioned his war experiences in his interview:. It is good that a man knows how he behaves in mortal danger, with the bullets whistling. It is also a proving ground. And a ground where one has to care for others. It is also a great gift from destiny that I never had to gun anybody down [ 3 ].
This distinction allowed Asperger to emerge with a clean slate under the Austrian implementation of denazification since he had never joined the NSDAP. In , he moved to Innsbruck, where he headed the local university pediatric clinic until when he was formally appointed as Chair of the Vienna Pediatric Clinic, the most prestigious position in Austrian pediatrics.
According to some, Asperger in risked his life to speak out against the threat that race hygiene ideology posed to the children in his care. In , while explicitly addressing the war in a speech summarizing his intellectual legacy, he did not care to mention National Socialism, its millions of victims, or even the hundreds of children, some of them his patients, who had been killed practically under his eyes. At least in Austria, he dominated the field for decades, curtailed only by competition from the emerging discipline of youth psychiatry.
On a conceptual level, he saw his main opponents in the representatives of psychoanalysis and related theories focusing on dynamic psychological processes and childhood experiences [ 76 ]: 2—3, , and numerous other passages. In principle, he also distanced himself from the genetic determinism typical of Nazi race hygiene, at least to the extent necessary to claim a space for his own discipline and its therapeutic options [ 76 ]: It is hardly surprising, then, that he would refer to his work as a heroic and often hopeless fight against the terrible odds of constitutional deficiencies of all kinds [ 76 ]: —5.
Despite his emphasis on heredity and constitution, he mostly avoided explicit references to eugenics, which due to its association with Nazi crimes had become discredited in mainstream scientific discourse, at least in Austria and Germany. Multiple studies, above all in Germany, have shown that these families procreate in numbers clearly above the average, especially in the cities. It is clear that this fact presents a very serious eugenic problem, a solution to which is far off—all the more, since the eugenic policies of the recent past have turned out to be unacceptable from a human standpoint [ 76 ] One troubling consequence arising from this approach is how Asperger regarded the sexual abuse of children.
In a similar vein, Asperger rejected the possibility that constitutionally healthy children could suffer from war-related trauma. Any observable symptoms were again either due to some inborn constitutional defect or arose from the desire to gain material advantages, such as pensions [ 76 ]: , With his mother, Max then moved to Znojmo, a town annexed from Czechoslovakia after the Munich Agreement, from where he was expelled along with the German-speaking population in In August , Asperger wrote an expert opinion for the Juvenile Criminal Court on Max, who was accused of a series of thefts.
As in other countries, the Austrian public has over the last years been confronted with a wave of revelations on the violence, abuse, and neglect pervading institutions set up to protect children from precisely such conditions [ 74 , 97 — ]. The same is true for children with disabilities, who were often kept in asylum-type institutions where they were denied rehabilitation or therapy and exposed to severe hospitalism [ , ].
While there is no evidence that Asperger actively supported Nazism before , there was a common ideological ground, as he himself acknowledged after the war. After the Anschluss, like many Austrians who had not actively participated in the Nazi movement during the time it was banned — , Asperger tried to acquire political credentials by joining a number of organizations affiliated with the Nazi Party.
Overall, during the years of the Nazi regime, Asperger managed to extend his professional activities beyond his university position, mostly within the Vienna municipal administration and the juvenile court system. The exclusion of Jewish doctors, psychologists, and pedagogues from their professions opened new opportunities for those in the field who were not affected by anti-Jewish legislation or political persecution.
Apart from some initial reservations due to his Catholic orientation, there is no evidence that the Nazi authorities considered Asperger an opponent of their race hygiene agenda or to their policies more generally or that he ever faced reprisals such as the alleged attempts by the Gestapo to arrest him. At the same time, his relationships with Jewish colleagues indicate that he separated the anti-Semitic prejudices pervading the social and political spheres in which he was moving from his personal relations—not an uncommon phenomenon in the history of anti-Semitism.
Given that Asperger used the same arguments after the war, there is no indication that the utilitarian logic of social worth he used to advocate for his patients—children considered difficult but who sometimes had normal or even above-average intellectual abilities—was merely a rhetorical strategy. Just as with other diagnoses, everything depended on where they fell on the spectrum of intellectual and other abilities. Despite his advocacy, Asperger left the decisive question unanswered: What should happen with those who could not be helped by pedagogic, therapeutic, or medical means?
On the other hand, he appears to have been less inclined to directly invoke the possibility of hereditary defects, which could have justified interventions such as forced sterilization. The case records from his ward contain very few references to the sterilization program or other race hygiene measures, suggesting that he was reluctant to report his patients to the authorities for these specific purposes.
However, the fact that in some cases he did provide information to the authorities tasked with the implementation of race hygiene suggests that he did not fundamentally oppose these policies. There is no evidence that Asperger deviated from the official position of the Nazi state on sterilization, which in this case had decided—at least in principle, and more so in Austria than in Germany—to institute mechanisms of due process for its implementation. In this unwillingness to deal with the past, he was typical of large segments of Austrian post-war society.
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The postdoctoral thesis as submitted in has not been found. However, there is no indication that it differed substantially from the paper. The volume has a notation on the back cover that the copy was indeed received in I decided to share results of my work with the authors after meeting with John Donvan in September in Washington, D. He had contacted me after discovering my work via reports in Austrian media [ ]. To his credit, Silberman quotes the new evidence against Asperger in the recent editions of his book.
The files were found at the pediatric clinic and transferred to the archive in [ 77 ]. WStLA, 1. Medical Center, Kansas City. Asperger in his later years suggested that he was a direct successor to Erwin Lazar, while in reality, it was Bruck who introduced him to the therapeutic pedagogy as it was practiced at the Viennese clinic [ 4 ]: —9. Eppinger commited suicide in , presumably because he feared being indicted in Nuremberg for his involvement in medical experiments at the Dachau concentration camp [ ].
Much less is known about the group of trainee doctors and assistants before obtaining their Habilitation , such as Frankl and Asperger. In his interview, Asperger described how the Bund influenced his experience of puberty, which also points to the early s. Overall, his account of the Bund was a-political. According to another source, the Bund had members in [ 36 ] This state of affairs had to be ended in a quick and radical way.
Since membership was obligatory for public employees, however, this is not a reliable indicator of political sympathies. One of these common elements was anti-Semitism, in its religious or racist version. Cited in [ 10 ] The translation is quoted from [ 20 ]: I will not forget this! As far as can be inferred from the written record, Hamburger after never used this alleged episode in his defense, although he faced considerable pressure due to his Nazi past.
IVb 3. Johann, signature illegible. We would additionally have to explain why Franz Hamburger also kept silent over an episode that could have helped his reputation, which after the war was badly damaged by his heavy Nazi involvement. Wolfgang Neugebauer, one of the leading historians of National Socialism in Austria, considers the Gestapo episode a complete fabrication personal correspondence with the author, 2 December Hansi Busztin, Eitelkeit, undated [unpublished manuscript, mid to late s]. In Vienna, In all of Austria no numbers available for Vienna only , a further 8.
Marchet to Dekanat, 17 November and 15 April Cited in [ 10 ]: The city had approximately Jewish foster children in its charge; how many of these were living with non-Jewish foster parents is unknown. According to Austrian data protection laws, in many cases such as documents from public archives , full names can only be published if the person in question is confirmed dead. Ivo P. B5, Standesprotokoll For a history of anti-Semitism in Austria, see [ ].
The total number of forced sterilizations between and is estimated at , [ 60 ]: This view has recently been challenged on the grounds that the adoption of electroconvulsive therapy in Nazi Germany was in fact slower than previously assumed [ , ]. In , Jekelius fell out of favor with Hitler because of an affair with his sister Paula Hitler, who lived in Vienna. Jekelius was drafted into the army and sent to the front.
After the war, Jekelius was arrested and put on trial by the Soviets. He died in a Moscow prison in For more details on Jekelius, see [ 13 ]. Nevertheless, in many psychiatric hospitals, patients continued to be killed until by means of starvation, neglect, and frequently also by more direct means such as poisoning or electric shock [ 80 , ].
August bis 4. September in Wien stattfindenden Conti hanged himself in in a prison cell in Nuremberg. At the conference, the German Association for Youth Psychiatry and Curative Pedagogy was established, additional proof that the latter discipline was not controversial in the eyes of the regime [ ].
“Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions
For the proceedings of the Vienna conference, see [ 72 ]. B prov. Due to his Jewish background, Heller became an early victim of Nazi persecution after the Anschluss. He died in December , months after a suicide attempt he never recovered from. His wife and daughter were later deported and killed in Riga [ ]. Asperger himself did not give a talk at this one-day symposium, but he spoke at the pediatric conference that provided the framework see above.
In Vienna, 96 of approximately pediatricians were considered Jewish according to Nazi racial legislation and lost their livelihoods, their homes, and in at least 12 cases their lives [ ]: Franz Hamburger, Referaterstattung zur Habilitationsarbeit des Dr. Hans Asperger, 28 December A7, Parville to Vellguth et al.
In Vienna, information on more than , individuals was collected in this context. For details on this so-called erbbiologische Bestandsaufnahme hereditary inventory , see [ ]. I , S. Overall, files pertaining to out of a total of victims have been preserved. The human remains were buried in in Vienna cf. Kinderklinik Wien, 27 October , Dr. Illing, 22 October , cited in [ ]: In the Gugging psychiatric hospital, hundreds of patients were killed by doctors and nurses during the war [ ].
Not all the files are preserved, and the surviving ones may not be complete. In a sample of 76 files concerning children who died at Spiegelgrund or, in a few cases, at Gugging, 21 contain correspondence with parents. The 30 cases in the sample with detailed documentation: WStLA, 1. Friedrich K. A6, index card Friedrich K.
Psychologisches Gutachten, 11 June , signed Igor Caruso. After , Caruso — rose to prominence in Austria as the founder of his own psychoanalytical school. His involvement at Spiegelgrund became the subject of heated debate following a publication in which the topic was raised for the first time [ ]. After , Heinrich Gross — became one of the most prominent psychiatrists in Austria, partly thanks to the scientific exploitation of the brain specimens obtained from the children killed at Spiegelgrund [ 85 ]—4. Deutsche Dienststelle, Auskunft zur Wehrmachtdienstzeit des Dr.
Hans Asperger, 28 July On the denazification of the medical profession in Austria, see [ ]. This conflict also had political overtones, since the dominating figure in post-World War II youth psychiatry was Walter Spiel, a Social Democrat [ 74 ]. This passage remained in the book at least until the fourth edition, which was published in The author wishes to thank Thomas Mayer for the reference to this passage.
It served to deny benefits to war veterans who suffered from what today would be called PTSD. After World War II, the concept was often turned against survivors of Nazi medical experiments, concentration camps, and ghettoes, again by denying a causal link between experiences of persecution and long-term effects on mental health [ ]: A paper that Asperger published in with his colleague Heribert Goll demonstrates to what extent Asperger thought that inborn if not necessarily hereditary characteristics determined personality traits in later life.
The article was published in the journal Der Erbarzt , edited by leading race hygienist Otmar von Verschuer — [ ]. I thank Gertrude Czipke for these documents. There is no indication that Max actually suffered from epilepsy. In , the City of Vienna commissioned a research project on this affair, the results of which were published in [ ]. The other Austrian physician whom Kondziella places in this category is Andreas Rett — , discoverer of Rett syndrome, a former NSDAP member who became a leading figure in Austrian child neurology after World War II with a special focus on the care of children with disabilities, for whom he proved an effective and tireless advocate.
His paternalistic approach, focus on segregation, use of non-approved drugs, and support for sterilization remain controversial [ , ]. Federal Archives Berlin. Christian-Social Student Union. German Labor Front. Documentation Center of the Austrian Resistance. Lower Austria Provincial Archives. Austrian State Archive. Vienna University Archives. Previous studies reported that deficiency of the adsl gene might result in infantile seizures and autism [ 45 , 46 , 47 ].
Although the exact mechanisms are not yet clear, the possible mechanisms might include deficient synthesis of purine nucleotides, impairment of the purine nucleotide cycle, and a build-up of defective enzyme substrates [ 45 ]. Disruption of this complex due to mbd5 mutation altered gene expression in neurogenesis and neurodevelopment [ 48 ]. In a cohort study, deletion of mbd5 was also associated with autistic features [ 49 ].
The shank3 gene, which encodes synaptic scaffolding protein, is important for spine morphogenesis and synaptic plasticity [ 1 , 7 , 32 ]. It might play a critical role in the normal development of neuronal connectivity because its disruption at a genetic level causes defects at striatal synapses and cortico-striatal circuits [ 50 ], as well as development and speech delays [ 1 , 7 ], which might be associated with ASD.
The tsc1 gene is thought to be linked to ASD via perturbation of cytoskeletal dynamics and dendritic spine structure by inhibition of the mTOR signalling cascade, which plays a crucial role in synapse protein synthesis [ 1 ]. Deletion of tsc1 in mice elicited a loss of cerebellar Purkinje cells and produced ASD-like behaviour, including abnormal social interactions and repetitive behaviours [ 51 ]. In our qPCR analysis, transcriptions of those genes were significantly altered Fig 4.
These results were comparable with our results from RNA-seq analysis. As an exception, the direction of shank3a transcription was different. Among the exposed groups, however, the transcription pattern of shank3a was comparable. Despite the exception, the other results were considerably reliable. Various genetic pathways, such as cell adhesion molecules, ion channels, scaffolding protein, cytoskeleton, and signalling pathways, are implicated in ASD [ 1 ]. We found some of the genes included in those pathways nrxn2 cell adhesion molecules , cacna1e , scn1a ion channel , shank3 scaffolding protein , actn4 , gria3 , grid1 cytoskeleton , and eif4a signalling pathway in our transcriptome analysis S3 — S7 Tables.
Specifically, we reported 44 and 69 significantly altered GOs based on the transcription changes compared with the control group Table 2 and concentration-dependent response Table 3 , respectively. The commonality was up to Those values were higher than the commonality with other diseases, i. These comparison data of GO enrichments may support the idea that zebrafish, at least partly, share common physiology for ASD with other models. However, commonality was relatively low in the DEG comparison. These results might be because GO enrichments represent a comprehensive approach.
This implies that GO enrichments might adjust the bias from the transcriptions of certain genes. However, the results in S2 Fig are shown by a simple comparison among the respective lists of DEGs and GO enrichments, which could be due to methodological limitations.
Atypical sensory sensitivity as a shared feature between synaesthesia and autism
However, commonalities with other diseases, i. This might be expected because alterations of such basic pathways, such as the cytoskeleton or cell division, are also relevant to oral cancer or dermatological disorders [ 44 , 52 ]. In addition, VPA is known to have the potential to cause other side effects, such as hepatotoxicity and metabolic derangements, as well as VPA being an ASD inducer [ 53 ].
Among the significantly affected GOs, GOs involved in the cellular component pathway were abundant Table 2. Recent studies have indicated that mitochondria dysfunction augments and disseminates brain abnormalities related to ASD [ 54 , 55 ]. Interestingly, a significant proportion of ASD patients have concomitant diseases related to mitochondrial disease and abnormal energy generation [ 56 ]. The cytoskeleton is also important for the positioning of cell adhesion molecules and neurotransmitter receptors at the synapse [ 2 ] and is essential for maintaining synaptic function [ 14 ].
The tsc1 gene, which we found to be significantly transcribed in our study, is related to the cytoskeleton pathway in ASD [ 1 ]. We found that significantly affected GOs were extended in a concentration-dependent manner Table 3. GOs in the nervous system, e. Furthermore, many of the ion channel-related GOs, which play an important role in the aetiology of ASD by enhancing neuronal excitability [ 1 ], were also significant, e. These significant changes observed in GOs in our study imply that zebrafish, at least partly, share commonalties with humans or mice with respect to ASD aetiology.
This might indicate that zebrafish could be applicable to ASD research, e. In addition to changes in gene transcription, the development of an experimental animal model for ASD requires strategies for behavioural observation. This is important because the symptoms of ASD are generally defined by behavioural characteristics, i. Previous studies have examined locomotor activity and social interaction behaviour in a transgenic monkey model [ 12 ].
Similar behavioural tests, such as social preference tests, the partition test, and the reciprocal social interaction test, have also been applied to rodent models [ 27 , 57 ]. Stewart et al.
Love Narratively? So do we.
These included the social preference test, social interaction test, shoaling assessment, mirror stimulation test, and stereotypic circling and swimming [ 25 ]. However, adult zebrafish are not as effective as embryos for screening the ASD-like effects of many kinds of chemicals. The test tools for social behaviour in the zebrafish larvae stage have not yet been completely developed. Therefore, instead of social behaviour, locomotor activity and anxiety have been used as markers of the ASD phenotype in ASD toxicity tests involving zebrafish embryos [ 32 , 34 , 58 ].
Thus, in the present study, we analysed locomotor activity in zebrafish larvae after VPA exposure as a behavioural endpoint. We found that locomotor activity, i. Previous studies reported similar levels of hypoactivity [ 31 ]. However, these effects, observed in both the current and previous studies, might be related to a VPA-induced delay in zebrafish hatching Fig 1. This was in accordance with a previous study and might indicate that VPA exposure causes anxiety in zebrafish larvae [ 34 ].
In a previous study, VPA exposure caused anxiety in larval zebrafish and resulted in social interaction deficits in adults [ 34 ]. Therefore, the observed effects on locomotor activity at the larval stage in our study could be linked to ASD-like behaviour. Although locomotor activity alone is not sufficient as a model of ASD in zebrafish larvae, this may be an important step, as such locomotor changes could reflect changes in basal activity elicited by ASD in terms of transcriptional alteration. However, further studies are required. Second, genes that are common to multiple ASD models and those that are particularly sensitive to environmental exposure should be determined.
This genetic information may be useful in developing transgenic zebrafish models for screening the ASD-like effects of environmental chemicals and new drug candidates for ASD. We found behavioural and transcriptional changes that matched those from previous ASD studies using humans and rodent models.
Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field. Abstract Autism spectrum disorder ASD is a serious neurodevelopmental disorder characterized by impaired or abnormal social interaction and communication and by restricted and repetitive behaviour. Introduction Autism spectrum disorder ASD is an early onset neuropsychiatric disorder that is characterized by impaired social communication, restricted interests, and stereotyped and repetitive behaviours [ 1 , 2 ].
Materials and methods Maintenance of zebrafish Wild-type zebrafish 5D line were generously provided by Robert L. Download: PPT. Table 1. Fig 1. Effects of VPA on zebrafish survival, hatching status, and development. Illumina sequencing and mapping of RNA sequencing reads onto the zebrafish genome High-throughput sequencing generated approximately Fig 4. Table 2. Commonly observed GO enrichments in this and previous studies. Table 3. GOs that exhibited significant concentration-dependent alterations among the ASD-related GOs suggested by previous studies.
Supporting information. S1 Fig. S2 Fig. S1 Table. S2 Table. Statistics for read mapping. S3 Table. S4 Table. S5 Table. S6 Table. S7 Table. S8 Table. S9 Table. S10 Table. S11 Table. References 1. Genetic aspects of autism spectrum disorders: insights from animal models. Front Cell Neurosci. Bourgeron T. From the genetic architecture to synaptic plasticity in autism spectrum disorder.
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