Autisme de Kanner, syndrome d’Asperger : une genèse de leur opposition

Abstract

ObjectiveDespite the reunification of the two diagnostic entities that are Kanner's autism and Asperger's syndrome within the autism spectrum disorder, an opposition persists making one as representing the lower part of the spectrum, the other the upper part. We propose to update this perception of an opposition between these two disorders based on an analysis of the original documents. MethodWe will review the original articles that named the two troubles, Kanner's 1943 article and Wing's 1981 article, and analyze their differences, commonalities, and the socio-historical context of their elaboration. ResultsRegarding the 11 clinical cases described by Kanner, we can observe that some clinical cases noted by the latter could correspond to cases of high-functioning autism. Regarding Lorna Wing's article, she tends to demonstrate the uselessness of maintaining the difference between the two syndromes. DiscussionThe socio-historical context of the different eras, 1943, 1981, and the present, impacts the way people are viewed and their disorder. That of Asperger, i.e. the Nazi regime, not taken into consideration by Wing at the time of her research, particularly influenced the constitution of the disorder, pulling it towards the top and towards “normality,” while people too handicapped by the symptoms were most often euthanized. Nowadays, the modification of the diagnosis of mental retardation in intellectual and social deficiency, as well as the development of early detection, supports the diagnosis of Kanner's autism. ConclusionIt would seem that this opposition of the two syndromes is more the result of the different socio-cultural contexts that built them than a clinical reality. The dissensions that characterize the field of autism constitute a form of splitting, of which the opposition of these two syndromes could be one of the manifestations. It also manifests itself in the opposition of the behaviors of Kanner and Asperger, one oriented towards the parents, the other towards the patients themselves. It would be interesting, beyond the clinical and scientific data, to question the foundations of these intense splits that persist, regardless of the historical moment.