Hans Asperger and his eponymous syndrome have sparked controversy within autism communities in the years since he first published his research on "autistic psychopathy" in 1944. Some praise Asperger as the lost prophet of neurodiversity who valiantly protected autistic children from Nazi persecution and others condemn him as a Nazi collaborator. 1 In her book Asperger's Children: The Origins of Autism in Nazi Vienna historian Edith Sheffer offers crucial context for understanding Asperger's work and legacy. She analyzes how his work was shaped by larger trends in Nazi child psychiatry, examining how it reflected and reified Nazi emphasis on "community spirit" and conformity. In doing so she demonstrates the socially constructed nature of diagnosis. She asks why was it that traits which existed throughout human history were labelled as signs of "psychopathy" in the 1940s. She also carefully documents Asperger's participation in the Third Reich's killing machine, including his close professional connections with leaders of the T-4 program, the Nazi's mass murder of disabled people. Sheffer's book offers valuable insights on how social values shape the development of diagnosis while shedding new light on the origins of autism as a diagnosis and the impact of this history on contemporary perceptions of autism.

In the 1920s, Vienna was known as one of the most progressive cities in the world. In the wake of WWI, the Viennese had elected a progressive Democratic socialist government that worked with reformers to implement ambitious social welfare policies, including extensive child welfare programs undergirded by Erwin Lazar's theory of "curative education"(32-33). Sheffer opens her book by describing the development of this milieu where Asperger would complete his early research. She also outlines how the progressive, eugenics-based child welfare programs of "Red Vienna" were eventually incorporated into the Nazi killing machine. Specifically, Sheffer looks at how the system of surveillance and removal of "abnormal" children adopted by the Vienna's government and enacted by social workers and medical professionals like Asperger, became a means of identifying youth who would be eliminated under the Nazi's "euthanasia program". Sheffer emphasizes that Vienna's child welfare system was primed to become a component in what she refers to as the Third Reich's diagnosis regime (48).

Sheffer goes on to examine how the Nazi obsession with classification and conformity impacted Asperger's definition of autism. She does this in part by comparing Asperger's work to that of his colleagues at the Curative Education Clinic, George Frankl and Anni Weiss. Sheffer explains that Frankl and Weiss both wrote about children with autistic traits as early as the mid-30s but that, in keeping with the ideology of the clinic during the period, which rejected strict classification, they did not identify these children as having a specific "disorder" or "pathology". Both Frankl and Weiss were Jewish and later emigrated to the United States to avoid persecution. Frankl was sponsored by Leo Kanner, a fellow Austrian Jewish émigré, whose 1943 paper would introduce autism to the English-speaking world and form the basis of contemporary understandings of autism. Both Frankl and Weiss's work influenced Kanner's definition of autism. Sheffer contrasts Frankl and Weiss's distrust of rigid diagnosis with the Nazi diagnosis regime's reliance on strict classification as a means of dehumanization.

Sheffer also shows how Asperger's own writing about autism shifted during the late 30s and 40s to better reflect trends in Nazi child psychiatry. Particularly she looks at how Asperger incorporated the concept of "gemüt" a German term that was used to describe a person's ability to form rich social bonds with others, into his definition of autism. German psychiatrists in the Nazi era increasingly characterized gemüt as the primary means of measuring a person's value. The Nazi regime prioritized gemüt as a trait that allowed people to become embedded into the national community. Those who were labeled as gemüt-less or as being deficient in gemüt were considered a danger to the project of national socialism. As Sheffer puts it gemüt was seen as a "key ingredient for Nazism" (71). This increased emphasis on gemüt, on "correct" social feeling, perhaps helps to explain why autistic traits became increasingly pathologized during the Nazi era. By 1944 Asperger was arguing that autistic children could be defined by their anomalous or insufficient gemüt. To be autistic was to be an unfit member of the volk, a bad Nazi.

Sheffer seeks to unravel the complicated contradictions inherent in Asperger's characterization of autism. Asperger defined autistic children as in many ways being the inverse of the proper member of the volk, emphasizing what he defined as their "dangerous" lack of gemüt. Yet, Asperger also argued that some autistic children, those who he deemed to be intellectually gifted, had the potential to contribute enormously to society through intellectual pursuits. Asperger characterized autistic people as at once a threat and a potential resource to the state. In doing so Asperger reaffirmed eugenic notions that sought to determine human value based on productivity. His work lies at the cross section between two common and troubling ways of measuring the value of human life: those based on productivity and on social relationships. This is something for disability studies scholars to keep in mind as we seek to complicate means of defining human worth. The ability to form and maintain social relationships is itself a type of capacity, and the prioritization of human relationships creates its own forms of exclusion.

Sheffer examines both how Asperger's definition of autism was influenced by the eugenic and sexist ideologies of the Reich and how some of these dangerous ideas continue to be propagated in contemporary methods of classifying autistic people. Much has been made of Asperger's supposed defense of autistic children during the Nazi era. Asperger certainly praised autistic boys who he considered to be on the more "favorable"(to use his term) end of the autism spectrum. He argued that some of them may even be intellectually "superior" to "normal" children and emphasized their potential contributions to society (177). In contrast, he derided children who he did not see as having the same potential for productivity. As it does today, gender played a significant role in who he diagnosed as autistic. Asperger argued that autism might be a form of "extreme male intelligence" and that women and girls were thus incapable of being autistic. 2 Asperger praised some autistic boys as prodigies of abstract thinking and worked to provide them with individual support, which has won him praise from some commentators. Yet, Sheffer shows that Asperger dismissed girls who showed similar traits, showing no compunction about sending them to Spiegelgrund, the center of the Third Reich's child "euthanasia" program. These hierarchies are in many ways perpetuated today through the continued use of labels such as "high functioning" and "low functioning" to describe autistic people and through the gendered disparity in autism diagnosis rates and support programs.

Sheffer directly addresses the debate about Asperger's involvement in the brutal extermination campaigns of the Nazi regime. She notes his close ties with leaders of the T-4 program. Asperger did not simply rub elbows with killers, but rather records show that he and his staff not only sent children they deemed uneducable to the killing ward at Spiegelgrund for execution but also advised other clinicians to do so. Sheffer's discussion of the role of doctors, nurses, and other members of the helping professions in the holocaust is worth contemplating, especially at this moment when many are lauding health care professionals and social workers as progressive alternatives to police . That is not to say that health care professionals and social workers cannot provide vital services for communities, but it is important to remember that these professions can also be co-opted to serve discriminatory and even violent ends. Surveillance of disenfranchised communities by authority figures with power to make decisions about the fate of community members comes with its own dangers, no matter what title those authority figures hold.

Sheffer is careful to include the voices of survivors in her account of Nazi killing machine. She draws on harrowing accounts by survivors of the T-4 program. She contrasts the continued suffering endured by these survivors with the relatively lax treatment of the many of the medical professionals who were responsible for, and often benefited from, their pain. She notes that like Asperger, many who were involved in the T-4 program remained prominent figures in their fields in the post war era, with Spiegelgrund doctor Heinrich Gross continuing to research based on the preserved brains of children killed at Spiegelgrund decades after the fall of the Third Reich.

Although she does invoke the neurodiversity movement, Sheffer primarily grounds her work in the field of holocaust studies and 20th century German history rather than in disability history. Yet, her focus on the context in which Asperger developed his ideas has allowed her to write a history of autism research that reflects the tenets of the social model of disability. While many accounts of the history of autism follow a teleological narrative in which scientists (and occasionally parents) slowly uncover the secrets of autism; Sheffer emphasizes that definitions of autism are created at specific moments by specific stakeholders and reflect the values of the society in which they develop. Some have critiqued Sheffer for her lack of attention to earlier autism research, such as that of Grunya Sukhareva in the Soviet Union, but in many ways the strength of her work lies in its specificity. This is not a book about autism, it is a book about scientific discourse in Nazi Vienna and the role of diagnosis in the Third Reich. Sheffer is as interested in what Asperger's work can tell us about understandings of community and issues of complicity under Nazism as she is in how Nazi ideology shaped Asperger's definition of autism. By focusing on the context in which Asperger developed his syndrome Sheffer unearths critical insights not only about the history of autism but about the role of disability in history. Asperger's Children would be a valuable addition to any class on neurodiversity, disability history, the history of eugenics or holocaust studies.

Endnotes

  1. For examples of authors who have praised Asperger, see Silberman, Steve. NeuroTribes: The Legacy of Autism and the Future of Neurodiversity. New York: Avery, 2015.
    and Feinstein, Adam. A History of Autism: Conversations with the Pioneers. Malden, Massachusetts: John Wiley & Sons, 2010. https://doi.org/10.1002/9781444325461
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  2. Such gender essentialist definitions of autism continue in the work of researchers like Simon Baron-Cohen. For examples, see Baron-Cohen, Simon, and Sally Wheelwright. "The Empathy Quotient: an Investigation of Adults with Asperger Syndrome or High Functioning Autism and Normal Sex Differences", Journal of Autism and Developmental Disorders. 2004;34(2):163-175. https://doi.org/10.1023/B:JADD.0000022607.19833.00
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