Review by New York Times Review
IN FEBRUARY 1981, a British psychiatrist named Lorna Wing published an academic paper highlighting a 1944 clinical account of "autistic psychopathy" by a recently deceased Austrian physician named Hans Asperger. It wasn't an obvious piece of work to single out: As Wing acknowledged, Asperger's study had received almost no attention from English-language researchers in the decades since publication. That was about to change. Wing argued that the disorder that Asperger had described was a unique syndrome, distinct from autism, and should be considered as one of "a wider group of conditions which have, in common, impairment of development of social interaction, communication and imagination." Wing, whose daughter had been diagnosed with autism in the 1950s, understood from her own experience that this was a disorder with multiple gradations, which affected people across the full spectrum of intellectual abilities. But this was a radical notion: At the time, one of the dominant paradigms for understanding autism was that the condition was caused by "refrigerator mothers" - emotionally frigid women who were not warm enough to nurture developing children. It's impossible to know why Wing chose to ground her report in Asperger's rather flimsy research - his paper, after all, had referenced just four patients - rather than relying solely on her own, significantly more impressive work. (It is worth pointing out that then, as now, virtually all eponymous psychiatric conditions were named after men.) Whatever her motivation, Wing's efforts were successful: "Asperger's syndrome," the term she proposed, soon entered the clinical vernacular. By the 1990s, it was recognized around the world as an accepted diagnosis - and autism was no longer viewed as a singular condition. Wing, who died in 2014, spent the rest of her life as one of the world's leading autism researchers and advocates. Asperger, on the other hand, after 1945 and until his death 35 years later, didn't do any significant research on the condition that would bear his name. But it was Asperger, and not Wing, who came to be seen as the patron saint of the neurodiversity movement. That could be about to change. In April, an Austrian historian named Herwig Czech published evidence of Asperger's long-rumoréd collaboration with Third Reich murderers during World War II. Specifically, Czech uncovered proof that in 1942, Asperger was one of the members of a commission that screened and classified more than 200 Viennese children with mental disabilities. Thirty-five of the children in that pool were labeled "uneducable" and "unemployable" ; as a result, they were sent to the notorious Am Spiegelgrund clinic, where they were ultimately slaughtered. The historian Edith Sheffer's new book, "Asperger's Children: The Origins of Autism in Nazi Vienna," builds and elaborates on these new revelations. (While Czech had not yet published his findings when Sheffer's book went to press, he did give her access to his research.) But Sheffer has larger goals than highlighting Asperger's complicity in wartime atrocities; she also wants to upend notions of autism as a legitimate diagnostic category by locating its source in Nazi notions of mental health and sickness. Sheffer starts her narrative in the early 1940 s, with Asperger examining one of the children he would highlight in his 1944 paper, before pulling back to describe the milieu in which Asperger operated. She is at her best when she unpacks how the Third Reich created what she calls a "diagnosis regime" by labeling anyone who disagreed in any way with Nazi aims, achievements, or ideology as being fundamentally ill. This was done primarily through the use of two catchall terms: Volfe, which referred to the importance of the German national character and its people, and Gemüt, a word the Nazis used to indicate a person's "fundamental capacity to form deep bonds with other people." Viewing the world through these lenses led to the medicalization of any and all dissent: Anything less than fullthroated chauvinism meant a person was deficient in Gemüt, which, in turn, was potentially damaging to the Volfe. The most primal end to this line of thinking was that threats to the Volfe had to be exterminated. Sheffer's account of the "program of systematic child killing" that grew out of this mind-set is chilling. Starting in the summer of 1939, a Nazi decree mandated that all physicians, nurses, and midwives report any child under 3 with mental or physical disabilities. Sheffer goes on to explain: "The children would enter one of the Reich's 37 'special children's wards' for observation and, regularly, medical murder." Her descriptions of children's pleading letters home or parents' confusion as to their children's sudden deaths are devastating in their routine matter-of-factness. sheffer's pivot from describing deadly Nazi conceptions of community to Asperger's complicity with the Reich's killing machine is less effective. Because Asperger did not have a direct hand in any of the more than 700 children who were murdered in the regime's child euthanasia program, she is left relying on conditionals and suppositions: An educational society Asperger helped found "may have disseminated the child euthanasia directive behind the scenes"; surviving documents "suggest" Asperger "had a hand" in transferring dozens of children to a killing pavilion. On one page, Sheffer states that a transfer to Am Spiegelgrund was a "lethal prescription"; on another, she writes that seven out of nine children the "staff" on "Asperger's ward" transferred there did not die, although "it is possible that Asperger's clinic still marked some of them for death." None of this is to say that Asperger's actions during the war were blameless - or even that he was not guilty of crimes against humanity. But a more nuanced approach would have further examined the other, conflicting evidence that Asperger was able to save the lives of some disabled children who had been marked for death. It is this evidence, after all, that was pointed to when Asperger was hailed as a hero. Even more disconcerting than Sheffer's approach to Asperger's wartime actions is her attempt to ground the notion of autism in Asperger's World War II-era work. Because Asperger relied heavily on notions of Gemüt in his treatise on autistic psychopathy, Sheffer argues that he defined the condition "in terms of Reich rhetoric and values." Fair enough - but she goes on to claim that today, almost three-quarters of a century later, "his final 1944 description has had a lasting impact. His words live on, shaping the lives and the self-images of millions of individuals." Even the most cursory comparison of Asperger's work, which is peppered with descriptions of "sadistic traits" and children who "delight in malice," with Wing's groundbreaking paper reveals that it is her research that has helped shape our modern-day understanding of the autism spectrum. (Asperger's paper wasn't even translated into English until 10 years after Wing's 1981 report - and it was done then only at her behest.) What's more, "Asperger's syndrome" is no longer even a recognized diagnosis in the United States: In 2013, it was one of three conditions that were folded into a more expansive diagnosis of "autism spectrum disorder." Sheffer is a careful and nuanced researcher, which made her clumsy effort to "destabilize" our notions of autism feel all the more out of place. Then, on the very last page of the book, at the bottom of her acknowledgments, she tells readers that her now-teenage son, to whom the book is dedicated, was diagnosed with autism when he was an infant. "Autism is not real," she quotes him saying. "It is not a disability or a diagnosis, it is a stereotype for certain individuals.... It made me feel humiliated, and I wanted to put an end to the label of autism." I was glad to hear his voice: Too often people diagnosed with autism are excluded from discussions about the condition. But I wish Sheffer had trusted her readers enough to let us know about her personal connection to this story at the outset of her book instead of inserting it as a concluding aside, where it became an unsettling coda to her ardent effort to undermine our notions of autism and its origins. ? SETH mnookin, the director of M.I.T.'s graduate program in science writing, is the author, most recently, of "The Panic Virus." He can be found on Twitter @sethmnookin.
Copyright (c) The New York Times Company [June 17, 2018]
Review by Booklist Review
Because it was important to the Third Reich to include children in the community as happy participants in the Hitler Youth programs, psychologists began evaluating young people's health and dispositions. Unfortunately, for many children with physical and psychological disabilities, especially autism, their limitations became their death sentences. One of the psychologists was Hans Asperger, an early child psychology expert specializing in high-functioning autistic disorders, including the syndrome that carries his name. In this well-documented and deeply disturbing study, historian Sheffer traces the influences of Nazi eugenics on child psychology. Programs that began as outreach and aid to children with special needs led to the systematic euthanasia of those considered undesirable. Sheffer finds that though Asperger never officially joined the Nazi Party, he was involved in the murder of children. Tracking hospital records and testimonies of survivors, Sheffer follows Asperger's rise and influence on the treatment of autism. This frightening record of science warped by Nazism will fascinate readers searching for new insights into WWII and those interested in the full story of autism.--Smith, Candace Copyright 2018 Booklist
From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review
Historian Sheffer (Burned Bridge: How East and West Germans Made the Iron Curtain) examines the confounding legacy of Austrian psychiatrist Hans Asperger, who worked with autistic children during the 1930s and '40s, unveiling a figure who initially offered benevolent support to some autistic children, but then death to others. In 1937, Asperger advocated a nonjudgmental approach toward children's differences; a year later, following the Nazi annexation of Austria, he publicly recommended "the overhaul of medicine according to guiding principles of National Socialism"-with its emphases on group assimilation and physical perfection as determinants of whether people deserved to live or die-and introduced his concept of "autistic psychopathy," which forms the basis of the present-day diagnosis of autism spectrum disorder. Asperger was likely involved in sending 44 children to the Vienna Municipal Youth Welfare Institution at Spiegelgrund, where at least 789 children died, inhumane neglect and brutal punishments were daily rituals, and euthanasia was considered a treatment. "Evil [was] just a part of life" there, one survivor later wrote; "it was everyday life, and nobody questioned it." At the end of the war, Asperger was cleared of wrongdoing and even described his war service as somewhat heroic; he continued an illustrious career in child psychiatry. This is a revelatory, haunting biography of a gifted practitioner who chose to fall in line with the Nazi regime and the far-reaching consequences of that choice, for his own patients and for those still using and being labeled with the diagnostic concepts he originated. (May) © Copyright PWxyz, LLC. All rights reserved.
(c) Copyright PWxyz, LLC. All rights reserved
Review by Library Journal Review
Historian, author, and parent of a child diagnosed with autism, Sheffer (senior fellow, Inst. of European Studies, Univ. of California, Berkeley; Burned Bridge) delves into the story of Hans Asperger (after whom Asperger's syndrome is named). Asperger was the director of the Curative Education Clinic at the University of Vienna Children's Hospital in Vienna during the years leading up to World War II. A practicing Catholic and believed not to have joined the Nazis, Asperger has been favorably regarded. Sheffer makes clear that her subject was a minor figure in the child euthanasia program (unlike his contemporaries such as Heinrich Gross). However, Asperger not only worked but thrived within a system of mass killings, wherein increasing categorization of defects led to state-imposed murder. He labeled children as being of positive or negative worth, with the "unworthy" placed in Vienna's infamous Spiegelgrund institution. Sheffer's descriptions of the children and excerpts from their letters are heartbreaking. VERDICT A tragic yet thought-provoking and extensively researched account that vividly portrays the child victims. This remains a cautionary tale of the influences on diagnoses and how dangerous they can be.-Elizabeth -Safford, Boxford Town Lib., MA © Copyright 2018. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
(c) Copyright Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Review by Kirkus Book Review
The reputation of child psychiatrist Hans Asperger (1906-1980) comes under close scrutiny in this chilling and well-documented account of how the political and social values of Nazi psychiatry determined the fates of supposedly inferior children.Sheffer (Modern European History/Stanford Univ.; Burned Bridge: How East and West Germany Made the Iron Curtain, 2011) reveals how the Nazi regime categorized children and examines Asperger's role in its killing system. In its first conference in 1940 in Vienna, the German Society for Child Psychiatry and Curative Education established the doctrine of eugenicist selection and "the grandiose experiment of Nazi child psychiatry as a distinct field." Experts would differentiate between children who were valuable to society and who, in the words of Paul Schrder, "the Reich's father' of child psychiatry," were "mostly worthless and ineducable." Asperger, present at the convention, endorsed this doctrine and became director of the Curative Education Clinic at the University of Vienna Hospital, where, as a medical consultant for the Nazi administration, he assessed children. On numerous occasionslikely hundreds of timeshe recommended transfer to Spiegelgrund, the clinic in Vienna where "inferior" children were killed under the state's euthanasia program. Sheffer's research demonstrates how Asperger's diagnoses emerged from the values of the Nazi regime, and her account is filled with revealing notes from Asperger's clinic and disturbing stories of the experiences of children who survived Spiegelgrund. The author examines Asperger's writings and his career after the war, when he claimed that he was a resister of Nazism. She reports that he has been viewed in various ways: as "a resister who rescued children, as a determined perpetrator, or as a passive follower." Her own conclusionthat he was a conscious participantis persuasive.A compelling picture of the evils of the Nazi regime and of the perversion of Nazi psychiatry. Copyright Kirkus Reviews, used with permission.
Copyright (c) Kirkus Reviews, used with permission.
