Infantile autism and childhood schizophrenia: Review of the issues from the sociocultural point of view

After presenting an historical overview of the development of the concept of childhood psychosis, this paper discusses the various etiologies which have been offered to explain severe disturbances of childhood. Reference is made to the nature/nurture polemic. In spite of the general belief that the etiology is biologically determined, particularly in infantile autism, the actual evidence tends to be meagre. Furthermore, the literature includes a number of studies which have been found to be methodically weak and which seem to disclaim the intellectual and socioeconomic superiority of the parents of autistic children, contrary to Kanner's original finding that such superiority exists. The link between social class and autism, according to Cantwell's review, does not appear to fit a purely biological causation of autism. This remains an awkward finding which still demands an explanation. The contention of this paper is that contradictory findings could be explained, as stated by Kanner, by the 'inordinate' use of the label 'autism' to include various types of children's severe disorders, even brain-damaged children. Furthermore this review emphasizes the fact that a total neglect of sociocultural variables in the study of such children has led to confounding results. A careful reading of the literature and correspondence with numerous psychiatrists around the world have led the author to believe that infantile autism is more prevalent in highly technological countries where there is extensive geographical and economic mobility coupled with the nuclearization of the family. This paper offers supportive evidence for this speculation.