Before autism had its own name, children who would meet today’s diagnostic criteria were classified under a surprisingly wide range of labels. The most common was childhood schizophrenia, which served as a catch-all for decades. But the full story stretches back further, through terms like “dementia praecocissima,” “schizoid psychopathy,” and “autistic psychopathy,” each reflecting how doctors at the time understood what they were seeing. Autism did not become its own official diagnosis until 1980.
Where the Word “Autism” Came From
The word “autism” existed long before it described the condition we know today. German psychiatrist Eugen Bleuler coined it in 1911, but he was talking about adults with schizophrenia, not children with developmental differences. For Bleuler, “autism” described a withdrawal into an inner fantasy world. He saw it as a symptom where a person replaced unsatisfying reality with hallucinations and fantasies, thinking in “symbols, in analogies, in fragmentary concepts, in accidental connections.” The word’s roots trace back to Freud’s concept of “autoerotism,” referring to a stage of self-focused thought before an infant engages with the outside world.
This original meaning is almost the opposite of how we understand autism today. Bleuler’s “autistic thinking” was about rich but disconnected fantasy life in psychotic adults. It had nothing to do with the social and developmental differences that define autism in modern medicine. But the word stuck, and when researchers in the 1940s began identifying a distinct pattern in children, they borrowed Bleuler’s term and gave it an entirely new meaning.
The Labels Used Before the 1940s
In the early 1900s, children displaying what we would now recognize as autistic traits were often lumped in with broad psychiatric categories. Italian psychiatrist Sante De Sanctis proposed the term “dementia praecocissima” in 1906 to describe severe mental disorders appearing in very young children. The name was a variation on “dementia praecox,” the era’s label for what we now call schizophrenia, with the added Latin suffix meaning “very early.” It was essentially a way of saying “the youngest possible version of psychosis.”
Even earlier, some children now retrospectively considered autistic were simply called “feral” or “wild.” The most famous case is Victor of Aveyron, a boy found living alone in the woods of southern France around 1800. He was studied extensively by physician Jean-Marc-Gaspard Itard, who tried to socialize and educate him. At the time, there was no psychiatric framework for his behaviors. He was simply “the wild boy.”
Sukhareva’s “Schizoid Psychopathy” in 1926
One of the most striking early descriptions came from Soviet child psychiatrist Grunya Sukhareva, who published a detailed clinical paper in 1926 describing children with what she called “schizoid psychopathy.” Her observations read like a modern autism assessment. She documented children who kept themselves apart from peers, avoided communal games, and showed “a tendency towards solitude and avoidance of other people from early childhood onwards.” She noted flat emotions, a lack of facial expressiveness, strong exclusive interests, frequent word repetition, and unusual sensitivity to noise.
Sukhareva even used the word “autistic” in her descriptions, writing about children’s “autistic attitude” and “autistic reactions.” She identified a pattern of core features: social withdrawal, unusual emotional responses, a tendency toward abstract and rigid thinking, and clumsy or angular movements. Her work predated the more famous descriptions by Kanner and Asperger by nearly two decades, yet it remained largely unknown in the English-speaking world for most of the 20th century.
Childhood Schizophrenia: The Dominant Label
From the 1930s through the 1970s, the most common diagnosis given to autistic children was childhood schizophrenia. This was the official label in American psychiatry’s diagnostic manual for nearly three decades. The first edition of the DSM in 1952 listed “Schizophrenic reaction, childhood type” and explicitly stated that “psychotic reactions in children, manifesting primarily autism, will be classified here.” The second edition in 1968 refined this slightly to “Schizophrenia, childhood type,” describing it as a condition “manifested by autistic, atypical and withdrawn behavior; failure to develop identity separate from the mother’s; and general unevenness, gross immaturity and inadequacy of development.”
The symptoms clinicians attributed to childhood schizophrenia overlap remarkably with today’s autism criteria. These children were described as disliking interruptions, following rituals, having compulsions, being sensitive to criticism, and struggling with novel situations. Some had coordination problems, some showed unusual skill in the arts or abstract thinking, and some could not transfer abilities from one setting to another. Clinicians noted non-functional play, monotone speech, and pronoun difficulties. Notably, unlike adults with schizophrenia, these children typically did not hallucinate. In hindsight, the description fits autism far better than schizophrenia, but without a separate diagnostic category, the schizophrenia label was all clinicians had.
Kanner’s “Early Infantile Autism” in 1943
The pivotal moment came in 1943, when Johns Hopkins psychiatrist Leo Kanner published the first systematic description of what he called “early infantile autism.” He studied 11 children and concluded they shared something distinct from schizophrenia: “these children have come into the world with an innate inability to form the usual, biologically provided contact with people.” This was a radical claim. Rather than seeing autism as a retreat from reality (Bleuler’s meaning) or a childhood version of psychosis, Kanner described it as something present from birth, a fundamental difference in how these children related to the world.
Just one year later, in 1944, Viennese pediatrician Hans Asperger independently described a similar group of children, though he used the term “autistic psychopathy.” His patients tended to have higher intelligence and more distinct skills but shared the core social difficulties. Asperger’s work remained relatively obscure outside German-speaking countries until the 1980s, when British researcher Lorna Wing brought it to wider attention.
Why It Took Until 1980 to Become Official
Despite Kanner’s 1943 paper, autism remained trapped under the schizophrenia umbrella in official psychiatric classification for another 37 years. The DSM’s first two editions kept it there. It was not until the DSM-III in 1980 that autism finally received its own diagnostic category, separate from schizophrenia entirely.
The 1980 criteria created a new umbrella called “Pervasive Developmental Disorders” with several subcategories. “Infantile Autism” required a pervasive lack of responsiveness to other people, major deficits in language development, peculiar speech patterns like echolalia or pronoun reversal, and bizarre responses to the environment such as resistance to change. All of this had to appear before 30 months of age. For children whose symptoms appeared later (after 30 months but before age 12), a separate label called “Childhood Onset Pervasive Developmental Disorder” was used. A third catch-all category, “Atypical PDD,” covered children who had social and language distortions but didn’t fit neatly into either box.
This 1980 split was a watershed. It meant that for the first time, a child could be diagnosed with autism without being told they had a form of schizophrenia. It also opened the door to the further refinements that followed: the addition of Asperger’s Disorder in 1994, and eventually the consolidation of all subtypes into the single diagnosis of Autism Spectrum Disorder in 2013.
A Quick Timeline of the Labels
- 1906: “Dementia praecocissima,” used for severe early-childhood mental disorders
- 1911: “Autism” coined by Bleuler, but only as a symptom of schizophrenia in adults
- 1926: “Schizoid psychopathy” described by Sukhareva in children with recognizably autistic traits
- 1943: “Early infantile autism” introduced by Kanner as a distinct condition
- 1944: “Autistic psychopathy” used by Asperger for higher-functioning children
- 1952–1968: “Schizophrenic reaction, childhood type” and later “Schizophrenia, childhood type” in the DSM
- 1980: “Infantile Autism” becomes its own diagnosis in DSM-III, finally separated from schizophrenia
- 2013: All subtypes merged into “Autism Spectrum Disorder” in DSM-5
The naming history of autism reflects how dramatically our understanding has shifted. What was once seen as childhood psychosis or a withdrawal into fantasy is now recognized as a neurodevelopmental difference present from birth. The children themselves never changed. The labels did.