Kanner Syndrome: what it is and how it relates to ASD.

A concept used to refer to certain cases of Autism Spectrum Disorder.

Until relatively recently, autistic disorders were given different names depending on the cognitive, emotional, relational and social characteristics of each individual.

In addition to Asperger's syndrome, Kanner syndrome was one of the autistic disorders that were diagnosed until changes in the autismuntil changes in the diagnostic manuals put an end to its concept.

Today we are going to discover a little more in depth what Kanner syndrome is, who discovered it, how it differs from Asperger's syndrome, the history of its discovery and theoretical conceptualization as well as understanding why it is no longer diagnosed.

What is Kanner syndrome?

Kanner syndrome is one of the names by which classic autism became known, as opposed to Asperger syndrome.. If in Asperger syndrome we would speak of a highly functional autism at a cognitive level, in Kanner syndrome we would speak of children with problems in different intellectual abilities, in addition to social, relational and empathy problems. This disorder was described for the first time by the same person who gave it its last name, Dr. Leo Kanner.

Although nowadays the different syndromes and disorders associated with autism have been encompassed within the have been grouped under the category of Autism Spectrum Disorders (ASD), it is true that they continue to have a number of common characteristics.It is true that the names Kanner's syndrome and Asperger's syndrome continue to be very important. Each person with autism is different and, depending on each case, it will be necessary to take into account how affected are the cognitive abilities, as well as the emotional and communicative ones.

Symptoms of this syndrome

The main symptom of Kanner's syndrome or classic autism is abnormal or impaired development of social interaction and communication.. People suffering from this syndrome give the impression that they are indifferent to the reactions of other human beings, even to people who are part of their closest circle, whether they are adults or children. As can be observed in Asperger's syndrome, the person has hardly any empathy and affection.

It is normal for babies without psychopathology to smile at a moving human face, as well as to show interest and curiosity in other people. They soon pay attention to what others are doing. On the other hand, children with Kanner Syndrome show an inordinate interest in inanimate objects, leaving people to one side.and are very much oblivious to the people themselves. They may spend hours and hours doing ritualistic behaviors, such as spinning a spinning top or playing or bouncing a ball.

People with Kanner syndrome often do not make eye contact with other people, and if they do, they appear to be looking through them. In addition, they have problems at the communicative level, with a high linguistic impairment or delayed language acquisition.. Their way of speaking is very anomalous, with a shrill, monotonic and metallic voice. There are cases of adults with global aphasia, i.e., total speech restriction, although there are also cases of linguistic impairment.

They also present language disorders, such as delayed echolalia, pronominal inversion and other linguistic phenomena, repetitive and stereotyped play activities, mostly developed alone. Kanner himself called these ritualistic phenomena "insistence on identity"..

In addition, people diagnosed with this syndrome would be characterized by a significant lack of imagination, good mechanical memory and no motor or physical deformities or problems. Kanner emphasized that these features were already visible in early childhood, emphasizing their differences with other "autistic" disorders of later onset, such as schizophrenia.

Among the most severe symptoms found in Kanner's syndrome are those that provoke aversion to others. Among these symptoms we find behaviors such as intense rocking, head banging, random aggressive behavior and self-mutilation.. Hypersensitivity and hyperreactivity to sensory stimulation can also be observed, which causes people with Kanner syndrome to express it through screaming, running away, covering their ears to a sound or not tolerating touch.

History of this concept in psychiatry

Since the beginnings of psychology and psychiatry, autism has been seen as a specific form of infantile psychosis.

Kanner's syndrome was first described in 1943 by Dr. Leo Kanner, who worked at the John Hopkins Hospital.. He made his findings just one year before another important doctor in the field, Mr. Hans Asperger, described his well-known syndrome. The first definition of Kanner's syndrome corresponds to the traditional idea of autism, i.e. people who from a very young age show relational problems, empathy and cognitive impairment.

In 1956 Kanner published a paper on the syndrome he had conceptualized together with his colleague Leon Eisenberg, known for being the inventor of the adhd diagnostic label. Since then, autism has acquired greater importance in scientific research, with new autistic disorders being considered and knowledge about this type of psychological problem in the pediatric field expanding more and more.

Numerous authors, such as Lorna Wing, Michael Rutter and van Krevelen described cases of autism that differed from those seen by Kanner, although the main symptoms of lack of empathy and relational problems were still present. They saw that there were different levels of cognitive impairmentThe Kanner-Asperger dichotomy was popularized, especially in the 1980s, to differentiate between cognitively dysfunctional autism and functional autism.

Likewise, it should be said that Kanner syndrome has not been such a popular expression to refer to classic autism, since that term is preferred to Kanner's. Kanner conceptualized his syndrome when the definition of autism proposed by Eugen Bleuler at the beginning of the 20th century already existed. Bleuler defined autistic subjects as persons who were actively withdrawn into their fantasy world. Kanner related this definition to schizophrenia, so he preferred to speak of Kanner's syndrome as something different from the idea of autism, although in essence it coincides.

Both Kanner's syndrome and Asperger's syndrome and other related disorders have been defined with some subjectivity and vagueness in nomenclature. Other autism scholars, such as Lorna Wing or Van Krevelen had some problems in objectively defining each autistic disorder, which called into question the soundness of these problems as independent constructs.

It is therefore not surprising that autism spectrum disorders have ended up being lumped together in a single category. Today the labels "autism," "Asperger syndrome," and "Kanner syndrome," among others, are collected in the relatively new category introduced in the DSM-5 (2013), "Autism Spectrum Disorders."

Kanner syndrome was conceptualized at a time when child psychology, psychiatry and clinical pediatrics were not mature disciplines.. The scientific methods to demonstrate his constructs were still somewhat rudimentary, in addition to the problem that the researchers themselves could have a high bias when interpreting their results and there was not as much control as today.

Regardless of the mistakes Dr. Kanner may have made, this psychiatrist has the merit of being a pioneer in research on traditional autism, its conceptualization and treatment, in addition to expanding the knowledge of child psychiatry. At that time, children who were not like the rest, regardless of their specific symptoms, could end up in an orphanage or in a psychiatric hospital without receiving specialized care, something that changed with the scientific study of autism and its varieties.

Reflection and conclusion

Kanner syndrome is a diagnostic label that, due to changes in the relatively recent DSM-5. Now autistic disorders are now encompassed under the same label and, while still taking into account the differences between individuals with relational, emotional and empathic problems based on whether or not they are cognitively functional, it is agreed that they are, in essence, autistic.

Classic autism coincides with the definition given of this syndrome by Kanner. Nowadays there would not be, at least officially, a diagnosis with this syndrome, but certainly the type of intervention that would be applied to the person would coincide with that of the rest of autistic people, focused on knowing how to interpret the emotional clues of the face and control of self-injurious and repetitive behaviors.

Although the term is obsolete, there is no doubt that the research carried out by Kanner and other autism scholars has contributed to a more scientific and humanitarian vision of people suffering from this disorder. We have gone from seeing autistic children as impossible to "correct" or "cure" to gradually including them in all kinds of activities and situations in which they can relate to others. and situations in which they can relate to children without any psychopathology, although, of course, with limitations.

Bibliographical references:

• Atlas of Genetic Diagnosis and Counseling (3rd Ed) 2017, Harold Chen, ISBN: 978-1-4939-2400-4, P. 233. (English)
• De Ajuriaguerra, J (1973). Manual de Psiquiatría Infantil, Editorial Masson, Barcelona, 4th edition.
• Gómez, C., Rojas, A., Vengoechea, J. (2002) Tratado de Psiquiatría, Editorial Javegraf.
• Happé, F (1998). Introduction to Autism, Editorial Alianza, Madrid.
• Hobson, P. (1995) Autismo y desarrollo de la mente, Madrid, Editorial Alianza.
• Lozano, J. (2000). El diagnóstico de autismo, Revista cubana de pediatría.
• Klin, A., Volkmar, F., Lord, C., Cook, E. (2002) Autism and the Pervasive Developmental Disorders.
• Ozonoff, S., Dawson, G., McPartland, J (2002). A Parent's Guide to Asperger Syndrome and High-Functioning Autism. The Guilford Press. Nueva York.