What Was Autism Called Before It Was Called Autism?

Autism has not always carried that name. For most of the twentieth century, the behaviors and developmental differences now grouped under autism spectrum disorder were described with a shifting set of labels, most of which are no longer used and some of which are now considered inaccurate or offensive.

The word “autism” itself dates to 1911, when Swiss psychiatrist Eugen Bleuler used it to describe a withdrawal from reality that he saw in some patients with schizophrenia. It was not applied to children with social and communication differences until the 1940s, when American psychiatrist Leo Kanner and Austrian pediatrician Hans Asperger independently described groups of children with distinct patterns of behavior. Before Kanner’s work, children with these traits were often labeled with terms like “childhood schizophrenia,” “feebleminded,” or “emotionally disturbed.”

So the short answer is this: what we now call autism was once folded into childhood schizophrenia, intellectual disability, and various psychiatric categories, or simply described as “childhood psychosis.” The modern understanding of autism as a distinct developmental condition is relatively recent.

What Was Autism Called Before It Was Called Autism?

Before the term was applied to children, there was no consistent name. Children who would today be diagnosed with autism were absorbed into other diagnostic categories, and the labels depended heavily on which specialist they happened to see.

In the early 1900s, a child with limited speech, difficulty with social interaction, and repetitive behavior might be described as having “childhood schizophrenia” or “childhood psychosis.” These terms reflected a then-widespread belief that autism-like traits were an early form of schizophrenia. That belief shaped diagnosis for decades and was not fully abandoned until the 1970s and 1980s, when research began to show the two conditions were distinct.

Other children were placed in institutions with a diagnosis of “mental retardation,” now called intellectual disability. Still others were labeled “feebleminded” or “moral imbecile,” terms that were used in medical and legal writing in the early twentieth century and are now understood as both inaccurate and degrading.

The key point is that there was no single predecessor term. Autism as a category did not exist. What existed was a scattering of labels that captured overlapping symptoms without recognizing a shared underlying developmental pattern.

Who First Used the Word Autism and Why Did the Meaning Change?

Eugen Bleuler coined “autism” in 1911. He derived it from the Greek word “autos,” meaning self, to describe a retreat into one’s own inner world. In Bleuler’s usage, autism was a symptom of schizophrenia, not a separate condition.

That meaning held for roughly three decades. Then in 1943, Leo Kanner at Johns Hopkins published a paper describing eleven children who showed what he called “early infantile autism.” These children had difficulty relating to people, delayed or unusual language, and a strong preference for sameness. Kanner used Bleuler’s word but applied it to a distinct group, and he believed he was describing something separate from schizophrenia.

One year later, in 1944, Hans Asperger described a similar group of children in Vienna, noting they had average or above-average intelligence and strong verbal skills but struggled with social understanding. His work was published in German and went largely unnoticed in the English-speaking world until the 1980s, when it was popularized and the term “Asperger’s syndrome” entered common use.

Kanner’s and Asperger’s descriptions did not immediately replace older labels. For decades, “childhood schizophrenia” remained a common diagnosis for children we would now recognize as autistic. The shift came gradually as research clarified that autism and schizophrenia have different developmental trajectories, different symptoms, and different underlying biology.

What Other Terms Were Used Over the Decades?

The vocabulary around autism changed with each generation of clinicians. Some terms described a similar group of children. Others reflected mistaken theories that have since been disproven.

• Childhood schizophrenia — widely used from the 1940s into the 1970s for children with autism-like traits.
• Childhood psychosis — a broader label that overlapped with the above.
• Early infantile autism — Kanner’s original term.
• Kanner’s syndrome — used to describe the pattern Kanner identified.
• Asperger’s syndrome — introduced into English-language use in the 1980s.
• Pervasive developmental disorder (PDD) — an umbrella category introduced in the 1980s and 1990s.
• Pervasive developmental disorder not otherwise specified (PDD-NOS) — used for children who met some but not all criteria.
• Atypical autism — used when symptoms did not fit the full pattern.

Some of these terms were simply descriptive. Others carried assumptions that later proved wrong, including the idea that autism was caused by cold parenting, a theory proposed by psychologist Bruno Bettelheim in the 1950s and 1960s. That theory, sometimes called the “refrigerator mother” idea, was never supported by evidence and caused lasting harm to families. It has been fully discredited.

The 1980 publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorders, known as DSM-III, marked a turning point. For the first time, autism was listed as its own condition, separate from schizophrenia. The DSM-IV, published in 1994, added Asperger’s syndrome and PDD-NOS as distinct diagnoses.

Why Did the Diagnosis Change to Autism Spectrum Disorder?

In 2013, the DSM-5 replaced the separate categories of autistic disorder, Asperger’s syndrome, and PDD-NOS with a single diagnosis: autism spectrum disorder. The reasoning was that these conditions shared core features and differed mainly in severity and support needs, not in kind.

Researchers had found that the boundaries between the older categories were inconsistent. Two clinicians could evaluate the same child and arrive at different diagnoses depending on how they interpreted the criteria. The spectrum model was meant to reflect that autism traits occur along a continuum.

The change was not universally welcomed. Some people who had identified with an Asperger’s diagnosis felt the shift erased part of their identity. Others argued the new criteria might exclude some people who would previously have qualified. Studies on whether the overall number of diagnoses changed after DSM-5 have produced mixed results, and the debate over diagnostic boundaries continues.

How Has the Understanding of Autism Changed Over Time?

The biggest shift has been from seeing autism as a psychiatric illness to understanding it as a developmental difference with a strong genetic component. Research consistently shows that autism is highly heritable, though the specific genetic factors involved are numerous and complex, and no single gene explains most cases.

Early theories blamed parenting. Those theories are now rejected. Modern research points to differences in brain development that begin before birth, influenced by a combination of genetic and environmental factors. The exact causes are still not fully understood, and no single factor has been identified as responsible.

Another significant change involves who is diagnosed. In the 1940s, autism was thought to be rare. Today, it is recognized as common, and diagnostic rates have risen substantially over recent decades. Researchers attribute much of this rise to broader criteria, increased awareness, and better screening rather than a true increase in how often autism occurs. Whether some portion of the increase reflects a real change in prevalence remains an open question.

Language has also shifted. Many autistic adults and advocacy groups now prefer identity-first language (“autistic person”) over person-first language (“person with autism”). Others prefer person-first. There is no universal agreement, and preferences vary by individual and community.

What Do the Old Terms Tell Us About How Medicine Changes?

The history of autism terminology is a clear example of how medical understanding evolves. Terms that once seemed precise later appear crude or wrong. Categories that clinicians treated as fixed turn out to be overlapping.

This does not mean the earlier clinicians were careless. They worked with the evidence available at the time. It does mean that current diagnoses and labels should be held with some humility. What we call autism today may be understood differently in fifty years, just as childhood schizophrenia gave way to a more specific understanding.

For families and individuals reading about autism now, the practical takeaway is that the label matters less than the support. The behaviors and needs described under older terms are the same ones described today. What changed is the framework for understanding them.