Lang Heldi Marleen
University of Tartu, Tartu, Estonia.
Health Care Anal. 2025 May 29. doi: 10.1007/s10728-025-00527-0.
The diagnosis and perception of autism have undergone significant transformations throughout history. Initially conceptualised as a symptom of schizophrenia, autism later emerged as a distinct diagnosis, evolving into the broader classification of autism spectrum disorder (ASD). This essay explores the main shifts in the understanding of autism throughout its history and different approaches to its treatment. While the traditional psychiatric perspective aligns with a naturalist view of disease, the Neurodiversity Movement advocates for a normative approach, emphasising societal adaptation over medical intervention. The study examines historical milestones, including the contributions of Eugen Bleuler, Grunya Sukhareva, Leo Kanner, and Hans Asperger, alongside the conceptual transition from low- and high-functioning autism to the spectrum model. It also discusses the implications of language in shaping autism discourse, highlighting the shift from person-first to identity-first terminology. The essay ultimately argues that the expansion of the autism diagnosis supports the neurodiversity paradigm, which fosters greater inclusion and empowerment of neurodivergent individuals. However, considerations of severity and linguistic framing remain crucial in advancing this perspective.
自闭症的诊断与认知在历史进程中经历了重大转变。自闭症最初被视为精神分裂症的一种症状，后来逐渐成为一种独立的诊断，并演变为更广泛的自闭症谱系障碍（ASD）分类。本文探讨了自闭症认知在其整个历史中的主要转变以及不同的治疗方法。传统精神病学观点与疾病的自然主义观点一致，而神经多样性运动则倡导一种规范方法，强调社会适应而非医学干预。该研究考察了历史里程碑，包括尤金·布鲁勒、格鲁尼亚·苏哈列娃、利奥·坎纳和汉斯·阿斯伯格的贡献，以及从低功能和高功能自闭症到谱系模型的概念转变。它还讨论了语言在塑造自闭症话语方面的影响，突出了从以人为主的术语到以身份为主的术语的转变。本文最终认为，自闭症诊断范围的扩大支持了神经多样性范式，该范式促进了对神经差异个体的更大包容和赋权。然而，在推进这一观点时，对严重程度和语言框架的考量仍然至关重要。
