Autism — The Children We Misunderstood

Long before autism became a diagnosis, there were children who experienced the world differently, children overwhelmed by noise, comforted by routine, or struggling to connect in ways others expected. But for much of history, those differences were misunderstood.

In this episode of Before It Had a Name, we trace the evolving understanding of autism from early descriptions of “withdrawn” children to Leo Kanner’s first clinical observations, the damaging “refrigerator mother” theory, and the modern neurodiversity movement. Along the way, the story becomes about more than diagnosis; it becomes about belonging, identity, and what happens when society mistakes difference for disorder.

What if the problem was never that some people experienced the world differently… but that the world expected everyone to experience it the same way?

Topics: autism, neurodiversity, masking, psychology, mental health history, child development, parenting, behavioral science

Before It Had a Name explores the history of mental health diagnoses and the stories behind the labels.

Follow Jon Watkins on Instagram: @JonWatkinsHost

Transcript

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A boy sits alone at the edge of the playground. The other children are yelling, they're laughing, chasing each other in circles. He watches them for a moment, then looks away. A whistle blows nearby and he covers his ears. Not dramatically. Almost automatically. Like his body reacts before he has time to think about it. Later, a teacher will describe him as distant. Another adult will say he seems like he's in his own world. And years from now, someone might call it autism. But long before there was a diagnosis, there were children who experienced the world differently, and adults trying to decide what the difference meant. There has always been a tension between difference and disorder, especially in children. A child who speaks differently or plays differently really connects differently. And for much of history, those differences weren't understood. In fact, sometimes they were feared or dismissed, sometimes treated as something that needed to be corrected. Today, we call this autism spectrum disorder. But like many mental health diagnoses, the experience came long before the label. This is before it had a name. Before we go further, a quick note this podcast explores the history of mental health diagnoses. It's not medical advice, it's not therapy, it's not a diagnosis. So if you're concerned about yourself or someone else, it's important to speak with a qualified professional. You know, for most of history, there wasn't a category for autism. There were simply children who seemed different. Some avoided eye contact, some became intensely focused on specific interests, some struggled with social interaction or communication, but there wasn't a shared framework for understanding why. And without framework, people tend to create explanations that reflect the culture around them. Some children were described as shy, others as withdrawn. Some were labeled intellectually disabled. And even others were viewed as emotionally detached. You see, looking back now though, the descriptions feel familiar. Children overwhelmed by noise. Children comforted by routine. Children who experienced the social world differently than the people around them. The experience, it existed. But the language did not. And often the children themselves were left carrying the weight of that misunderstanding. In 1943, an Austrian-American psychiatrist named Leo Canner publishes a paper describing 11 children with remarkable similar patterns of behavior, difficulty with social interaction, a strong preference for sameness and routine, repetitive behaviors, intense focus on special interests. See, Canner calls it early infantile autism. And for the first time, autism begins to take shape as a distinct diagnosis. And initially, this is important progress, because many of these children had previously been misunderstood entirely. But the understanding, it's still very limited. Canner describes the children as emotionally distant or detached. And some clinicians begin interpreting autism through a deeply, deeply flawed lens. And this lens would shape families for decades. In the mid-20th century, a painful theory gains traction. Some psychologists they start suggesting that autism is called by emotionally cold parenting. Especially on mothers. The term refrigerator mother begins to appear. I mean, think about this. The implication is devastating. Imagine bringing your child to a doctor because you're desperate for answers. And being told the reason your child struggles is because you didn't love them correctly. And for many parents, now especially mothers, the diagnosis becomes tangled with guilt. And looking back now, it's difficult to overstate how damaging this idea was because it placed blame where understanding should have been. Many families were already feeling isolated. Now they were being told that they had caused the isolation themselves. And this happens very often in the history of mental health, where science just doesn't have clear answers, so culture decides to fill the gap. And sometimes, yes, there's compassion, but a lot of times it's with blame. Over time, research begins moving away from parental blame. They start doing twin studies and developmental research and neurological findings. The understanding of autism slowly changes. Autism is increasingly viewed as neurodevelopmental rather than emotional injury. And something else begins to shift too. Clinicians start noticing that autism doesn't look the same in every person. Some individuals require significant daily support, and others live independently. Some speak very little. Others can communicate fluently, but still experience profound social exhaustion or sensory overwhelm. This idea of a spectrum begins to emerge. So not a single presentation, but a wide range of human experience. And slowly the conversation changes. The question becomes less, what's wrong with my child? And more, what is this child experiencing that we don't yet understand? As awareness grows, many autistic adults begin describing something clinicians hadn't fully recognized before: masking. This is the effort of learning how to appear socially typical, studying facial expressions, practicing conversations, suppressing behaviors that feel natural. For some people, masking becomes so constant that they don't realize how exhausting it is until much later in life. Think about that boy from the playground. The boy grows older. Maybe he learns when to force eye contact. Maybe he studies how long to pause before responding in conversation. Maybe he becomes very good at appearing comfortable while feeling completely overwhelmed inside. And because he adapts, people assume he's fine. This becomes especially important in conversations about girls and women, many of whom were historically overlooked because their differences didn't match early diagnostic expectations. Again, the diagnosis evolves. Not because autism suddenly changed, but because our understanding of it did. In recent decades, a broader cultural conversation begins to emerge. Some autistic individuals begin asking a different question. What if autism isn't simply something to fix? What if it's also a different way of experiencing the world? Not everyone agrees on how autism should be understood. So for some families, autism is primarily experienced as disability. And for other families, it's deeply connected to identity. And both realities can exist at the same time. This conversation doesn't erase the struggle, though. Many autistic individuals experience real challenges, sensory overwhelm, communication difficulties, social isolation. But it does reframe the goal. The focus shifts from how do we make this person appear normal? toward how do we better understand and support different kinds of minds. And for many people, the shift is deeply meaningful. Because the experience of being misunderstood can sometimes hurt as much as the symptoms themselves. That child sitting alone on the playground at the beginning of this episode. Maybe he wasn't disconnected from the world. Maybe he was experiencing too much of it at once. Maybe the sounds were louder than anyone realized. Maybe the social rules felt invisible to everyone except him. Maybe solitude felt safer than unpredictability. Across generations, autistic individuals and their families have often lived inside the gap between experience and understanding. Different eras offered different explanations. Shyness, detachment, poor parenting. Now, autism spectrum disorder. The label changed. But the human experience underneath it was always there. And maybe one of the most important shifts wasn't medical at all. Maybe it was the moment people stopped asking, How do we make this child normal? And started asking, what does this child need in order to feel understood? Autism did not begin when we named it. There was always been people who experienced the world differently. What changed was how society interpreted those differences and whether we responded with fear, blame, or curiosity. What if the problem was never that some people experienced the world differently, but that the world expected everyone to experience it the same way? You know, in many ways, the history of autism is also the history of how we respond to people who don't move through the world the way most people do. And that conversation is still evolving. You know, in the episodes ahead, we're going to continue exploring how diagnoses evolve and how the language we use shapes the way people understand themselves and each other. I hope you'll continue listening as we explore the stories behind the labels. This is before it had a name.