Early Infantile Autism in Identical Twins

Abstract

Early infantile autism, a form of schizophrenia first appearing in infancy, was described by Kanner in 1944.1 In the hope that a study of this condition might shed clearer light on the etiology of schizophrenia, much interest has since then been shown in early infantile autism.2-5 Two cases have been reported in which this condition occurred in identical twins,6,7 and a third such instance is here reported. This illness characteristically appears in only one child of any family, and its occurrence in identical twins is hence of particular interest.A striking withdrawal from interpersonal activity is the prime feature of early infantile autism. As early as the fourth month of life the child may show apathy to the attention of those caring for him. As he becomes older, this withdrawal from emotional contact with people becomes more obvious. The autistic child has a marked interest in things as opposed to persons. He ignores the people around him and concentrates his attention on inanimate objects. An intense preoccupation is shown in maintaining the sameness of things; he becomes upset if the order of the objects in his room is changed, and he will set about putting them back in their previous arrangement. He may sit for hours scarcely moving, or he may engage in stereotyped play.Often such children show a remarkable interest in music and a precocious ability to learn melodies and songs. Repetitive, superfacially meaningless physical movements are common.Memory is usually excellent, sometimes phenomenal.Language is often very sparse, and onethird develop no speech at all.8 Those who talk may have a peculiar confusion in learn¬ ing to use "you" and "I" correctly. These children are often unresponsive to the speech of those around them and may, for a time, be considered deaf.The prognosis is very guarded, and it is not clear whether treatment is effective in altering the course of the illness. The prognosis of those children who do not speak by the age of 5 years is extremely poor,9 but is somewhat better in those who have learned to talk by this age. As these children grow older, they take on the appearance of childhood and adult schizo¬ phrenics in whom catatonic features pre¬ dominate.The etiology cannot be clearly stated. The parents of autistic children are described as emotionally cold, compulsive people, often with intellectual and professional accomplish¬ ments. Though it is assumed that early interpersonal trauma is important in pro¬ ducing this condition, it is often difficult to explain why such a quantitatively severe collapse of interpersonal relationships has occurred. One of our cases occurred in a family with 12 children, of whom the pa¬ tient was a middle child, and the only one who had difficulty in making an adequate social adjustment.Early infantile autism charcteristically occurs in only one child in a family.6 It is of interest, therefore, that Sherwin and Bakwin have each reported it in identical twins. We have also observed it in a set Downloaded From: http://archneurpsyc.jamanetwork.com/ by ...

Syndromes and epistemology II: Is autism a polygenic disorder?

“…Early family and twin studies also suggested a heritable component of autism. Chapman first reported a case of identical twins with autism [Chapman, 1957]; Darby 1976 reported on six sib pairs diagnosed as autistic, while McQuaid 1975 found concordance of infantile autism in a pair monozygotic (MZ) twins. On the other hand, Vaillant 1963 and Kamp 1964 identified MZ twins discordant for autism.…”

Syndromes and epistemology II: Is autism a polygenic disorder?

“…Early family and twin studies also suggested a heritable component of autism. Chapman first reported a case of identical twins with autism [Chapman, 1957]; Darby 1976 reported on six sib pairs diagnosed as autistic, while McQuaid 1975 found concordance of infantile autism in a pair monozygotic (MZ) twins. On the other hand, Vaillant 1963 and Kamp 1964 identified MZ twins discordant for autism.…”

Syndromes and epistemology II: Is autism a polygenic disorder?

“…Early family and twin studies also suggested a heritable component of autism. Chapman first reported a case of identical twins with autism [Chapman, 1957]; Darby 1976 reported on six sib pairs diagnosed as autistic, while McQuaid 1975 found concordance of infantile autism in a pair monozygotic (MZ) twins. On the other hand, Vaillant 1963 and Kamp 1964 identified MZ twins discordant for autism.…”

Syndromes and epistemology II: Is autism a polygenic disorder?

“…Early family and twin studies also suggested a heritable component of autism. Chapman first reported a case of identical twins with autism [Chapman, 1957]; Darby 1976 reported on six sib pairs diagnosed as autistic, while McQuaid 1975 found concordance of infantile autism in a pair monozygotic (MZ) twins. On the other hand, Vaillant 1963 and Kamp 1964 identified MZ twins discordant for autism.…”