For someone researching the history of autism, NeuroTribes is significant

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1. The "Pre-History" of Autism (The Changeling Connection)

Silberman argues that before the word "autism" existed (coined in the 1940s), autistic people were not absent from society; they were simply hidden in plain sight under different labels.

• The Changeling as a Folk Diagnosis: Silberman explicitly cites the "Changeling" myth as the primary way medieval Europe explained the sudden onset of regressive autism. He notes that the specific details—sensory distress, lack of speech, and "otherworldly" behavior—map almost perfectly onto the modern diagnostic criteria for autism.

• The "Village Idiot" and the "Eccentric": He also tracks high-masking or "Aspie" presentation through history, noting that people we might now diagnose as autistic were often protected in monasteries (where silence, routine, and obsessive scribing were valued) or lived as "eccentric" inventors and scientists (like Henry Cavendish or Paul Dirac).

2. Debunking the "Epidemic" (The Great Expansion)

The central thesis of the book is to explain why autism diagnoses skyrocketed in the 1990s and 2000s without a biological plague or environmental toxin being the cause. Silberman calls this the "Great Expansion."

• Kanner vs. Asperger: The book reveals a historical divergence. In the 1940s, two men discovered autism simultaneously.

  • Leo Kanner (USA): Defined autism very narrowly as a rare, tragic form of childhood psychosis. He blamed "Refrigerator Mothers" (cold, unloving parents) for the condition. His narrow view dominated psychology for 50 years, keeping diagnoses artificially low.

  • Hans Asperger (Vienna): Saw autism as a broad spectrum, ranging from non-speaking children to "little professors" who could be highly successful. His work was lost/buried due to WWII.

• The Unification: In the late 80s and early 90s, Lorna Wing (a psychiatrist and mother of an autistic child) rediscovered Asperger’s work. She translated it and fought to broaden the diagnostic criteria in the DSM-IV.

• The "Epidemic" Illusion: When the criteria were widened to include the full spectrum (not just Kanner's narrow definition), the number of diagnoses exploded. Silberman argues this wasn't an epidemic of cases, but an epidemic of recognition. We finally started counting the people who had been there all along.

3. Why It Matters

For someone researching the history of autism, NeuroTribes is significant because it shifts the narrative from "What went wrong with these children?" to "How did we fail to understand these human variations for so long?"

It frames the "epidemic" not as a tragedy to be feared, but as a correction of historical erasure—much like how the changeling myth was a misunderstanding of natural neurology.