The Metamorphosis of Autism: A History of Child Development in Britain by Bonnie Evans (review)

From the nursery to the workplace, by way of the intimacy of family life, how have psychological ideas and practices infused the way we conduct our personal life and social relations? One pivotal analysis of the impact of the psychological gaze on individuals’ day-to-day lives has been undertaken by the sociologist Nikolas Rose. Through the case of the Tavistock Clinic, he historically laid out the rise of the “psy” sciences as a set of technologies of (self-)governance.¹ More recently, this picture has been interrogated, in particular, its inference that psychological techniques were developed solely by an intellectual elite, who disseminated them to other professionals and ultimately imposed them on the unthinking public.² The historian Bonnie Evans’ Metamorphosis of Autism is located at the confluence of these stances. Her comprehensive study links our current understanding of the autism spectrum not merely to Kanner’s and Asperger’s theories of the 1940s, but to a longer conceptual, legal, and institutional history of our fluctuating understanding of children’s psychological and social development.

Drawing on the writings of major figures in developmental psychology, and on primary sources from public administrations and the Maudsley Hospital, Evans divides her account of the genesis of autism into two parts, corresponding to the two predominant meanings of the term. Following Ian Hacking and John Forrester’s works on “styles of reasoning,”³ she distinguishes a first period running from the psychiatry of the very late nineteenth century to the closing of “deficiency” institutions in 1960s Britain. Her second period starts at the end of the 1950s and extends to present-day developments in experimental neuropsychology. Whilst the “first autism” refers to the original use of the term, mainly within psychoanalytically oriented psychiatry, the “second” one relates to our current understanding, which arose from the progressive inclusion during the 1950s of statistics into both the “psy” professionals’ toolbox and public administrations as means of assessing children’s population health and “educability.” The major issue underlying the former lay in the comprehension of children’s unconscious and internal fantasies and the mechanisms underpinning emotional reactions in order to clarify and forestall (a)social adult behaviours. Conversely, from the 1960s onwards, the latter came to relate to a “state of mind that completely lacked any content of its own and which gained its meaning only via the instruments used to measure it” (189–90). The key concern then became understanding the psycho-physiological evolution of children’s consciousness, by means of behaviour quantification (226–31).

In the first three chapters, Evans presents the legal and institutional networks that enabled the integration of the concept of autism into psychological theory in Britain and examines how the uptake of the notion occurred alongside the persistence of theories of the “social instinct” and intellectual development. The psychologists Cyril Burt and William McDougall, by following evolutionary models of society and studying undesirable behaviours such as criminality and delinquency, implemented these theories in the mainstream education system and the Board of Control authorities. Those interested in child development, such as Melanie Klein and Susan Isaacs, drew from the work of Freud, Bleuler, and Piaget, and introduced the concepts of “primary narcissism” and “autoerotism” into child guidance clinics, permissive schools, and major mental health institutions, from which children with low IQs were excluded (35–93).

Evans continues with the interwar years and the 1940s, a period marked by many controversies – notably initiated by proponents of behaviourism – that interrogated the evidential basis of “instinctive drives” theory. These arguments occurred between “psy” professionals, educationalists, and other groups working with children. When the war drew to a close, these voices were silenced, and psychologists shifted their attention to the welfare state’s growing concern to replace the closed asylum system with a more liberal model of outpatient treatment, mindful of individual rights and freedoms (96–136). Against this background, understanding children’s social development became an important institutional issue, and a...