Grunya Sukhareva characterized autism nearly two decades before Austrian doctors Leo Kanner and Hans Asperger. So why did the latter get all the credit?

It was 1924 when the 12-year-old boy was brought to the Moscow clinic for an evaluation. By all accounts, he was different from his peers. Other people did not interest him much, and he preferred the company of adults to that of children his own age. He never played with toys: He had taught himself to read by age 5 and spent his days reading everything he could instead. Thin and slouching, the boy moved slowly and awkwardly. He also suffered from anxiety and frequent stomachaches.

At the clinic, a gifted young doctor, Grunya Efimovna Sukhareva, saw the boy. Caring and attentive, she observed him with a keen eye, noting that he was “highly intelligent” and liked to engage in philosophical discussions. By way of a diagnosis, she described him as “an introverted type, with an autistic proclivity into himself.”

‘Autistic’ was a relatively new adjective in psychiatry at the time. About a decade earlier, Swiss psychiatrist Eugen Bleuler had coined the term to describe the social withdrawal and detachment from reality often seen in children with schizophrenia. Sukhareva’s characterization came nearly two decades before Austrian doctors Leo Kanner and Hans Asperger published what have long been considered to be the first clinical accounts of autism. At first, Sukhareva used ‘autistic’ in the same way Bleuler did — but as she started to see other children with this trait, she decided to try to characterize it more fully.

Over the course of the following year, she identified five more boys with what she described as “autistic tendencies.” All five also showed a preference for their own inner world, yet each had his own peculiarities or talents. One was an extraordinarily gifted violinist but struggled socially; another had an exceptional memory for numbers but could not recognize faces; yet another had imaginary friends who lived in the fireplace. None were popular with other children, she noted, and some saw peer interaction as useless: “They are too loud,” one boy said. “They hinder my thinking.”

In 1925, Sukhareva published a paper describing in detail the autistic features the six boys shared. Her descriptions, though simple enough for a nonspecialist to understand, were remarkably prescient.

“Basically, she described the criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5),” says Irina Manouilenko, a psychiatrist who runs a clinic in Stockholm, Sweden. Manouilenko translated Sukhareva’s original descriptions from Russian to English in 2013 and then compared them with the diagnostic criteria described in the DSM-5. The similarities between the two left Manouilenko in awe. “When you start looking at it all systematically, it’s very impressive,” she says.

For example, what the DSM-5 describes as social deficits, Sukhareva wrote about as a “flattened affective life,” “lack of facial expressiveness and expressive movements” and “keeping apart from their peers.” What the diagnostic manual portrays as stereotyped or repetitive behaviors, restricted interests and sensory sensitivities, Sukhareva explained as “talking in stereotypic ways,” with “strong interests pursued exclusively” and sensitivities to specific noises or smells. In her analysis, Manouilenko was able to match each of the manual’s criteria to one or more of Sukhareva’s observations.

Historians are beginning to ponder why it took nearly a century for the DSM-5 — published in 2013 after years of debate — to arrive back at something so close to Sukhareva’s list. They have found that Sukhareva isn’t the only clinician whose research was overlooked or lost before autism was described in the DSM-III. As more archival material is digitized, it’s becoming clear that Kanner and Asperger may need to share credit for the ‘discovery’ of autism — and that the condition’s history could be as complex as its biology.

Despite her relative obscurity in the West, Sukhareva is “the most well-known name in child psychiatry” in Russia, says Alexander Goryunov, lead researcher in the child and adolescent psychiatry department at the Mental Health Research Center in Moscow. In 2011, on the 120th anniversary of Sukhareva’s birth, the Neurology and Psychiatry Journal, of which Goryunov is executive editor, reviewed her wide-ranging contributions to the field. Sukhareva published more than 150 papers, six monographs and several textbooks on topics as diverse as intellectual disability, schizophrenia and multiple personality disorder, among other conditions. She was also a gifted teacher and mentored scores of doctoral students.

Goryunov describes Sukhareva as a “versatile specialist.” After graduating from medical school in Kiev in 1915, Sukhareva joined a team of epidemiologists that traveled to areas in the Ukraine affected by outbreaks of encephalitis and other infectious diseases. But when the Russian Revolution broke out two years later and medical professionals fled or died in battle, she joined Kiev’s psychiatric hospital. The country faced a huge shortage of doctors, and qualified medics such as Sukhareva often moved wherever they were needed most.

In 1921, Sukhareva relocated to the Psycho-Neurological and Pedagogical Sanatorium School of the Institute of Physical Training and Medical Pedology in Moscow. (‘Pedology’ was a Russian term for a combination of pedagogy, psychology and medicine.) The government opened the sanatorium to help the country’s many children who had been orphaned, displaced or traumatized by World War I, the revolution, the ensuing civil war or the deadly Spanish flu epidemic. As its long-winded name suggests, it was no ordinary clinic. It took a more scientific approach to understanding child development than most other clinics at the time. Children with serious problems lived at the sanatorium for two to three years, during which time they received social- and motor-skills training. They took classes in gymnastics, drawing and woodwork, played team games and went on group outings to zoos and other public places. At the end of the intensive program, many had made enough progress to be able to join regular schools or music conservatories.

The socialist government covered all costs for this intensive intervention, viewing child-rearing as important for society’s well-being. And the clinicians could observe children in a myriad of contexts, gaining a nuanced picture of their strengths and weaknesses.

That setup may have helped Sukhareva to describe autistic traits as accurately as she did. Her assessments were extraordinarily detailed. They included the children’s physical health, noting hemoglobin counts, muscle tone, gastric health, skin conditions and more. She documented small changes in their behavior, such as a lack of smiles, excessive movements, a nasal voice or what sparked a tantrum — in one case, seeing a funeral procession go by. And she spoke with many family members — parents, grandparents, aunts and uncles — observing that some atypical behaviors ran in families. Her descriptions were so vivid, readers could recognize “each [child] in the street, or at least in a classroom,” Manouilenko says.

Another facility like the sanatorium, dubbed the Forest School, housed dozens of children on the outskirts of Moscow. Altogether, the staff evaluated about 1,000 children over a period of a few years. Throughout her life, Sukhareva launched similar schools all over the country. But her reach stopped at the borders, hindered in part by political and language barriers. Only a small fraction of Russian research from that time was translated into other languages besides German. And although her 1925 paper on autism traits appeared in German the following year, the translation butchered her name, misspelling it as “Ssucharewa.” That paper did not reach the English-speaking world until 1996, some 15 years after Sukhareva’s death, when British child psychiatrist Sula Wolff stumbled upon it.

There is another, darker reason why Sukhareva’s work may have been lost for so long, Manouilenko says. Given the limited number of psychiatry journals at the time, it is possible that Asperger, for whom Asperger syndrome was named, read Sukhareva’s paper in German and chose not to cite it. Earlier this year, historians Edith Sheffer and Herwig Czech independently reported that they had found evidence of Asperger’s cooperation with the Nazi Party, and that he may have sent dozens of disabled children to be euthanized. Sukhareva was Jewish, and Asperger may not have wanted to give her credit. Manouilenko offers a more benign possibility: Given Asperger’s position, he may not have been permitted or felt able to credit Sukhareva.

A story not unlike Sukhareva’s played out in Vienna at around the same time that she was making her observations about autism. Two young Jewish doctors, physician Georg Frankl and psychologist Anni Weiss, worked at a child psychiatry clinic similar to the sanatorium in Moscow. The head psychiatrist at the Vienna clinic, Erwin Lazar, believed that doctors should play with children to understand their behavior, and the facility had 21 beds to accommodate children with severe problems. By closely observing those children, Frankl and Weiss also described autistic traits in a way we would recognize today. And they did so at least a decade before Kanner and Asperger did.

In the early to mid-1930s, Frankl and Weiss wrote a number of reports describing children who were socially withdrawn, spoke in atypical ways and showed a fondness for particular objects and routines. They described classic autism features: Frankl pointed out a “disconnect between facial expressions, body language and speech,” and Weiss zeroed in on “hidden intelligence, fixations and communication impairments,” according to John Elder Robison, a scholar in residence at the College of William and Mary in Williamsburg, Virginia. Unlike Sukhareva, neither one explicitly used the word ‘autistic’ in their writing, but it may have entered their conversations, says Robison, who is autistic.

When Lazar died in 1932, Frankl became senior psychiatrist at the clinic, and a 25-year-old pediatrician named Hans Asperger joined the clinic and likely trained under him. Soon after, Hitler came to power, and the new regime looked for opportunities to get rid of Jewish doctors. Weiss spoke English and, decamping to America, found a position as a child guidance associate at Columbia University in New York.

Once she had settled in, she tried to find a way for Frankl to join her — and sought help from Kanner, then a rising star at Johns Hopkins University in Baltimore. Kanner, an Austrian-Hungarian Jew, had lived in Berlin and understood the threat of the Nazi takeover. Altogether, he helped about 200 Jewish doctors, Frankl included, escape from Europe. Frankl married Weiss six days after he arrived in the United States in 1937.

After his arrival, Frankl worked with Kanner at Johns Hopkins. In 1943, they each published a paper in the journal Nervous Child, both focused on communication difficulties in young children — but, crucially, the two papers bore different titles. Frankl’s work was “Language and affective contact,” whereas Kanner’s was “Autistic disturbances of affective contact.” From that point on, the word ‘autism,’ so entered into American psychiatric vocabulary, became associated with Kanner’s name.

A few months later, Asperger started using the term autistic, publishing a paper with the title “Die ‘Autistischen Psychopathen’ im Kindesalter,” or “The ‘Autistic Psychopaths’ in Childhood,” in June 1944. At the time, both Kanner and Asperger maintained that their work was separate and distinct, but modern scholars have wondered whether one plagiarized from the other. Some, including Steve Silberman in his book “Neurotribes,” blamed Kanner, suggesting that he had lured Frankl away from the Vienna clinic, along with some of his ideas. John Donvan and Caren Zucker, co-authors of “In a Different Key,” as well as Robison, refute that notion in their own writings. But Robison points out that both men interacted with Frankl and Weiss, who remained uncredited.

In 1941, Frankl left Johns Hopkins and took a job as director of the Buffalo Guidance Center in upstate New York. He and Weiss moved on with their lives, shifting their interests away from academic work and the subject they had covered so promisingly in their youth.

If political circumstances had been different, Frankl and Weiss might have made other important discoveries about autism. If nothing else, their journey helped transfer seeds of knowledge from Vienna — and possibly Russia — across the ocean, where they found fertile soil.

Working in different political, cultural and research settings might have influenced how each of these researchers perceived autism. Asperger, who focused on people at the mild end of the spectrum, saw it as a largely behavioral problem, which could be caused by a child’s environment and ‘corrected’ through therapy. By contrast, Sukhareva, Frankl and, subsequently, Kanner viewed it as a neurobiological condition people are born with.

Ultimately, it took a spectrum of these researchers to define autism’s full spectrum.

Sukhareva was ahead of her time in many ways. She started to disentangle autism from childhood schizophrenia during the 1950s, nearly 30 years before they were listed as separate conditions in the DSM-III. Half a century before brain scans started to implicate specific regions in the condition, she postulated that the cerebellum, basal ganglia and frontal lobes might be involved. According to Manouilenko, whose own work involves brain imaging, that’s exactly what research is revealing now.

Because Sukhareva saw autism as rooted in brain development, she never subscribed to the widespread belief that took hold in the 1940s that autism might be caused by ‘refrigerator mothers’ tending to their children in a cold and unemotional way. She never had children of her own but may have had a more intuitive take on mother-child relationships than some male clinicians.

In the original Russian, her writing is official in tone but always warm, and it shows how much she cared for the clinic’s children — in some cases, describing them as she might have her own family members. Her notes often describe with almost maternal pride how a child had become physically stronger, less moody, more social or less anxious under her care. And she always made mention of a child’s skills — some were “gifted musically,” “talented in science and technology” or wrote “insightful poetry” — alongside their behavioral challenges.

Like any parent, Sukhareva wrote that her goal was to help the children “stay connected with real life, its tempo and movement.” Given her sensitivity and intuition as a clinician, it’s unfortunate that the research community in the West was not connected with her ideas during her life. “It’s impressive how she managed to achieve all of this,” Manouilenko says. “She didn’t have her own family, so she gave her entire life to studying science and teaching.”

The K-drama breeds acceptance and empathy for those who live with ASD, and that itself is cause for celebration.

My name is Woo Young-woo, whether it’s read straight or flipped. Kayak, deed, rotator, noon, racecar, Woo Young-woo. Yeoksam Station (station is translated to yeok in Korean).” Our titular protagonist lists out other palindromes, similar to that of her name, to introduce herself. The first impression is crucial to know who someone is as a person – and for Young-woo (Park Eun-bin), a 27-year-old rookie attorney with autism spectrum disorder (ASD), it tells us almost everything we need to know about her, as she puts herself: “I’m not an ordinary attorney.”

Her passion for the law began at the mere age of five, the same day she was first diagnosed with ASD. She grew up as the only child to a single father named Woo Gwang-ho (Jeon Bae-su), who had been pursuing a law degree at Seoul National University at the time. Despite not being able to communicate on a level that was on par with the rest of her peers, Young-woo had read and memorised every single line in her father’s law textbooks, unbeknownst to him until he had gotten into a physical altercation with his landlord over a misunderstanding.

Young-woo, growing increasingly overstimulated and panicked, began regurgitating the criminal laws against inflicting bodily injury upon others, complete with the legal penalties if the aggressor were to ever be found guilty of such an offence. All Gwang-ho could do was stare at his daughter in shock – not only did she just recite the laws applicable to their situation verbatim, it was also her first time speaking at all.

Fast forward to two decades later, and we bear witness to how Young-woo has learned to adapt to the world around her, following her meticulously structured routine on the morning of her first day as a rookie attorney at Hanbada Law Firm. Aside from her passion for law, to say that she loves whales might be a severe understatement. Everything from her room slippers to framed pictures are imbued with imagery of these aquatic mammals, and she’s a repository of obscure whale knowledge personified. She also likes her food prepared a specific way; for example, her father makes a special “Woo Young-woo kimbap”, where all the ingredients are carefully wrapped between layers of rice and seaweed, which allow her to see exactly what’s been put inside in order to prevent surprise from unfamiliar flavours or textures.

Unfortunately for Young-woo, life isn’t always as unexacting as whales and kimbap. She bears the brunt of all sorts of ableism in her day-to-day life as an adult. But perhaps the most jarring of all is from her new supervisor, lawyer Jung Myeong-seok (Kang Ki-young), who ostracises her as soon as she shows signs of her neurodivergence. In spite of her unmistakable credentials and aptitude for the role, he is apprehensive enough to call for a meeting with the law firm’s chief executive, going so far as to question CEO Han’s (Baek Ji-won) judgement, stating that “she’s different from me”.

Of course, Young-woo manages to continuously rise against the odds. Despite Myung-seok’s oversight of her ability as a lawyer, she steps up to the plate with her flawless memory of both the law and case materials to bridge gaps in her first-ever case as a Hanbada attorney, areas where even her superiors had overlooked. Not only was she awarded the chance to prove both Myung-seok and her peers at the firm wrong about her capacity as an attorney, she also managed to alleviate her elderly client of a false murder charge.

As a legal procedural, Extraordinary Attorney Woo’s approach to this usually uninspired genre is distinctive. While many legal K-drama forebears have dabbled in dramatic, unyielding explorations of ferocity in the courtroom, this series chooses to shine a buoyant light on the matters of the law instead, as told through the innocent eyes of Young-woo.

Extraordinary Attorney Woo spurs an overarching storyline to allow for the characterisation of Young-woo’s adaptability to each episodic case and client of various circumstances to take centre stage. The obstacles stacked against her, be it jealous colleagues or a disrespectful opposing counsel, all fail to sway her unadulterated passion for and focus on her job. Park Eun-bin’s performance as Young-woo is a remarkable indicator of her acting chops as she steps into the shoes of an autistic character, the representation of which is rare within the stratosphere of Korean entertainment itself.

Media depictions of autism spectrum disorder have always been a toss-up – they’re either glorified as socially awkward yet misunderstood geniuses with savant-like abilities, or written off as flat side characters written in to showcase the uglier, undesirable sides to ASD – but if there is anything to be said about Extraordinary Attorney Woo, it’s that Young-woo’s characterisation tends to lean towards the former.

Two episodes in, the series is already sending the message that there is an expectation for neurodivergent people to be able to compensate for their undesirable traits by being natural-born prodigies – not entirely dissimilar to what many underrepresented minorities have to go through both in fictional works and in real life. It might be too early to predict the depths writer Moon Ji-won is willing to explore in Extraordinary Attorney Woo, but there remains ample space to do so; all we can do as the audience is to hold out hope that this space will be well-utilised.

Extraordinary Attorney Woo is a witty, light watch that rarely demands an understanding of the law nor ASD for viewers to appreciate. It holds up the mirror for those of us, like the people Young-woo crosses paths with, to reflect on our own behaviours and misconceptions about neurodivergence. The show – while not entirely flawless in its depictions so far – breeds acceptance and empathy for those who live with ASD, and that itself is cause for celebration.

New episodes of Extraordinary Attorney Woo are available every Wednesday and Thursday on South Korean streaming platform ENA, as well as on Netflix in select regions.

The business magnate and new owner of Twitter Elon Musk revealed a while ago that he is autistic. Musk, the wealthiest person in the world, is autistic. Musk, a fellow of the prestigious Royal Society and Time’s 2021 Person of the Year, is autistic. One of the most famous people on Earth is autistic. Perhaps it is worth letting that sink in?

As autism researchers, we think it is important to raise awareness of and improve attitudes towards autism. There is now a growing appreciation of “neurodiversity” in society, especially in the science and technology sector. There has also been discussion of how people, such as environmental campaigner Greta Thunberg, can be great activists due to their autistic traits (although there is no statistical link between autism and environmentalism).

It is surprising, then, that there has been so little discussion of Musk’s autism. Not only would this be useful for understanding Musk, who is now an influential but increasingly criticised figure, but it might also go a long way to highlighting autism-related strengths and difficulties.

It is important to remember that he is neither representative of the autistic population nor the general one. But, if we believe that individual experiences matter, Musk’s story is a chance to learn about him, autism and neurodiversity. Given his defining position in society, it is worth trying to understand Musk rather than leaving public discourse to sour further.

Musk has shared stories of his social struggles as a child. He reports being bullied and “almost beaten to death” for being different. In a documentary, Musk’s mother talks about him as a “young genius”, but also a shy and awkward child without friends. Together, Musk has what psychologists call a “developmental history” of autistic characteristics and adverse experiences of not being accepted in childhood.

Abuse directed at Musk for being autistic has continued into adulthood, with a Twitter executive referring to him as “literally special needs” and “a looney tune”. Only a few people called this out. This is sadly reflective of the bullying that autistic people face in the workplace and more generally.

Such hostility is thought to partly explain why autistic people face the highest rates of unemployment of all disabled groups. Musk is in a much more powerful position to defend himself than most others. But it is possible that the bullying he’s experienced throughout his life speaks to why he can be defensive and combative on Twitter.

It is also worth remembering that, although Musk appears emotionally robust, there is often more going on beneath the surface for autistic and neurodivergent people. Our research shows that autistic people use psychologically exhausting coping strategies, such as “masking” or hiding their authentic self, which can worsen mental health. This is why autism is considered an “invisible disability”.

Autism is also sometimes linked to a literal way of thinking. This was epitomised by Musk physically carrying a bathroom sink into Twitter HQ, which he has recently taken ownership of, as a play on the common phrase “let that sink in”.

It was, of course, a publicity stunt, but he might also have been making a comical point from the fact that many idioms don’t literally make sense. The non-literal use of words like this doesn’t necessarily come naturally to autistic people.

While some people understand and appreciate this unconventional style of humour, many are likely to think it is strange or inappropriate. This has probably contributed to the polarised opinions about Musk, which might partly reflect differences in humour between autistic and non-autistic people, as revealed by research.

Appearing on the US hit show Saturday Night Live, Musk himself commented on how his autistic communication style can be unusual and humorous: “I don’t always have a lot of intonation or variation in how I speak … which I’m told makes for great comedy.”

An unusual way of speaking has indeed been linked to autism in research. For example, autistic people may have different acoustic features of their speech, such as pitch, which can make them appear blunt or rude. That is how Musk might be coming across in public situations, following his acquisition of social media giant Twitter.

Musk’s achievements are also likely to reflect autistic strengths in science and tech that are worth celebrating. In an interview last year, he talked about how he “found it rewarding to spend all night programming computers … just by myself”.

This dedication to specific interests, instead of socially conventional activities such as playing with friends as children, might explain why some autistic people have extraordinary talents and can sometimes outperform non-autistic people on certain tasks. Research on this is sparse but growing.

One of the world’s most famous people being autistic will invariably raise awareness of autism. This is what researchers, charities and the autism community have been trying to do for decades. If remembering that Musk is autistic can advance this endeavour, it may be worthwhile.

Francis Hutcheson (August 8, 1694 – August 8, 1746) was an Irish philosopher and one of the founding fathers of the Scottish Enlightenment. Although his philosophy covers a wide range of subjects, he is known primarily for his moral theory and his study of aesthetics. His ideas include the concepts of the “moral sense” and the “benevolent theory” of morals, the latter for which he stood in sharp opposition to Thomas Hobbes and other egoists. He anticipates the utilitarianism of Jeremy Bentham in his use of the phrase “the greatest happiness for the greatest number,” and his influence can be traced through his students, which include David Hume and Adam Smith.

Beginnings

Hutcheson is thought to have been born at Drumalig, in the parish of Saintfield, County Down, Northern Ireland, to a Presbyterian minister. He spent six years at the University of Glasgow, first in the study of philosophy, classics, and general literature, and afterwards in the study of theology.

On leaving university, he returned to Northern Ireland, and received a license to preach. When, however, he was about to enter upon the pastorate of a small, dissenting congregation, he changed his plans on the advice of a friend and opened a private academy in Dublin. While residing in Dublin, Hutcheson published anonymously the four essays by which he is best known: the Inquiry concerning Beauty, Order, Harmony and Design, the Inquiry Concerning Moral Good and Evil, in 1725, and the Essay on the Nature and Conduct of the Passions and Affections and Illustrations upon the Moral Sense, in 1728. The alterations and additions made in the second edition of these essays were published in a separate form in 1726. To the period of his Dublin residence are also to be referred the Thoughts on Laughter (a criticism of Thomas Hobbes) and the Observations on the Fable of the Bees, being in all six letters contributed to Hibernicus’ Letters, a periodical which appeared in Dublin (1725-1727, 2nd ed. 1734). At the end of the same period occurred the controversy in the London Journal with Gilbert Burnet; on the “True Foundation of Virtue or Moral Goodness.” All these letters were collected in one volume (Glasgow, 1772).

In 1729, Hutcheson succeeded his old master, Gershom Carmichael, in the chair of moral philosophy at the University of Glasgow. Yet the works on which Hutcheson’s reputation rests had already been published.

Philosophy

Hutcheson dealt with metaphysics, logic, and ethics, but he is primarily known for his contributions to moral theory and the field of aesthetics. His works expound on various ideas including the relationship between beauty and virtue, the functions assigned to the moral sense, and the position that the benevolent feelings form an original and irreducible part of our nature.

According to Hutcheson, humans have a variety of senses, internal as well as external, reflex as well as direct, the general definition of a sense being “any determination of our minds to receive ideas independently on our will, and to have perceptions of pleasure and pain” (Essay on the Nature and Conduct of the Passions, sect. 1). He does not attempt to give an exhaustive enumeration of these “senses,” but, in various parts of his works, he specifies, besides the five external senses commonly recognized (which, he rightly hints, might be added to):

• consciousness, by which each human has a perception of himself and of all that is going on in his own mind (Metaph. Syn. pars i. cap. 2)
• the sense of beauty (sometimes called specifically “an internal sense”)
• a public sense, or sensus communism, “a determination to be pleased with the happiness of others and to be uneasy at their misery”
• the moral sense, or “moral sense of beauty in actions and affections, by which we perceive virtue or vice, in ourselves or others”
• a sense of honor, or praise and blame, “which makes the approbation or gratitude of others the necessary occasion of pleasure, and their dislike, condemnation or resentment of injuries done by us the occasion of that uneasy sensation called shame”

It is plain, as the author confesses, that there may be “other perceptions, distinct from all these classes,” and, in fact, there seems to be no limit to the number of “senses” in which a psychological division of this kind might result.

Of these “senses,” that which plays the most important part in Hutcheson’s ethical system is the “moral sense.” It is this which pronounces immediately on the character of actions and affections, approving those which are virtuous, and disapproving those which are vicious. “His principal design,” he says in the preface to the two first treatises:

is to show that human nature was not left quite indifferent in the affair of virtue, to form to itself observations concerning the advantage or disadvantage of actions, and accordingly to regulate its conduct. The weakness of our reason, and the avocations arising from the infirmity and necessities of our nature, are so great that very few men could ever have formed those long deductions of reasons which show some actions to be in the whole advantageous to the agent, and their contraries pernicious. The Author of nature has much better furnished us for a virtuous conduct than our moralists seem to imagine, by almost as quick and powerful instructions as we have for the preservation of our bodies. He has made virtue a lovely form, to excite our pursuit of it, and has given us strong affections to be the springs of each virtuous action.

Though Hutcheson usually describes the moral faculty as acting instinctively and immediately, he does not confound the moral faculty with the moral standard. The test or criterion of right action is with Hutcheson its tendency to promote the general welfare of mankind. He thus anticipates the utilitarianism of Bentham—and not only in principle, but even in Hutcheson’s use of the phrase “the greatest happiness for the greatest number” (Inquiry Concerning Moral Good and Evil, sect. 3). Hutcheson does not seem to have seen an inconsistency between this external criterion with his fundamental ethical principle. Intuition has no possible connection with an empirical calculation of results, and Hutcheson in adopting such a criterion practically denies his fundamental assumption. Connected with Hutcheson’s virtual adoption of the utilitarian standard is a kind of moral algebra, proposed for the purpose of “computing the morality of actions.” This calculus occurs in the Inquiry concerning Moral Good and Evil, sect. 3.

Hutcheson’s other distinctive ethical doctrine is what has been called the “benevolent theory” of morals. In this theory, he stands in sharp opposition to the philosophy of Thomas Hobbes and other egoists. Hobbes had maintained that all other actions, however disguised under apparent sympathy, have their roots in selfishness. Hutcheson not only maintains that benevolence is the sole and direct source of many actions, but, by a natural recoil that it is the only source of those actions of which, on reflection, people approve. Consistently with this position, actions which flow from self-love only are pronounced to be morally indifferent. But surely, by the common consent of civilized men, prudence, temperance, cleanliness, industry, self-respect and, in general, the personal virtues, are regarded, and rightly regarded, as fitting objects of moral approbation. This consideration could hardly escape any author, however wedded to his own system, and Hutcheson attempts to extricate himself from the difficulty by laying down the position that a man may justly regard himself as a part of the rational system, and may thus be, in part, an object of his own benevolence (Ibid)—a curious abuse of terms, which really concedes the question at issue. Moreover, he acknowledges that, though self-love does not merit approbation, neither, except in its extreme forms, did it merit condemnation, indeed the satisfaction of the dictates of self love is one of the very conditions of the preservation of society. To press home the inconsistencies involved in these various statements would be a superfluous task.

Hutcheson may further be regarded as one of the earliest modern writers on aesthetics. His speculations on this subject are contained in the Inquiry Concerning Beauty, Order, Harmony and Design, the first of the two treatises published in 1725. He maintains that humans are endowed with a special sense by which they perceive beauty, harmony, and proportion. This is a reflex sense, because it presupposes the action of the external senses of sight and hearing. It may be called an internal sense, both in order to distinguish its perceptions from the mere perceptions of sight and hearing, and because “in some other affairs, where our external senses are not much concerned, we discern a sort of beauty, very like in many respects to that observed in sensible objects, and accompanied with like pleasure” (Inquiry, etc., sect. 1). The latter reason leads him to call attention to the beauty perceived in universal truths, in the operations of general causes and in moral principles and actions.

Hutcheson’s writings naturally gave rise to much controversy. To say nothing of minor opponents, such as “Philaretus” (Gilbert Burnet, already alluded to), Dr John Balguy (1686-1748), prebendary of Salisbury, the author of two tracts on “The Foundation of Moral Goodness,” and Dr John Taylor (1694-1761) of Norwich, a minister of considerable reputation in his time (author of An Examination of the Scheme of Amorality Advanced by Dr Hutcheson), the essays appear to have suggested, by antagonism, at least two works which hold a permanent place in the literature of English ethics—Butler’s Dissertation on the Nature of Virtue, and Richard Price’s Treatise of Moral Good and Evil (1757). In this latter work, the author maintains, in opposition to Hutcheson, that actions are in themselves right or wrong, that right and wrong are simple ideas incapable of analysis, and that these ideas are perceived immediately by the understanding.

Other works

In addition to the works named, the following were published during Hutcheson’s lifetime: A pamphlet entitled Considerations on Patronage (1735); Philosophiae moralis institutio compendiaria, ethices et jurisprudentiae naturalis elementa continens, lib. iii. (Glasgow, 1742); and Metaphysicae synopsis ontologiam et pneumatologiam campleciens (Glasgow, 1742). The last work was published anonymously. After his death, his son, Francis Hutcheson published the longest of his works, A System of Moral Philosophy, in Three Books (2 vols. London, 1755). The only remaining work assigned to Hutcheson is a small treatise on Logic (Glasgow, 1764). This compendium, together with the Compendium of Metaphysics, was republished at Strassburg in 1722.

Notices of Hutcheson occur in histories, both of general philosophy and of moral philosophy, as, for instance, in pt. vii. of Adam Smith’s Theory of Moral Sentiments; Mackintosh’s Progress of Ethical Philosophy; Cousin, Cours d’histoire de la philosophie morale du XVIII’ siècle; Whewell’s Lectures on the History of Moral Philosophy in England; A Bain’s Mental and Moral Science; Noah Porter’s Appendix to the English translation of Ueberweg’s History of Philosophy; Sir Leslie Stephen’s History of English Thought in the Eighteenth Gentury, etc.

Almost all of us have experienced bullying in school. While bullying is a common experience for any child, it is particularly common in autistic children. In this article we explore bullying from an autism lens. How prevalent is bullying in autism? What factors lead to bullying of autistic individuals? And what interventions show evidence of effectively addressing bullying specific to autism?

Prevalence of Bullying in Autism

It is widely accepted that bullying is more prevalent in autistic children than neurotypical children. However, when we actually break down the numbers, it is still shocking to see how pervasive bullying is. Up to 94% of autistics report experiencing bullying in school! Furthermore, 87% of autistics report being bullied weekly and 40% report being bullied daily, compared to 15% of neurotypicals. This bullying includes both physical and emotional forms of bullying. For example, 75% of parents report that their autistic child had been hit or emotionally bullied in the past year compared to 30% of neurotypical children.

Autistic children socialized as boys seem to have the highest rate of bully victimization. Although, one must wonder whether more covert forms of bullying and higher levels of masking, often associated with children socialized as girls, may explain this difference or may result in less noticing and reporting by teachers and parents.

Victim or perpetrator?

There is a misconception that autistic children tend to be the perpetrators of bullying. In reality, research findings over the years have actually been mixed. More recently, this was found to be because studies historically have not controlled for demographics or co-occurring conditions like ADHD. When studies properly controlled for these variables, autistics tended to be the victims of bullying more often than the perpetrators. The numbers are quite inconsistent across studies however, as an example, one study found that autistics are perpetrators 10% of the time versus 44% of the time in neurotypicals.

Research methods aren’t the only reason this misconception exists. Here are some other explanations:

Bullying involves intent to harm

Autistic children can often display emotional outbursts and aggressive behaviour. However, the underlying trigger for these behaviours is important to understand. In order for these behaviours to be considered bullying, they must be acted out with the intent to cause harm. Research finds that autistic behaviours that are aggressive do not typically fall under this category. It is more likely that the autistic individual is having a meltdown in an attempt to self-regulate or that their aggression is a reaction to a situation but is not intentionally violent. Notably, it has been shown that bullying is what causes the emotional overload, meltdowns, and aggression in the first place!

Bullying involves an imbalance of power

Moreover, in order for bullying to occur, there must be an imbalance of power. We must recognize that due to ableism, autistics tend to have less power than their peers. They also tend to have lower social status. Since bullying tends to victimize the person with less power, this often targets autistic individuals.

Factors Influencing Bulling of Autistics

There are several factors which predict the risk of experiencing school bullying in autistic children. Research shows that with the presence of each of these factors, the cumulative risk of experiencing bullying increases exponentially.

Social and communication differences

Our social and communication differences make autistics easy targets for bullying. Autistics have even been described as “perfect victims” by some researchers. It is often found that because of these social communication differences, autistics are particularly easy for bullies to target without getting caught. For example, autistics don’t always recognize when bullying occurs, even if they feel a negative reaction towards an interaction. This may look like not picking up on the difference between an insult and a joke. Additionally, autistics may not recognize when it’s appropriate to report a negative social interaction or even how to report.

One consequence of these social communication differences is that bullying becomes normalized and can escalate beyond what is typically tolerated by neurotypical children.

Noticeable education-related differences

Research shows that neurotypical children find differences easy to target and difficult to empathize with. In a school setting, autistics are labeled as different because they may be removed/isolated from their peer group, for example because of their IEP (Individualized Education Plan). They also stand out in their class because they may have accommodations or educational supports in place, for example using an AAC (Augmentative and Alternative Communication) device to communicate.

It seems that receiving support for autistic educational needs is necessary, but simultaneously creates reasons for peer ostracization.

Mainstream schooling

Not surprisingly, these educational supports stand out more in Mainstream schools. Accordingly, multiple studies show that autistics attending mainstream schools tend to experience higher rates of bullying. In comparison, autistics don’t stand out as as much in special education schools where neurodiversity and autistic traits are more accepted.

Outwardly observable social struggles

Interestingly, it seems that autistic adolescents who report less social difficulties are also more targeted for bullying. It seems that more social understanding and social integration with neurotypical peers leads to a higher risk of bullying. One hypothesis worth exploring in future research is whether masking and camouflaging mediate this relationship. I wonder if neurotypical peers have less empathy for a student who is labeled as “quirky” or often has social “slip ups” compared to a student who is more outwardly identifiably autistic or who is less able to pass as neurotypical. (Of course both these views are ableist and don’t align with embracing neurodiversity!)

Consequences of bullying on autistic individuals

Prolonged bullying has been shown to be associated with many negative outcomes in autistics. Research shows an association between bullying and a reduction in relationship building and social interaction, an increase in difficulty completing school work, damages to self-esteem, refusal to attend school, and reduced overall mental health. Bullying is also associated with a clinically significant increase in suicide and suicidal ideation. This increase is 28x higher for autistic students than for neurotypical students.

Addressing bullying as a parent/teacher/clinician

If you are someone who interacts with autistic children and teens, here is a long list of what you can do to be proactive about addressing bullying:

• If you notice that there is a change in behaviour, particularly related to withdrawing from school and social activities, a decrease in capacity to do schoolwork, and poor mental health, this is an indication that you should inquire about bullying.
• Recognize that autistics are less likely to seek advocates or supports when bullied. Often autistics feel obliged to take matters into their own hands, which can lead to aggression as self-protection.
• Therefore, if you notice aggressive behaviours, directly inquire about bullying.
• In the absence of aggressive behaviours or reporting, it is important to check-in around bullying anyway given how prevalent it is.
• When autistics do come forward, believe what they say! Autistics tend to be truthful about their experiences. In contrast, findings show that neurotypical peers do not report bullying as accurately as teachers do.
• Promote respect for diversity and difference. Neurodiversity should be included in all school equity, diversity, and inclusion (EDI) initiatives
• If you are a teacher, avoid singling out your autistic/disabled students. This tends to heighten difference and increase bullying outside the class.
• As a teacher, you can also demonstrate acceptance of difference (instead of conformity). Allow neurodivergent students to be neurodivergent in the classroom!
• Normalize accommodations that are typically only associated with autistic students. For example, ask all students if the classroom lights are too bright, not just the autistic students.
• Dismantle the false belief that more assertiveness will mitigate bullying. This may work in neurotypicals, but it is not effective in autistic individuals.
• Teach all children the skills needed to identify social cues and vulnerable situations that relate to bullying.
• Teach children how and when to report bullying. This may not be obvious to all children.
• Avoid peer mediation. It has been shown to not be effective against autism-related bullying.

Bullying is one of the most persistent and costly workplace problems. It harms employee physical and mental health and results in the loss of productivity, as well as talent loss via turnover. And yet, bullying is hardly ever addressed.

While workplace bullying is highly problematic for all employees, it has particularly severe consequences for autistic individuals. Bullying of autistic people in the workplace is a problem that cost many their jobs and is likely contributing to the extremely high rates of unemployment (85% in the US, 78% in the UK, and 60% in Australia). In this paper, I propose that bullying of autistic people is also a problem made particularly persistent due to its cyclical nature: autistic people are more likely to be bullied, and are also more strongly affected by bullying, both psychologically and physiologically. Sadly, autistic employees are also less likely to be believed while seeking a recourse, and less likely to receive empathy. This leads to further cycles of bullying.

Autistic people are more likely to be bullied

Starting in the childhood, autistic people are more likely to be bullied both at home and at school. This continues in the workplace. Compared to other employees, autistic individuals are more likely to be targeted by bullies. In the UK, half of the autistic employees report bullying, harassment, or other discrimination or unfair treatment at work.

Exceptionally high productivity of many autistic people, along with their strong focus on work, are often touted when presenting the business case for autism employment. After all, no other group of employees has been shown to be up to 140% more productive than their typical counterparts. However, there is a danger to this focus and productivity. “Get smarty pants” phenomenon, also known as bullying and victimization of top performers, is well documented in the workplace as well as at school. A key explanation is coworker envy and concern with unfavorable comparison. High performance and the resulting coworker envy are likely to contribute to bullying of autistic performers. Moreover, autistic focus on work rather than socializing, while contributing to productivity, can also be perceived by coworkers as negative. Other “strikes” against autistic performers include blunt communication perceived as lack of agreeableness, and simply being different.

On the other end of performance distribution, low performers are also likely to experience bullying. If an autistic individual is poorly matched to the job or the job calls for skills associated with “lows” of one’s “spiky” profiles, the lower performance is also likely to cause bullying.

Bullying of high performers is likely to be covert. Typical tactics include withholding of information and resources, gossip, making false complaints to supervisors, sabotage, and backstabbing. Bullying of low performers is more likely to be overt and to involve yelling, threats, and other forms of direct hostility.

It is well-documented that bullying is detrimental to individuals’ productivity. It can harm performance by affecting cognitive processes – and likely more so for autistic employees due to the tendency toward rumination and other physical and mental health differences described in the next session. Hence, unfortunately, bullying coworkers may achieve their goal of hampering the high performer’s success. However, bullying does not help improve low performance.

Autistic people are more strongly affected by bullying

While all workers suffer the negative effects of bullying, these effects are often particularly detrimental to autistic individuals. Autistic people are more likely to have chronic autonomic nervous system (ANS) hyperarousal – a chronic biological threat response. This makes autistic individuals more vulnerable to harmful physiological stress response to bullying and incivility, possibly resulting in physical illness or even cardiac events.

In addition, the history of bullying trauma typical of autistic individuals results in another vulnerability factor – gelotophobia, the conditioned fear of being laughed at and ridiculed. The term is derived from the Greek word ‘‘gelos’’ for laughter and ‘‘phobia’’ for fear. It is a type of anxiety related to an intense feeing of shame arising as a long-lasting result of prior bullying, ridicule, and mockery. Because ridicule and mockery are some of the most typical ways in which the world treats autistic people, high levels of gelotophobia are reported to occur at much higher rates in autistic (87.4) vs. non-autistic populations (22.6%). It is likely that the repeated experience of bullying creates the phobia of being mocked, which likely exacerbates social awkwardness in autistic people, leading to a cycle of torment and further increases in fear and anxiety.

Autistic people are less likely to be believed

Most workplaces in the US lack regulations against bullying, and despite generally stronger legislation, Canada and many European countries still lack anti-bullying recourse. In many cases, there is simply no recourse. And if there is any possibility of recourse, the burden of proof rests on the target on bullying – and autistic people are less likely to be believed.

Experimental research indicates that autistic individuals are seen as more deceptive and of lesser character” than neurotypical individuals when telling the truth. These judgments relied on perceivers’ impressions such as “he seemed nervous,” or “body language seemed off” and the overall liking.

The pervasive and unfounded stereotypes held by the general public as well as some supposed “experts” label gaze aversion and fidgeting (nervousness and the “off” body language) as indicating deception. In reality, reliable behavioral cues to deception do not exist. Unfortunately, stereotypical “liar” behaviors are also typical autistic behaviors, and without training and education, most individuals make incorrect attributions. Moreover, their disbelief and denial of the autistic person’s experienced reality will likely contribute to the gaslighting trauma often experienced by autistic individuals, which is turn is likely to make them even more nervous – and thus, to typical observers, deceptive-looking.

Autistic people are less like to receive empathy

Due to the lack of effective, systematically applied anti-bullying mechanisms, targets of bullying are often at the mercy of individual decision-makers within organizations. Such decision-makers may hear their concerns – or side with bullies. In some cases, leaders rely on their own empathy in “taking sides” – and empathy is likely to result in taking the side of those more similar to decision-makers themselves rather than to those actually telling the truth.

Most decision-makers are allistic and are thus more likely to side with other allistics rather than with autistics. Research demonstrates that non-autistic individuals tend to lack empathy toward autistic people and display significant automatic bias of disliking after a very brief first impression, which persists into further interaction, and is accompanied by exclusionary behaviors. Thus, an allistic bully will likely have an advantage over an autistic target in the judgment of allistic decision-makers.

The lack of empathy from decision-makers and the lack of recourse are likely to inflict a further betrayal injury on autistic employees. The resulting trauma reactions (dejection, depression, anxiety, self-isolation) will likely, in turn, perpetuate victimization.

In sum, the cycle of bullying in the workplace is embedded in both organizational systems and in human biases. Therefore, it is unlikely to be broken without significant structural intervention. I will discuss several possible mechanisms that may help reduce bullying in the workplace in general and bullying of autistic employees specifically in the next installment.