Review: Amanda Tinkon Asperger's Children

Looking Terrified into the Years

‘How is it’, I wondered, ‘that there are so many links from autism back to the Holocaust?’ I was reading the rerelease of Judy Singer’s ground-breaking 1998 honours thesis ‘Odd People In: The Birth of Community amongst people on the Autistic Spectrum’. In her thesis Singer coined the term ‘neurodiversity’ and explored how autistic people were isolated by society but had created a new social movement based on valuing the diversity, rather than imposing a hierarchy, of human biology.

Singer was an Australian in the middle of three generations of women with Asperger’s Syndrome, whose thesis was published only four years after Asperger’s Syndrome had been included in the DSM-IV. Unfortunately, at that time, few people from anywhere, let alone Australia, had heard of Asperger’s Syndrome, and those that had heard of it believed it was a condition exclusive to males. Thus Singer’s revolutionary ideas remained unknown beyond the autistic community, until the 2015 publication of Steve Silberman’s book NeuroTribes.

The words that grabbed my attention were in Singer’s commentary preceding her original thesis:

I must mention a significant omission in my thesis and other published works to date. My mother was a Holocaust survivor, and the only one in her family who survived Auschwitz. I chose to omit this fact, knowing it could easily be used to explain away my mother’s behaviours as a reaction to trauma rather than as an example of an AS [Asperger Syndrome] mind. But I knew trauma did not explain everything.

This was late 2018, and I was nearing the end of the second year of my PhD. It had begun as a thesis on the influence of impairment and disability on three Australian disabled writers – but there was so much to say about Les Murray that it was becoming a thesis about him only. Murray, of course, was my first example of links between autism and the Holocaust: I wanted the writers I studied to not only be disabled, but to have publicly identified as disabled, and been an advocate for other disabled people. There was nobody better than an autistic person, with an autistic son, who felt so strongly about the lack of public knowledge of the Nazi genocide of disabled people that he wrote a poem about it, ‘Dog Fox Field’, and made that poem the title of one of his books.

My second example of autism-Holocaust links was Bruno Bettelheim, who popularised his own version of the theory that autistic children are the result of refrigerator parents. The ‘refrigerator’ metaphor was first used in 1956 by Leo Kanner, who was one of the two child psychiatrists credited with designating autism as a diagnosis. He believed that autism was the result of ‘cold’, ‘rational’ and ‘highly-organised’ parents whom he characterised as ‘just happening to defrost enough to produce a child’. In the sixties Bettelheim popularised and expanded on this theory, labelling autistic children as ‘prisoners of the fortress’ and likening their situation to that of Nazi concentration camp prisoners. Bettelheim himself was a survivor of Buchenwald and Dachau, thus his use of this metaphor gave it extraordinary power and longevity such that when Kanner renounced his refrigerator parent theory in 1969, it had no effect.

Murray experienced the continuing influence of the refrigerator parent theory in 1981 when his and Valerie’s fourth child, Alexander, was diagnosed with autism. This is underscored in the thirteenth line of his poem ‘It Allows a Portrait in Line Scan at Fifteen’:

Giggling, he climbed all over the dim Freudian psychiatrist who told us how autism resulted from ‘refrigerator’ parents.

This might be my favourite line in the poem for the reams of information it compresses into eighteen words: the autistic child who is theorised to lack empathy for, or interest in interacting with, anyone else, but who is in fact giggling with and climbing on the psychiatrist; the psychiatrist who ignores that the autistic child is giggling and climbing all over him in favour of out-of-date theories about autism, and who labels Valerie and Les ‘“refrigerator” parents’, while claiming, as a medical professional, to be the empathetic one; the parents noting these contradictions, and also that the psychiatrist, who is supposed to be skilled in recognising autism, has not noticed what they are becoming sure of – that Les is also autistic.

The third example was Hans Asperger himself – the other child psychiatrist credited with designating autism as a diagnosis. His story, as told by many, including Silberman in NeuroTribes, was of a doctor who so fervently believed in the worth of his patients that he resisted Nazi policy by refusing to recommend any of them for euthanasia. This is a story that has never sounded plausible to me for two reasons: one is that, as a disabled person, I regularly experience non-disabled people denying their own discriminatory actions or those of others, and reframing those actions as benevolent, often appropriating disabled peoples’ actions or culture into the bargain. A recent example of this is the tactile feature on the new series of Australian bank notes, in circulation as of 1 September 2016. The reason these notes have a tactile feature is that blind teenager Connor McLeod made a disability discrimination complaint against the Reserve Bank of Australia, but his efforts are not acknowledged on the Reserve Bank of Australia website. Instead, the Reserve Bank give the impression that they had always planned to make bank notes accessible to blind Australians, but, until now, had been thwarted by inadequate technology.

The other reason the story of Asperger’s heroism did not sound credible to me was Silberman’s account of it in NeuroTribes. And I was not the only one. As Anna de Hooge, who identifies as autistic, wrote of NeuroTribes:

In this book, intended for the general public, he [Silberman] writes that Asperger convinced his superiors of the value of his patients by suggesting to them that “his little professors would make superior code breakers for the Reich”. While Silberman intends this example as a show of Asperger’s good faith, … he inadvertently highlights a disregarded demographic; if autism was forgiven in potential cryptographers due to their usefulness to the Reich, what happened to the children who did not fit the “little professor” box?

As Edith Sheffer, who does not identify as autistic but has an autistic son, makes clear from the outset of her book Asperger’s Children, the person who did the most to entrench the story that Asperger had resisted the Nazis, including that in doing so he had ‘risked his life’, was Asperger. However, as Sheffer thoroughly details, that is not the truth. As well as disproving a number of Asperger-made myths about Asperger, Asperger’s Children contributes vital information to the deconstruction of autism as a purely biological label.

As Sheffer outlines, in Asperger’s 1943 postdoctoral thesis ‘The “Autistic Psychopaths” in Childhood’, he identified the symptoms of his patients as problems of assimilation. He believed their behaviour demonstrated that they did not have any interest in, or drive to conform to, the expectations of their parents, their peers, or society and consequently, Asperger said, ‘The community rejects them.’ He did emphasise that his patients were spread throughout a range of a measure he felt was particularly important – intelligence. Nevertheless, regardless of intelligence, he wrote that ‘the positive aspects of autistic traits do not outweigh the negative ones’.

Central to Asperger’s conception of autism was eugenics, a theory that had swiftly gained worldwide popularity throughout the late nineteenth and early twentieth centuries because it established scientists and medical professionals as the sole arbiters in a system that, due to its basis in subjectivity and its claim to objectivity, sustains itself endlessly as it is adapted to local prejudices. For example, while both German and US early twentieth-century eugenicists targeted disabled people, in accordance with other prejudices popular in those countries, another primary target of German eugenicists was Jewish people, and in the US, African-American people. Charles Darwin is often blamed for originating the theory that developed into eugenics. However, Darwin, at least in his earlier writing, was opposed to humans intervening in the development of species. He believed that environment determined whether species survived and that variations within species are the natural and necessary response to this reality. His cousin Sir Francis Galton believed the opposite, that species development was solely determined by heredity and, therefore, that all a person could be was determined by the biology of their ancestors. Thus he believed that the human race would be continuously improved by encouraging humans with ‘desirable’ characteristics to have children, and preventing humans with ‘undesirable’ characteristics from having children. Or, as Murray summarises it, ‘sex is a Nazi’.

Key to the German adaptation of eugenics was Gemüt or ‘soul’, a term that had existed since the eighteenth century but, throughout the 1920s and 1930s, developed from a topic of discussion into grounds for a potential death sentence. As Sheffer explains:

Inadequate Gemüt was no longer an abstract quality but a quantifiable pathology. Failings of Gemüt were supposedly heritable and predicted children’s future value, or danger, to society. Asperger, in his thesis, stated that “A person’s whole personality speaks from the Gemüt.”

Before exploring the history of Asperger and ‘autistic psychopathy’ in detail, Sheffer provides a brief history of the Aktion T4 program. Aktion T4 was a Nazi program that targeted disabled adults. It began with World War II on 1 September 1939 and ended on 24 October 1941. Sheffer reiterates the myth that Hitler ordered the cessation of Aktion T4 in response to public protests. However, Susan Knittel, in her 2015 book The Historical Uncanny: Disability, Ethnicity, and the Politics of Holocaust Memory, states that this has been conclusively proved untrue. She explains that, like so many other Nazi programs, Aktion T4 had a quota of victims and the program stopped when that quota was reached.

To me, Sheffer’s portrayal of Aktion T4 in the introduction, combined with understated accounts of the scale of the Nazi genocide of disabled people throughout the book, suggests that disabled peoples’ lives were only under threat for two years of the Nazi regime. It risks promoting the idea that the threat wasn’t all that serious anyway since it was susceptible to public protests, while other Nazi genocides were not. Nothing could be further from the truth. According to Suzanne E. Evans, in her book Forgotten Crimes, at least half a million disabled people were sterilised and at least three quarters of a million were murdered under a number of Nazi programs that began in 1933 and continued to the end of the second world war and beyond. Collectively these programs are now known as the Krankenmorde. Because I agree with Sheffer that ‘when we invoke the autism label, it should be with full knowledge of its origins and implications’, here is a brief history of the Nazi genocide of disabled people. 

On 14 July 1933, fewer than six months after Adolf Hitler was appointed German Chancellor, he enacted the Law for the Prevention of Offspring with Hereditary Diseases, mandating the compulsory sterilisation of people who were labelled as congenitally impaired. The conditions named as the targets of this law were: blindness, deafness, epilepsy, Huntington’s chorea, schizophrenia, bipolar, ‘feeblemindedness’, severe physical impairment, and severe alcoholism. While doctors interpreted each of these conditions broadly, feeblemindedness in particular was a catch-all diagnosis. Feeblemindedness was first used to refer to intellectual impairment, but could be expanded to cover any behaviour deemed to be anti-social or unusual. Thus it included autism. The majority of sterilisations were justified by this diagnosis. For example, in 1934, 52.9 per cent of the sterilisations carried out were for ‘feeblemindedness’. In other words, the list of targeted conditions was not an attempt to be scientific; the point was to appear scientific.

Disabled people could be denounced by anyone, but most often they were betrayed by the staff entrusted with their medical care or education. The denouncer presented evidence of what they labelled as the disabled person’s hereditary impairment, to specifically established hereditary health courts. Then a panel of one judge and two doctors decided, at least 85 per cent of the time, that the person should be forcibly sterilised. The person could appeal, but their appeals were successful fewer than 3 per cent of the time. They could also postpone their sterilisation by committing themselves to an institution, but they could not leave the institution until the sterilisation had occurred.

In response to the pregnancies that the sterilisation law prompted, on 26 June 1935 the sterilisation law was expanded. Doctors were then authorised to perform abortions – providing them with the opportunity to sterilise the person at the same time – if either parent of an unborn child was labelled as having a hereditary impairment. Subsequently, from 18 October that same year, any person labelled as having a hereditary impairment was not permitted to marry. In the meantime, however, German hospitals’ capacity to perform sterilisations could not keep pace with the tens of thousands of sterilisations that the courts mandated each year, and each year the hospitals fell further behind.

Hitler decided as early as 1935 that he would institute euthanasia for disabled people as soon as war began. The first victims were disabled children. As of 18 August 1939, any child labelled as having a hereditary impairment was registered and assessed by a panel of doctors. The children chosen to be murdered were taken from their homes or institutions and brought to a children’s ward. The murder method was decided by the staff managing the ward, but there were quotas to be met and bonuses were paid for meeting them. This encouraged methods that facilitated the secrecy required, while murdering as many children as possible. After much trial and error, most hospitals settled on starvation, medication, or exposure. From this experimentation doctors quickly realised there were many other kinds of experiments they’d like to perform on disabled children while they were alive, as well as on their bodies after they died.

As of 1 September 1939 the previously mentioned Aktion T4 program was implemented against disabled adults. Doctors had been willingly involved in the planning of this program over the previous few months but still had one concern – that they would be made legally responsible for the deaths. Thus a secret authorisation issued by Hitler in October (backdated to 1 September) allowed that ‘patients who, on the basis of human judgment, are considered incurable, can be granted a mercy death after a discerning diagnosis’. Disabled adults chosen to be murdered were sent to one of six killing centres where they were gassed to death. The stop order, issued by Hitler on 24 August 1941, in addition to only being acknowledgment of a quota, applied solely to the four Aktion T4 killing centres in operation at that time. In effect, then, the stop order was a license for the murder of disabled adults to spread throughout Nazi-occupied territory in what is now known as decentralised euthanasia. As Evans details: ‘Indiscriminate mass murder thus became part of general hospital routine as hundreds of thousands of patients with disabilities in Germany, Austria, and the occupied territories were shot, burned, frozen, starved, tortured, or poisoned to death.’

Any German disabled people who had been sent to the concentration camps with unnoticed impairments, or who had acquired impairments since arriving, were captured by the Aktion 14f13 program and gassed to death using the four Aktion T4 gas chambers. Aktion 14f13 was discontinued on 27 April 1943, but, in the same way as Aktion T4, this did not mean an end to the murders, only a change in agenda. As the war continued the Nazi requirements for forced labour increased, therefore those declared incapable of work decreased. Those chosen to be murdered did not need to be transported to the Aktion T4 killing centres anymore because larger gas chambers had since been built nearby.

The murder of disabled people in Nazi-occupied territory began when World War II did, with Polish disabled people. Any disabled people thought to have incurable impairments were murdered, without the pretence of assessment. Many were shot, many were given lethal injections and many others were murdered using the exhaust of the trucks in which they had been locked. Some of the people from these countries who were assessed as non-disabled were sent to Germany to work. As of 6 September 1944, any of these people who were later found to have an impairment were brought to one of eleven designated hospitals and murdered by injection.

The murder of disabled people continued after World War II ended on 8 May 1945 because it took some time for allied troops to challenge German requests to not enter hospitals. In The Origins of Nazi Genocide, Henry Friedlander provides the example of a hospital in Kaufbeuren where, ‘only on 2 July, after rumours had reached military offices in Munich, did American soldiers enter the hospital and discover “a wholesale extermination plant”.’

I stood facing a tall, tall man in a white coat. Light-haired. The size difference was enormous. And I only know that he greeted my mother, and then he looked at me and punched me in the stomach with full force. Yes? My reaction was: no howling, nothing, but I probably looked at him angrily. And so he told me, he told my mother that I had aggression.” Kimmel said she was institutionalised, held in a caged bed for a month. Afterward, Kimmel reflected, “I never heard from Asperger again. I don’t know, was I a test subject? Was I a person? Was I a piece of wood? A guinea pig? I have no idea.

This, according to Sheffer, was what it was like to be one of Asperger’s patients, not during the Third Reich, but afterwards. The staff in Asperger’s clinic, like many others throughout Austria and Germany, ceased murdering their patients, but otherwise continued on as before. What Asperger was doing was testing Kimmel’s Gemüt – or ‘empathy’, as he began to call it after World War II. As Sheffer recounts, Asperger’s eugenic understanding of Gemüt began when his career did. In 1931, when Asperger was 25 and had just finished his medical degree, Professor Franz Hamburger became both his boss at the University of Vienna Children’s Hospital, and his postdoctoral adviser. Hamburger had been appointed as director of the hospital two years prior. He brought to the role a deep commitment to eugenics, including having co-founded a Society for Racial Hygiene in 1924. And while Sheffer does not discuss Hamburger’s thoughts on Gemüt, she does observe that he ‘proclaimed, “The medical practitioner’s most important daily work is the care of souls.”’

Sheffer notes that ‘many of Hamburger’s protégés went on to be Nazi enthusiasts and leaders in the euthanasia program.’ And Asperger was one of them. In 1932 Asperger began working at the hospital’s Curative Education clinic. A year and a half later Hamburger appointed him director of the clinic, a position that he held until at least 1951. By 1940 Hamburger was so impressed by Asperger’s work that, in closing the first assembly of the German Society for Child Psychiatry and Curative Education, he named Asperger’s clinic as an exemplar of Third Reich values and practices.

Throughout the 1930s Asperger also took up many other opportunities to advance his career: In April and May of 1934 Asperger interned with Paul Schröder, who Sheffer names as ‘[t]he preeminent figure in shaping the Nazi approach to child psychiatry’ at the Leipzig University’s psychiatric hospital where he was director. As zealously as Hamburger was committed to eugenics generally, Schroder was committed to the importance of Gemüt in particular. Sheffer quotes him as declaring that, ‘“The degree of one’s richness of Gemüt is one of the most important determinants of the practical usefulness and social value of a person”’. Two years earlier, Schroder’s student Hans Heinze had published a work titled On the Phenomenology of Gemüt, which quickly became central to Nazi psychiatry. Asperger was an enthusiastic supporter of both men and quoted them liberally in his 1943 thesis.

As a concept that was now infused with eugenics, Gemüt guaranteed the central and increasing importance of medical professionals in the Third Reich. The most important medical professionals were child psychiatrists, who determined whether a child had healthy Gemüt, or one of the many Gemüt-related diagnoses that had suddenly been discovered throughout the 1930s by German and Austrian doctors. For each child that was given a diagnosis, a child psychiatrist then determined if they were ‘educable’. If they were not they would be murdered. Child psychiatrists and their staff were both the educators and the murderers.

In October 1938 Asperger proclaimed a diagnosis of his own: ‘this well-characterized group of children who we name “autistic psychopaths”—because the confinement of the self (autos) has led to a narrowing of relations to their environment’. Throughout 1938 Asperger also began working as a psychiatric expert for Vienna’s children’s homes, juvenile courts and Hitler Youth. And then, between October 1939 and July 1940, Hamburger appointed Asperger, on top of his other roles, to direct the Motorized Mother Advising service. This service ‘examined 5,626 infants and children up to age fourteen’ and claimed to be improving children’s health. In fact, the information it collected was fed into the children’s euthanasia program, which began at the Spiegelgrund institution at the end of August 1940:

Spiegelgrund was the second-largest killing center in the Reich; it boasted the highest death rate and trained killing staff for other “special children’s wards”.

The first director of Spiegelgrund was Erwin Jekelius, another of Hamburger’s postdoctoral students who also worked at the Curative Education Clinic, including for two years under Asperger’s leadership.

During this time, Asperger also manoeuvred his Curative Education Clinic into its central role in Vienna’s child euthanasia system. Sheffer notes that: ‘by August 7, 1940, the New Viennese Daily (Neues Wiener Tagblatt) praised Asperger’s Curative Education Clinic as an “advisory body” for the city of Vienna, treating children with the “closest cooperation with the entire municipal welfare department”.’

On 1 October Asperger then applied to be, and soon became, a ‘specialist physician’ in ‘curative educational and child psychiatric concerns’ to Vienna’s Public Health Office. The goal of the Public Health Office was to centralise the records of every citizen in order to make a determination about each person’s ‘health’.

In short, by the end of 1940:

If [Vienna’s] schools, courts, the Hitler Youth, and the NSV [the National Socialist People’s Welfare Organization] required an expert opinion on a child, Asperger conducted an assessment … the exact number of children Asperger slotted for Spiegelgrund is difficult to assess from fragmentary records. But his recommendations are scattered through case histories. And his opinions mattered. When Asperger deemed two boys, Friedrich K. and Karl Sp., “incapable of education”, their reform school ordered them to Spiegelgrund on the “earliest possible transfer”.

In October 1943 Asperger presented his postdoctoral thesis on ‘autistic psychopaths’, and was then appointed ‘Dozent’, which Sheffer translates as ‘associate professor’, at the University of Vienna. Soon after, he was drafted into military service. When he returned he was appointed interim director of the University of Vienna Children’s Hospital until 1949. Once the Curative Education Clinic was rebuilt after it had been bombed in 1944, Asperger also continued there in his role as Director.

Rather than simply provide a portrait of Asperger’s life, one of the most important roles Asperger’s Children performs is to carefully deconstruct and disprove a number of claims Asperger made about his actions during the Third Reich. In 1974, for example, Asperger asserted, not only that he had not referred anyone for euthanasia but, due to his resistance to this Nazi policy, his life was at risk. He stated that: ‘I was never willing … to notify the Health Office of feebleminded children, as we were instructed, this was a truly dangerous situation for me.’

Sheffer finds that there is no evidence of this danger and that the file the Nazis kept on Asperger ‘consistently deemed Asperger loyal to the regime’. Asperger remained Catholic and did not join the Nazi party, therefore he was willing and able to resist Nazi policy. On medical matters, however, he chose not to. In fact, he often displayed an intense commitment to Nazi medical policy: ‘In June 1938 Asperger applied to the ‘National Socialist German Physicians’ League (NSDÄB), which was not a straightforward doctors’ professional association, but a lead “fighting organization” of the Nazi Party that sought to coordinate physicians according to party principles and was involved in the persecution of Jewish doctors.’ A few months later, when he gave the lecture in which he named the diagnosis of ‘autistic psychopathy’ he ‘continued with a tribute to Nazi ideals, using overtly pro-regime rhetoric that was neither obligatory nor even customary in Austrian scientific papers in 1938.’ In late 1941, with Hamburger, Jekelius, and Max Gundel (‘head of Vienna’s Public Health Office and municipal director of Spiegelgrund’), Asperger established the Vienna Society for Curative Education. This organisation ensured that everyone working in child development in Vienna was educated in Nazi medical values.

Asperger further claimed, in his 1943 thesis, that of the ‘more than 200’ autistic children his clinic had identified in ten years, ‘We have never met a girl with the fully fledged picture of autistic psychopathy’. However, records show that, when he examined three-year-old Ulrike Mayerhofer, he profiled her as ‘severely autistic’. This label led, after a number of transfers, to her death at Spiegelgrund in July 1944.

Furthermore, Sheffer demonstrates that Asperger’s assertion that ‘the autistic personality is an extreme variant of male intelligence’ is a conclusion based on bias. Sheffer provides detailed case histories of four patients from Asperger’s Curative Education Clinic: two boys – Fritz and Harro – who were two of the four case studies featured in Asperger’s thesis, and two girls – Margarete and Elfriede – who were not. Sheffer states that the four are described ‘in almost identical terms’, but the explanations for their behaviours vary according to gender. Boys’ creativity with language was ‘autistic introspection’, while the same in girls was ‘manic depressive insanity’; a tendency towards mature conversation meant that boys spoke ‘like an adult’, however in girls this conversation was ‘precocious, too wise’ and ‘primitive’; the reason for the boys’ behaviour was autism, while the reason for the girls’ behaviour was their menstrual cycle.

A third of the way through the book, Sheffer asks the question that is central to her thesis: ‘Does it matter if Asperger was only signalling regime values superficially to get by, to protect his career, or to advance it?’ Confusingly, her immediate answer is no: ‘It is Asperger’s words, not his innermost thoughts or beliefs, that affect our conception of the autism diagnosis more than seventy years later’.

In describing my confusion at Sheffer’s answer, I first want to acknowledge what I understand to be part of her point, that words have significant effects, regardless of whether the intention behind those words is known or not. Demonstrating this is Leopoldine Maier, a survivor of Spiegelgrund, quoted by Sheffer as saying, ‘The term “unworthy life” is still ringing in my ears. There is still a sign above my life that says: strictly speaking, you have no right to live.’ Regardless of whether the probably hundreds of people who Maier heard describe her and other disabled people this way during the Third Reich said ‘unworthy life’ because they believed it wholeheartedly, or just to pay their bills, those words have severely damaged her.

Nevertheless, Sheffer’s point that today we are affected by Asperger’s words is not nearly as straightforward as it seems because, as she details, before her book our conceptions of autism did not come from Asperger’s words directly. Our conceptions of autism came from translations of Asperger’s words, minus a number of key points: In 1981, when British psychiatrist Lorna Wing brought Asperger’s work to the attention of the English-speaking world, she chose to replace ‘psychopathy’ with the ‘neutral’ term ‘syndrome’. However, as Sheffer points out, Asperger deliberately chose the term ‘psychopathy’ to describe what he believed to be these patients’ ‘social deviance and recalcitrance—which were embedded in his Nazi-era diagnosis’. Similarly, ten years later, when German-born British psychologist Uta Frith published a translation of Asperger’s thesis, she translated ‘autistic psychopathy’ as ‘autism’ and did not include the preface which Sheffer says ‘engaged with Nazi child psychiatrists and situated the diagnosis within the intellectual framework of the Third Reich’. When one then read the thesis without its foundation, the references to Nazi rhetoric throughout were stripped of their significance, and thus easily dismissed as unimportant.

Sheffer’s point that today we are affected by Asperger’s words but not his beliefs is also confusing because, even in translation and with key details omitted, Asperger’s words were not separate from his beliefs – they were his beliefs. We know this because, as Sheffer details, they were not only Asperger’s beliefs, they were dominant beliefs in the German medical profession at that time. One of Asperger’s contemporaries was George Frankl, who emigrated to the US in 1937. He was assisted by, and came to work for, Leo Kanner, the other child psychiatrist credited with designating autism as a diagnosis. Yet another medical professional from Asperger’s time was Bruno Bettelheim, who emigrated to the US in 1939 and became famous for his ‘prisoners of the fortress’ theory of autism. The popular conception that autistics are all unempathetic males who might have a talent for maths or computers, but otherwise contribute nothing to society, is directly attributable to these men and, through them, to Nazi medical values.

Most troubling in this book are the instances where Sheffer chooses to hedge her bets rather than speaking unequivocally. For example, she writes: ‘Asperger, like his colleagues, appears to have benefited from the expulsion of his Jewish and liberal colleagues, writing his thesis in their wake.’ Whereas, on the basis of Sheffer’s evidence, I would say there’s no doubt Asperger benefited. Sheffer explains that after Hamburger removed many Jewish and liberal staff from the University of Vienna Children’s Hospital, ‘nine of his advisees, including Asperger, gained promotion between 1940 and 1945’. Despite Hamburger having to explain to university administration in December 1942 that Asperger was ‘coming to his research “just now”’, in October 1943 Asperger both presented his thesis and was appointed ‘Dozent’. Furthermore, although in his thesis Asperger referred to ‘only nine authors in sixty-one pages—he twice noted [Erich] Jaensch’s anti-semitic typology, with apparent endorsement’.

Another example is that, despite the mountain of evidence Sheffer has amassed that Asperger willingly and actively sought out every way possible – aside from actually opening the gas valves or injecting the drugs – to participate in the Nazi child euthanasia program in Vienna, she is keen to trivialise his role during the Third Reich. So much so that she frames her book with this argument. In the introduction she states: ‘Asperger was neither a zealous supporter nor an opponent of the regime. He was an exemplar of this drift into complicity, part of the muddled majority of the populace who alternately conformed, concurred, feared, normalized, minimized, repressed, and reconciled themselves to Nazi rule.’ In closing the last chapter Sheffer asserts:

While the facts of Asperger’s life are well documented, their meaning is subject to interpretation. Readers might differ in their judgments. Even the extent to which one could, or should, make moral judgments is an open question.

My question, given the evidence that Sheffer provides, is ‘Why?’ Why should moral judgements about Asperger be withheld? I’m not asking this of Sheffer alone, but of anyone who hesitates to judge people who were as involved in the Nazi genocide of disabled people as Asperger certainly was. To be clear, I am not interested here in whether you decide whether Asperger is good or bad. I’m interested in why you treat this question as if it is indecent or unfair to ask?

Even though there were others who were more involved in the Nazi murder system. Even though others are implicated in more deaths. Even though, so far, there is no record of Asperger performing any murders. He did all he could to place himself at the centre of Vienna’s child euthanasia system in a way that meant he directed what occurred, while avoiding the responsibility for it. And Asperger managed this so effectively that while Hamburger, his methods and his students entirely lost their credibility after the Third Reich, due to their role in the child euthanasia program, Asperger did not. He was the only one of Hamburger’s students who retained his right to teach and was one of two students who were allowed to continue in their role at the University of Vienna. He was cleared of wrongdoing, continued treating his patients as he always had, and died of natural causes in 1980.

Autistic people, by contrast, still have to contend daily with the theory he developed and promoted, that they have no empathy. Empathy is a concept that has not lost its nebulousness over time and thus has been a very effective method in excluding autistic people from society. I think Murray powerfully captures the penetration and relentlessness of this exclusion in his poem ‘The Averted’:

The one whose eyes
do not meet yours
is alone at heart
and looks where the dead look
for a comrade in his cause.

There are obviously many consequences of the assumption that autistic people are not empathetic, but I want to briefly explore one that is pertinent to Sheffer’s book: the conclusion that autistic people are not capable of creative writing. This is a conclusion that I encounter regularly as the researcher of an autistic poet. Despite Murray labelling himself as autistic in his poetry since 1974, critics have for the most part refused to engage with it. Those that do inevitably dismiss Murray’s understanding of himself as incorrect, with one version or another of ‘he can’t be autistic. He has empathy for people.’

By refusing to credit autistic people with the ability to write creatively (and to credit creative people with autism), they are denied the right to tell their own stories. This then expands to autistic people being denied the right to have input into their own stories, which is what occurs in Sheffer’s book. I’m not suggesting that she should necessarily have co-authored her book with an autistic person. However, in a book that was written ‘in service of neurodiversity’ and that ‘benefited greatly from academic exchanges’ I was expecting to read that she had discussed her work with US autistic academics such as Lydia X.Z. Brown, Melanie Yergeau, Ari Ne’eman or Nick Walker; or, at the very least, made references to their writing in her notes. I was expecting her acknowledgments pages to contain extensive lists of autistic people with whom she consulted, along the lines of Silberman’s NeuroTribes, but the only autistic-identified person she mentions is her son. Sheffer inadvertently demonstrates the problem with all of this in her Epilogue: ‘Multiple factors have shaped our current approaches to autism, such as research funding, disability legislation, public services, school policies, parent activism, awareness drives, non-profit organizations, and media representations.’ Conspicuously absent from this list are those who are most qualified to shape our current approaches to autism – autistic people.

Asperger’s Children brings much-needed attention to the central role of the medical profession in general, and Asperger in particular, in the Nazi genocide of disabled people, and its continuing destructive consequences for autistic people; and yet it does so in ways that minimise the threat that all disabled people experienced, and that many did not survive, and the responsibility of the people who designed and implemented that murderous system. This book is a valuable contribution to Holocaust research while simultaneously demonstrating the lack of progress that results from proceeding on the basis of a single perspective.

As Judy Singer argues: ‘Why not propose that just as biodiversity is essential to ecosystem stability, so neurodiversity may be essential for cultural stability? Why not strategically argue that the nurturing of neurodiversity gives society a repository of types who may come into their own under unforeseeable circumstances.’

Perhaps I agree with her because I also identify as neurodivergent. Nevertheless, the fact that – though many people have tried – the first person to succeed in mobilising people around the world to act on climate change is autistic, is compelling evidence.

Thanks to Michael Robertson and Edwina Light for their comments on an early draft of this essay.

Works Cited

The poems in this essay – ‘Dog Fox Field’, ‘It Allows a Portrait in Line Scan at Fifteen’, ‘Rock Music’, and ‘The Averted’ ­–all appear in Les Murray’s Collected Poems (Black Inc: 2018). The title for the essay is taken from the closing lines of ‘The Averted’.


Sources of information on the Nazi genocide of disabled people for this essay include:

Czech, Herwig. Hans Asperger, National Socialism, and ‘Race Hygiene’ in Nazi-era Vienna (Molecular Autism: 2018).

Evans, Suzanne E. Forgotten crimes: The Holocaust and people with disabilities (Ivan R. Dee.: 2004).

Friedlander, Henry. The Origins of Nazi Genocide: From Euthanasia to the Final Solution (The University of North Carolina Press: 1995).

Knittel, Susanne C. The Historical Uncanny: Disability, Ethnicity, and the Politics of Holocaust Memory (Fordham University Press: 2015).

Poore, Carol. Disability in Twentieth-Century German Culture (The University of Michigan Press: 2007).

Robertson, Michael. Et al. The First into the Dark: The Nazi Persecution of the Disabled (UTS ePRESS: 2019).


Sources of information on autism for this essay include:

De Hooge, Anna N. Binary Boys: Autism, Aspie Supremacy and Post/Humanist Normativity (Disability Studies Quarterly: 2019).

McGrath, James. Naming adult autism: Culture, science, identity (Rowman & Littlefield International: 2017).

Silberman, Steve. NeuroTribes: The Legacy of Autism and How to Think Smarter About People Who Think Differently (Allen & Unwin: 2015).

Silberman, Steve. Autism Informs and Empowers Greta Thunberg’s Climate Activism (Vox: 2019).

Singer, Judy. Neurodiversity: The Birth of an Idea (Kindle: 2017)

Yergeau, Melanie. Authoring Autism: On Rhetoric and Neurological Queerness (Duke University Press: 2018).