Fighting a tropical scourge, modernising the nation
This chapter shows how successive yellow fever vaccines, conceived as complex sociotechnical constructs, have been involved in the construction of the Brazilian nation state. Three distinct periods in the country’s political history are distinguished: the patriarchal oligarchic state (1822-1930), the national developmentalist state (1930-80), and the state which has since then oscillated between liberal dependency and national interventionism. The successful campaigns against yellow fever run by Oswaldo Cruz formed the backbone for the founding myth of scientific public health and medicine in Brazil. The trajectory of the yellow fever vaccine manufactured at the Oswaldo Cruz Institute, which eventually became the biggest producer worldwide, coincides with economic, welfare, and labour policies that principally benefited urban groups. Rural populations would be the main recipients of the yellow fever vaccine, and it became an important component when national agencies tackled endemic diseases in the interior. Immunisation programmes have helped strengthen the country’s health system, disseminating a culture of prevention. The social mobilisation achieved by the yellow fever and other vaccination campaigns led to new relationships between communities and health services.
This conclusion presents some closing thoughts on concepts discussed in this book. The book describes the origins and foundations of autism as a concept and the role of British researchers in appropriating the concept, making it their own via epidemiological exploration, and then promoting it to the rest of the world. This was an important project that enabled a complete transformation of models for thinking about child development. The book argues that new models of autism and social engagement are not just an extension of previous models of governance as characterised by the growth of 'human relations' psychology. The new autism was a critical concept for rethinking psychology and social development in the 1960s and it became increasingly important. The foundational work for the autism concept was conducted in a unique historical climate in Britain where a population of children were hidden from the gaze of important child psychology researchers.
This chapter explores how British epidemiological research on autism in the 1960s and 1970s came to define global attempts to analyse and understand what, exactly, autism is. Studies of autism have now almost become status symbols, and demonstrations of an advanced neoliberal approach to child rights, within the developing world. The growing focus on autism as a global health crisis has encouraged international organisations to shift their attention to child mental health too, an initiative supported by the WHO. One could argue that there have been so many controversies about the autism 'epidemic' precisely because it was a category that built itself on the idea that child psychology could be completely known through epidemiological research. One thing that Victor Lotter's study did reveal was that the level of provision for the treatment of childhood psychiatric and psychological problems was very limited.
The first autism can only be understood in the context of the legal and institutional networks that enabled the spread of psychological theory as applied to infants and children in Britain in the early twentieth century. This chapter examines the integration of the concept of autism into psychological theory in Britain and the significance of the concept of autism in altering theories of social development in children. Theories of the 'social instinct' in infants and children developed alongside theories of intellectual development. The concept of 'mental deficiency' served as a convenient throwaway label for all infants and children who both psychologists and policy-makers thought were beyond help and not worthy of investigation. The chapter explores how the establishment of the unprecedented legal and political climate for children in Britain encouraged the first applications of the concept of autism.
Most people are aware of many controversies surrounding autism today, as well as those that abounded in the 1960s asserting the fault of mothers in causing the condition. At the British Psychoanalytic Society, other controversial discussions ensued over how to describe the development of subjectivity in infants and children. Although the precise concept of 'autism' was rarely mentioned, the descriptive concepts of 'autoerotism' and 'primary narcissism', a term that had been developed by Sigmund Freud as a response to Bleuler's concept of autism, were discussed frequently. When considering the impact of child psychologists on British childcare policy, it is hard to underestimate the significance of John Bowlby. His work was so influential that historians have since referred to the phenomenon of 'Bowlbyism' as a wide-ranging social tendency to support the place of mothers in the home environment.
This chapter explores how new techniques were developed to measure 'social impairment' in children in light of the Seebohm reforms of 1968 and other legal changes of the early 1970s. These led to major changes in the organisation of educational and social services. The closure of mental deficiency institutions in the wake of the 1959 Mental Health Act, the Seebohm reforms and the slow integration of all children into the education system were transforming ideas about social work. The new theory of autism and the autistic spectrum provided new models for thinking about human social development that were just as detailed and complex as those presented by the psychoanalysts. Lorna Wing's work was important because she developed a new theory of social development that held both political and scientific sway.
The 1950s were turbulent, dramatic and provocative times for people interested in social change and its impact on child psychology. The 1950s was an important decade for psychological research that took 'society' and social causes within its remit. By the early 1950s, children classed with 'psychosis', 'schizophrenia' and 'autism' stood at the heart of controversies over the social and emotional development of children. The Maudsley psychotic clinic was founded partly to get 'childhood psychosis' recognised as a legal category and also to reinforce the role of medically trained child psychiatrists in determining the treatment that 'psychotic' children received. All of the children in the psychotic clinic were given a battery of tests on arrival in order to determine their physiological functions and their levels of intellectual and social development. Tests could help to build a picture of the child's internal conceptual framework and his sensory-motor functions.
Perceiving, describing and modelling child development
Autism is an essential concept used in the description of child development and its variances. This introduction presents an overview of the key concepts discussed in the subsequent chapters of this book. The book traces the radical transformation of the concept of autism in Britain, exploring the reasons behind the shift and the impact that it has had on psychological sciences relating to infants and children. It locates changes in psychological theory in Britain in relation to larger shifts in the political and social organisation of schools, hospitals, families and childcare. The book explores how government entities have dealt with the psychological category of autism. The history of child psychology in Britain has largely been compartmentalised into the history of child guidance, the history of intelligence testing, the history of special education and the history of psychoanalytic theory.
This book explains the current fascination with autism by linking it to a longer history of childhood development. Drawing from a staggering array of primary sources, it traces autism back to its origins in the early twentieth century and explains why the idea of autism has always been controversial and why it experienced a 'metamorphosis' in the 1960s and 1970s. The book locates changes in psychological theory in Britain in relation to larger shifts in the political and social organisation of schools, hospitals, families and childcare. It explores how government entities have dealt with the psychological category of autism. The book looks in detail at a unique children's 'psychotic clinic' set up in London at the Maudsley Hospital in the 1950s. It investigates the crisis of government that developed regarding the number of 'psychotic' children who were entering the public domain when large long-stay institutions closed. The book focuses on how changes in the organisation of education and social services for all children in 1970 gave further support to the concept of autism that was being developed in London's Social Psychiatry Research Unit. It also explores how new techniques were developed to measure 'social impairment' in children in light of the Seebohm reforms of 1968 and other legal changes of the early 1970s. Finally, the book argues that epidemiological research on autism in the 1960s and 1970s pioneered at London's Institute of Psychiatry has come to define global attempts to analyse and understand what, exactly, autism is.
This chapter examines the radical transformation of autism. It examines why the shift in meaning occurred by placing it into the context of legal and political changes in Britain concerning the rights of children, and the impact of these changes on the construction of scientific studies of children. In order to effect a major shift in the meaning of autism, there also had to be a major shift in the organisation of social life. In the 1960s, a new psychology of autism was used to challenge the social ideology of intervening in, and supposedly rectifying, child 'maladjustment'. The 1960s witnessed a revived interest in questions highlighted by earlier developmental psychologists concerning the primacy of sense perceptions in the development of early thought. In an international study group on infantile autism in 1970, a number of researchers put forward proposals for the central 'cognitive disorder' from which infantile autism developed.