A History of Controversies over the treatment of autism with behavioural therapies

23 March 2021

Nikita Hayden reviews Milana Aronov’s CEDAR Seminar Series talk: ‘A History of Controversies over the treatment of autism with behavioural therapies (France, 1960-1990)’ – delivered online on Thursday 11th February 2021.

A History of Controversies over the treatment of autism with behavioural therapies

23 March 2021

Nikita Hayden reviews Milana Aronov’s CEDAR Seminar Series talk: ‘A History of Controversies over the treatment of autism with behavioural therapies (France, 1960-1990)’ – delivered online on Thursday 11th February 2021.

For Warwick Seminar Series Lecture 1
Article author Nikita Hayden
Nikita Hayden

Milana Aronov opened her CEDAR Seminar Series talk by highlighting how relatively under-explored autism is in the humanities. Where historians do study autism and disability, it rarely gets on the radar of families, practitioners, educators, or health and psychology researchers. This seems a pity. We have a lot to learn from history, especially for those of us engaged with marginalised groups, including autistic and disabled people.

Aronov’s work considers the controversies surrounding autism and behavioural therapies in France from 1960-1990. She situated her work as a case study to explore the development of behavioural therapies in French child psychiatry. These archives were from parents’ associations, psychiatric hospitals, as well as from national organisations in France, such as the National Institute for Health and Medical Research (INSERM), and the French Association for Behavioural and Cognitive Therapy (AFTCC).

The talk began with an overview of the language used to describe autism in France from the 1960s to the 2010s. Aronov then focused on the structuring of institutional childcare provision in France in the 1960s and the 1970s. Aronov went on to present a case study about Sésame Autisme, an early autism parent association, to consider the relationship between parents and the state in relation to autism provision. Lastly, she discussed two contexts: autistic children’s educational and their therapeutic environments.

Where the French context has differed in comparison to the UK and the US, is in the persistence of psychoanalytic traditions well into the latter half of the 20th century. For Aronov, this has meant that there have been more problematic shifts in the French context. For example, there has perhaps been a slower move away from the idea of ‘refrigerator mothers’ – an out-dated and false idea that cold mothers somehow ‘cause’ autism in their children.

This psychoanalytic tradition has meant that France has not adopted behavioural interventions for autistic children to the same extent that other countries have done. Aronov carefully traced early epidemiological surveys of child populations labelled as ‘psychotic’ or ‘maladjusted’ in 1960s France. According to Aronov, the use of behavioural therapies for children in the 1970s and 1980s was categorised by some French psychiatrists at the time as a ‘risk factor for institutional violence’.

This controversy remains relevant given the criticisms of behavioural therapies being made by members of the autistic community. Psychoanalysis is, controversially, still used in France to ‘treat’ autism in children to this day.

What was perhaps most interesting, was the language being used to talk about autism that Aronov had identified in the archival sources. These criticisms about the language used in the past to talk about autism and disability seem uncomfortably relevant to our own present context. How we all talk about autism and disability continues to evolve and remains controversial.

This is why I think we have a lot to learn from historians. What most strikes me when studying the past, is less about how much things have changed, and more about how much things seem to stay the same. I am left considering how cyclical debates are, and how inequalities persist, rather than how progressive we have become as a society.

History is not only about looking at the past, and reflecting on today. It somehow forces us to imagine and interrogate how we – as a community of disabled people, families, carers, practitioners and researchers – will be judged in the future.

Nikita Hayden is a Research Fellow at the Centre for Educational Development, Appraisal and Research at the University of Warwick.

Milana Aronov is a visiting PhD student at the Centre for the History of Medicine, University of Warwick. Milana is studying her PhD at the Institute of Social Sciences at the University of Lausanne.

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