Autistic disturbances of affective contact
作者: Leo Kanner / 33548次阅读 时间: 2010年8月14日
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sN0]VM3D.P0Case 11
5U6C6v7O:De0Elaine C. was brought by her parents on april 12, 1939. at the age of 7 years, 2 months, because of “unusual development”: “She doesn’t adjust. She stops at all abstractions. She doesn’t understand other children’s games, doesn’t retain in stories read to her, wanders off and walks by herself, is especially fond of animals of all kinds, occasionally mimics them by walking on all fours and making strange noises.
v&[.~^ Oe n0Elaine was born on February 3, 1932, at term. she appeared healthy, took feedings well, stood up at 7 months and walked at less than a year. she could say four words at the end of her first year but made no progress in linguistic development for the following four years. Deafness was suspected but ruled out. Because of a febrile illness at 13 months, her increasing difficulties were interpreted as possible postencephalitic behavior disorder. Others blamed the mother, who was accused of inadequate handling of the child. Feeblemindedness was another diagnosis. For eighteen months, she was given anteriorpituitary and thyroid preparations. “ Some doctors, ”struck by Elaine’s intelligent physiognomy, thought she was a normal child and said that she would outgrow this.”心理学空间P t5@ Z ^G1d s
At 2 years, she was sent to a nursery school, where “she independently went her way, not doing what the others did. She , for instance, drank the water and the plant when they were being taught to handle flowers.” She developed an early interest in picures of animals. Though generally restless, she could for hours concentrate on looking at such pictures, “especially engravings."心理学空间 K/y$qc{2f
When she began to speak at about 5 years, she started out with complete though simple sentences that were “mechanical phrases” not related to the situation of the moment or related to it in a peculiar metphorical way. She had an excellent vocabulary, knew especially the names and “classifications”of animals. She did not use pronouns correctly, but used plurals and tenses well. She “could not use negatives but recognized their meaning when others used them.
J#~5{ Q `A:S(iH0There were many peculiarities, in her relation to situations.
"Q'Gv Z}Lb^(\x0She can count by rote. She can set the for numbers of people if the names are given her or enumerated in any way, but she cannot set the table “for three.”If sent for a specific object in a certain place, she cannot bring it if it is somewhere else but still visible
+a{g7{'` FG0She was “frightened”by noises and anything moving toward her. She was so afraid of the vaccum cleaner that she would not even go near the closet where it was kept, and when it was used, ran out into the garage, covering her ears with her hands.
N1y[R(TMl0Elaine was the older of two children. her father, aged 36, studied law and the liberal arts in three universities (including the Sorbonne), was an advertising copy writer, “one of those chronically thin persons, nervous energy readily expended.” He was at one time editor of a magazine. The mother, aged 32, a “self-controlled, placid, logical person,”had done editorial work for a magazine before marriage. The maternal grandfather was a newspaper editor; the grandmother was “emotionally unstable.”心理学空间d8S:ce!K4N#j
Elaine had been examined by a Boston psychologist at nearly 7 years of age. the report stated among other things:心理学空间 D6i/mF#G bF/Q
Her attitude toward the examiner remained vague and detached. even when annoyed by restraint, she might vigorously push aside a table or restraining hand with a scream, but she made no personal appeal for help or sympathy. At favorable moments she was competent in handling her crayons or assembling pieces to form pictures of animals. She could name a wide variety of pictures, including elephants, alligators, and dinosaurs. She used language in simple sentence structure, but rarely answered a direct question. As she plays, she repeats over and over phrases which are irrelevant to the immediate situation.心理学空间:Z+c$u@:u G7b e~1vi+Z
Physically the child was in good health. Her electroencephalogram was normal.心理学空间6GdmHs
When examined in April, 1939, she shook hands with the physician upon request, without looking at him, then ran to the window and looked out. She automatically heeded the invitation to sit down. Her reaction to questions after several repetitions, was an echolalia type reproduction of the whole question or, if it was too lengthy, of the end portion. She had no real contact with the persons in the office. Her expression was bland, though not unintelligent, and there were no communicative gestures. At one time, without changing her physiognomy, she said suddenly: “Fishes do’t cry.”After a time, she got up and left the room without asking or showing fear.心理学空间)c5?.jI Zk
She was placed at the Child Study Home of Maryland, where she remained for three weeks and was studied by Drs. Eugenia S. Cameron and George Frankl. While there, she soon learned the names of all the children, knew the color of their eyes, the bed in which each slept, and many other detalis about them, but never entered into any relationship with them. When taken to the playgrounds, she was extremely upset and ran back to her room. She was very restless but when allowed to look at pictures, alone with blocks, draw, or string beads, she could entertain herself contentedly for hours. Any noise, any interruption disturbed her. Once, when on the toilet seat, she heard a knocking in the pipes; for several days thereafter, even when put on a chamber pot in her own room, she did not move her bowels, anxiously listening for the noise. She frequently ejaculatedt stereotyped phrases, such as, “Dinosaurs don’t cry”; Crayfish, sharks, fish. and rocks”; “Crayfish and forks live in children’s tummies”;“Butterflies live in children’s stomachs, and in their panties, too”; “Fish have sharp teeth and bite little children”;“There is war in the sky”; “Rocks and crags, I will kill”(grabbing her blanket and kicking it about the bed) ()) “Gargoyles bite children and drink oil”; “I will crush old angle worm, he bites children”( gritting her teeth and spinning around in a circle, very excited); “Gargoyles have milk bags”;”Needle head. Pink wee-wee. Has a yellow leg. Cutting the dead deer. Poison deer. Poor Eliane. No tadpoles in the house. Men broke deer’s leg” (while cutting the picture of a deer from a book);“Tigers and cats”; “Seals and salamanders”;“Bears and foxes.”心理学空间6\ptS8_x.R-ne
A few excerpts from the observetions follow:心理学空间G:ufNh6@
Her language always has the same quality. Her speech is never accompanied by facial expression or gestures. She does not look into one’s face.
}(w QuV|8t:vP0Her voice is peculiarly unmodulated, somewhat hoarse; she utters her words in an abrupt manner.
G$|2E0E&j Xd:Z0Her utterances are impersonal. She never uses the personal pronouns of the first and second persons correctly. She does not seem able to conceive the real meaning of these words.心理学空间9jmW Ab0BR
Her grammar is inflexible. She uses sentences just as she has heard them, without adapting them grammatically to the situation of the moment. When she says, “Want me to draw a spider,” she means, “I want you to draw a spider.
6{\^&K l)x8c,h0She affirms by repeating a question literally, and she negates by not complying.
oRdEm x-P"?i0Her speech is rarely communicative. She has no relation to children, has never talked to them, to be friendly with them, or to play them. She moves among them like a strange being, as one moves between the pieces of furniture of a room.心理学空间/D T}#FT
She insists on the repetition of the same routine always. Interruption of the routine is one of the most frequent occasions for her outbursts. Her own activities are simple and repetitious. She is able to spend hours in some form of daydreaming and seems to be very happy with it. She is inclined to rhythmical movements which always are masturbatory. She masturbates more in periods of excitement than during calm happiness....Her movements are quick and skillful.
"BV:X/JDzd0Elaine was placed in a private school in Pennsylvania. In a recent letter, the father reported “rather amazing chances”:心理学空间Z {-@;zB+Z d
She is a tall, husky girl with clear eyes that have long since lost any trace of that animal wildness they periodically showed in the time you knew her.心理学空间,zHWf9r%y
She speaks well on almost any subject, though with something of an odd intonation. Her conversation is still rambling talk, frequently with an amusing point, and it is only occasional, deliberate, and announced. She reads very well, but she reads fast, jumbling words, not pronouncing clearly, and not making proper emphases. Her range of information is really quite wide, and her memory almost infallible. It is obvious that Elaine is not “normal.” Failure in anything leads to a feeling of defeat, of despair, and to a momentary fit of depression.心理学空间Im zy8A+V%v+b#x
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