We wrote to Henry himself when we learned of his address. Early in January 1972, he sent us a lengthy autobiographic letter; regretfully, we cannot reproduce it word for word but the following is an abstract:

On June 29, 1962, at 19� years of age, he entered the armed services. Upon completion of basic training, he was assigned to one of the intelligence services, received a top security clearance, took courses until December 6, 1962 (the nature of which he could not disclose because they were of a "highly confidential nature"), and received an honorable discharge on January 18, 1963. Then follows a list of various jobs held in California and later in Pennsylvania, (six altogether) mostly as a "general office worker"; at present he is "chief inventory controller in a Motion Picture Laboratory" where he has received "several healthy pay increases." After drifting around, he feels that "perhaps at last, I have found a place worthy of my talent for settling down in." All six jobs were described in great detail, giving dates, description of responsibilities, names and telephone numbers of supervisors, and reasons for leaving the jobs. Generally speaking, "I have never been dismissed from any place of employment because of any working habits or lack of working habits."

The letter addressed "To Whom It May Concern," starts as follows:

I am writing this resume with the intention of giving any person who would wish it a lucid account of my life, educational and working background, and experiences. I am 6 feet tall, weigh 145 pounds, have medium brown hair and hazel blue eyes. I am in excellent health with no history of any severe illnesses or injuries. I have an automobile and a permanent residence. I am also draft exempt and have no criminal record of any kind.

Elsewhere he writes:

As for my future, I have absolutely no worries whatsoever. I live each day as though it were my last, and let the devil take tomorrow... I am 28 years old and single (though several girls I know had hoped to change that) with no desire to get tied down for a good long time... I neither smoke nor drink but I do have an uncontrollable urge to gamble. (We all have to have a few bad habits.)

The letter is concluded as follows:

For as long as I live, I shall always remember you, Dr. Kanner, and how you have opened many doors for me. I cannot thank you enough for the limitless kindness you have shown me while rekindling the spark of living within me that had nearly died so very long ago.

Case 6

George W., born February 27, 1944, was first seen on January 11, 1951. His mother complained:

Although he has talked clearly, using big words and sentences since he was 18 months old, he still had never spoken with us — that is, carry on a conversation or even answer simple yes and no questions. He lives completely in a world of his own. As an infant he had not smiled like other children. At 2 years, he knew the alphabet and numbers. He never used the first person in speaking.

George was born 5 weeks past term, weighing 8 pounds at birth. He was on a rigid schedule and was awakened for feedings. His first words were spoken at 13 months, he walked alone at 18 months, and bowel control was established at 18 months; bed wetting continued until the age of 6 years. Gross motor development was described as poor and fine motor coordination as good; he could open and close a safety pin and replace the top on a toothpaste tube.

The boy's father, of Spanish (Latin American) descent, was a civil engineer who went into the armed services when George was 6 months old; he was away for about 2 years. On his return, he "had difficulty relating to George" and "kept looking for a physical (glandular) cause of George's problems."

The boy's mother had 3 years of college. "Intellectual pursuits" were important to her and she started George very early with letters and numbers. The case history is full of her expressions of conflicts with her father — fear of his displeasure and resentment of his domination. She blamed herself for anything that went wrong with George, at the same time hoping for some quick, miraculous cure. When the child was about 4 years old, she resorted to drinking for several years until she joined Alcoholics Anonymous.

Because George was not able to get along in kindergarten, he was referred to the Clinic where he developed a tenuous relationship with his therapist. He echoed things he heard, repeated names that came over the hospital's loud speaker, and used many neologisms. Also, he was preoccupied with traffic lights and with elevators.

At the age of 9, George was admitted to a center for emotionally disturbed children where he remained for 6 years. While there, he had many consuming obsessions, mainly focused on mechanical devices (plumbing, lighting), travel, map making, and physical health (he washed many times a day because of his fear of germs). These preoccupations gradually subsided and he became more interested in group activities, regressing occasionally, usually in association with changes in personnel. However, he did fairly well with his school assignments.

At the age 'of 15, George returned home and entered in public school in a "slow" sixth grade where "with encouragement but not much pressure" he was able to do the work. His teacher reported:

He conforms to rules and regulations as well as any immature sixth grade child. He plays the violin well, he appears to enjoy the company of his classmates, he is quite friendly and likes to joke. He is particularly fond of poems and plays on words.

George's mother took him out of school when he was in the eleventh grade so that he could concentrate on music. He had played violin in a number of youth orchestras and took courses at a prominent Conservatory. Concerned about not getting a high school diploma, George has, in recent years, spent much of his time subscribing to correspondence courses. He is especially interested in languages, having learned Spanish in school, teaching himself French, and having "a working knowledge" of Italian. At present George is employed as a page in a library and is also in charge of mailing books (mostly to foreign countries).

George lives with his parents. He is helpful with chores at home (to make things easier for his mother who describes him as "dependable") but has no friends and "girls are not interested in him." His major preoccupation now is an overconcern about pleasing people: "He is not relaxed and afraid of doing wrong."

Case 7

Walter P., born June 16, 1944, was first seen on July 8, 1952. He had seemed normal until he was about 3-1/2 years old when his mother noted that his speech was not progressing, he had become unusually quiet (sitting for long periods looking aimlessly around), and finally had just about stopped talking altogether. The child became unduly interested in spinning tops and other toys, was upset when things were moved from their accustomed positions, paid little attention to the people in his environment, and was slow in responding to being called.

Walter's parents gave the impression of being sociable, well-adjusted people. The father had 2 years of college and worked as an ordinance engineer for the federal government. He was able to give more specific and accurate information about the child than his wife. The mother also had 2 years of college and worked in a bank to provide money for the child's care and treatment. Both parents emphasized the harmony of their relationship. A brother, 3 years older than Walter, was getting along well.

Walter was born at term. At 3 weeks, he developed pyloric stenosis which was relieved by an operation from which he recovered uneventfully. There were no feeding problems. The boy began to talk at 2-1/2 years of age and was fully toilet trained by age 3 without any apparent difficulty or conflict.

When seen at the Clinic, Walter was an attractive child who cooperated in a stiff, automatic way. While he did not relate to the examiner, looking vaguely out of the window and responding only to the simplest questions, he immediately placed all the pieces in the Seguin formboard. The boy would respond to "What is your name?," "How old are you?," "Sit in the chair," but would not cooperate in any verbal tests. His behavior was repetitious, obsessive, and withdrawn.

At 9 years, Walter was still obsessive, used little speech but had progressed some in "play school," he had learned to copy and to spell some words, and was very destructive with anything chipped or broken.

At 10, the child's mother reported that he was "progressing well." Walter attended a school for retarded children, was learning to write and to do simple arithmetic, seeming to enjoy it, but reading was causing him some trouble. Also he was playing and talking better with other children and could give simple messages over the telephone (he was able to say what he wanted). The boy had a variety of rituals, first, tapping his chin until it was red, and later, rubbing his eyes. His mother found him a "lovable little boy" who behaved well when they took him out.

Arrangements were made with a psychiatric clinic near his home for follow-up consultations.

In 1971, the mother gave this follow-up report:

Walter attended a boarding school for exceptional children from 1956 to 1962, coming home on weekends, and then lived with her (his father had died). For 2 years, he attended a day school and then worked for a short time in a sheltered workshop. "Since June 1968, he has worked at a small restaurant as a dishwasher and bus boy, earning $1.25 an hour. He seems to enjoy his work, has pleased his employers, and has never missed a day. He is a handsome young man, takes complete care of himself and of his room, and is neat and clean at all times. There are no behavior problems. He helps with the housework and takes care of the yard, including complete care of the power mower. His main difficulty always is in communication. What he says, he says well and in a fairly clear manner, but there is no voluntary conversation. Walter talks enough to make his wishes known, will answer the phone and tell me who is calling, but when I am not home, unless I ask him, he will not tell me if someone called.

Case 8

Bernard S., born August 3, 1949, was first seen on June 7, 1952. He was referred by the nursery school which he attended. His teachers reported that he seemed "more alone than most children" and that he was "in the school but not a part of it." The child showed some bizarre behavior and echolalia. He referred to himself in the third person and often had a smile on his face which was unrelated to anything obvious to the onlooker.

Bernard's father was a pharmacist who spent long hours in his drug store. His mother had manic-depressive episodes and had been hospitalized for a few months 9 years before Bernard was born. She did not become pregnant until 14 years after her marriage, which came as a "delightful surprise."

Very soon after Bernard's birth, his mother became ill again and was hospitalized for over a year during which time Bernard was cared for by a nurse in her home. When the mother took him back, Bernard was 15 months old and was walking "but not feeding himself." The mother, was a perfectionist, especially about his eating. She continued to have mood swings and was under the care of a psychiatrist.

The parents separated when Bernard was about 2-1/2 years old. Six months later, the mother disappeared with the child to Florida. The father fetched him back, and placed Bernard with a paternal aunt. One of the nursery school teachers who visited at the time, described the boy as relaxed and happy with his aunt: "For the first time, I heard him speak quite volubly." The aunt did not return him to the nursery school as she wanted him to remain at her home "where he could get some much-needed love and attention, so that he could feel someone really cared for him." The parents came back to live together again and took Bernard home. He was reentered in the nursery school at 4 years of age. The boy had a good memory; he knew the names of all the children in the school and noted who was absent before the teacher did. However, he could be brought into group activities for only very brief times. In the neighborhood, he stayed in the house because the children would not play with him and called him "that crazy kid." Their attitude improved when he bribed them with cookies.

The father gave a follow-up report when Bernard was 20 years old:

He had graduated from high school at 19 and was struggling with junior college in a general course. His marks had been mediocre. He is not the studying type, seeking a job and a simple uncomplicated life. He lost 2 years of school in shifting around. One year he spent in a "progressive" boarding school, but that proved to be "more of a hippie colony" and his work was poor. The mother died while he was there and then he did not want to go back. After the paternal aunt who had cared for him as a small child came to live with them following her husband's death. Bernard showed marked improvement.

The father remarried in 1968 and Bernard got along well with his stepmother. He had had "no real psychiatric treatment."

Bernard is "backward and shy but that is the way he is." He did approach a girl once for a date in a very negative manner. He hates clothes, drives a car, does best if not pressured and helped his father in the drug store (he did not wait on customers but would fill the shelves). His chief interest is the streetcar museum. He is a member of a club that goes there on Sundays, laying track, painting cars, etc. They take trips. He used to like history, is up on world politics, and reads the newspapers.

Case 9

Fred G., born December 11, 1948, was first seen on August 11, 1952. His parents gave a history of difficulties dating from colic for 6 weeks after birth. He was carried around constantly by members of the family; when the colic subsided, he continued to demand attention. A practical nurse handled this by letting him "cry it out." At 3 months, the child was taken to visit his grandmother and placed unceremoniously into her arms on arrival. He reacted with terror, screaming for the 3 weeks, and since then had a great fear of strangers.

In spite of Fred's ability to go through some of the motions of the Binet test, it was not possible to get his full cooperation. He placed the small formboard figures. When asked to match forms, he named them first. He ignored people in the room and repeated questions rather than answer them.

Fred was born by Ceasarean section, walked at 14 months, and began to talk at one year. His speech was good and he had a large vocabulary but would not use the first person and repeated a phrase rather than say "Yes." Weaning from the bottle was difficult and slow, and there was also conflict over bowel training.

At home, he was preoccupied with music, being able to recognize records just by looking at them when he was 3 years old. He could identify compositions after hearing them by saying: "That's the Moldau," "That's Beethoven's Fifth," etc. Six months before coming to the Clinic, he had been sent to a nursery school where he was fearful of the children. After his mother stayed with him several days, he calmed down but ignored everyone, refused to participate in any form of group activity, and "was just there." The mother said that "at home there could not be a better child." "He likes to be by himself," she added. He would go into rages over inanimate objects that would not do just as he wished.

The father, who wanted to be a physician, took up a related course of study because family finances did not allow him to go through medical school. After 3 years, he abandoned it for government work involving secret documents and assignments. The mother, a college graduate, had taught school several years and quit a year before Fred's birth. She came from "a family of pushers" and had great intellectual drive. The woman expressed a fear that she might be blamed for the child's difficulties. There seemed to be no particular domestic problems. The home atmosphere was one of emphasis on such cultural pursuits as music and intellectual discussion.

For approximately 2-1/2 years, from 1952 to 1955, Fred regularly attended a day care center for emotionally disturbed children. He formed an attachment to the director and saw her often in the years that followed.

When tested at 16 years, he was found to have a full scale WISC IQ of 118 (verbal 126 and performance 104). His arithmetic score was at the ceiling with quick answers on the tests, and comprehension, similarities and rote memory were rated as being of high average. On the Rorschach, he showed "sharp alterations between impulsivity and repression" and "a struggle between feelings of relationship and isolation."

At 23 years of age, Fred is doing well at a university where he has a B plus average and is gifted in mathematics. He has adjusted well in college life and his schoolmates respect his academic prowess. The young man has sloughed off his obsessive preoccupations. For instance, he dresses well but is not as compulsive about clothes as he used to be.

Though described as "awkward and intellectual," he tries, at least on the surface, to take part in the concerns which he knows should be those for his age, even "experimenting" once with a double date arrangement (not repeated). Fred drives a car skillfully, with full knowledge of all the parts, and in his spare time has done some composing and built a telescope.

Until his first year in College, Fred had always lived with his parents. After some hesitation, particularly by the father, they supported his decision to move to a dormitory.

DISCUSSION

Now that 29 years have elapsed since the identification of early infantile autism, the children so diagnosed in the first decade of its recognized existence have reached adulthood. Despite considerable mobility of some of the families, it has been possible to learn about the patients' present status. The first of an anticipated series of follow-ups appeared last year as a report of the destinies of the eleven children whose condition had suggested and crystallized the specific syndrome (Kanner, 1943, 1971). Altogether, 96 patients had been designated as autistic before 1953 at our Clinic, the "birthplace" of the syndrome. Of this number we have selected those now capable of functioning in society. Besides the two presented in 1971, (Donald T. and Frederick W.), we have sketched the biographies of nine such persons (one female and eight males), currently ranging in age between 22 and 35 years. The nosological criteria, set down in 1943, had been uniformly applied to all 96 children.

The value of catamnesis has been sensed for quite some time. As far back as the early 1940's, Cottington (1942) compared the results of shock treatment, psychotherapy and socialization of a few psychotic children, none older than 14 years. Lourie, Pacella, and Piotrowski (1943) in a review of 20 children "with schizophrenic-like psychoses," saw three types of "adjustment": (1) Apparently normal (4 cases); (2) fair to borderline (5 cases); and (3) low grade (11 cases). These reports were pioneering innovations at a time when interest was centered mainly on description and speculation about etiology. However, they dealt with categories rather than individuals, whose subsequent fate after childhood or at most the early teens has remained unknown.

Continuous curiosity about the patients' progress has always been one of the primary concerns of our Clinic (Kanner, 1937a, 1937b). Names, symptoms, diagnoses, and any other relevant items were cross-indexed for all. Since, except or our own communications, early infantile autism did not enter the public arena until about 1950, our Clinic saw itself as a quasi ex-officio archive for all that pertained to the syndrome, to be kept in flux and added to as time went on. This gave helpful information for a study (Kanner & Eisenberg, 1955) which comprised children with an average age of 14 years and yielded one finding of potential predictive value:

The prognosis has shown to vary significantly with the presence of useful speech at the age of 5 years, taken as an index of the severity of autistic isolation.

Many are now in their 20's and 30's; all but two of them were available for "check-ups" in 1971. Their biographic profiles are — and will continue to be — a part of the "archive" and have aided us in picking out those who have gone farthest in terms of social adjustment.

Eleven autistic children (9 in this series plus Donald T. and Frederick W. reported in 1971) have emerged sufficiently to function as adults in varying degrees of nonpsychotic activity. Three have college degrees, three had a junior college education, one is now doing well in college, one graduated from high school, one passed the eleventh grade, one went to a private "boarding school for exceptional children," and one received vocational training in a sheltered workshop.

Their present occupations are bank teller, laboratory technician, duplicating machine operator, accountant, "blue collar job" at an agricultural research station, general office worker, page in the foreign language section of a library, bus boy in a restaurant, truck loading supervisor, helper in a drug store, and college student. Two (Thomas G. and Henry C.) had enlisted and been accepted by the armed services but were "honorably discharged" within a year.

What distinguishes them from those who, remaining wholly isolated, did not make the linkage with society? In comparing the two groups, no difference could be found with regard to ethnic origin, family characteristics, or specific intercurrent events. Nor is there anything in the features of physical health that stand out as a contrast, though Thomas G. began to experience convulsions after his twentieth year. (3)

We did, however, find a number of items which were shared by the patients who form the nucleus of this study. They have to do with a variety of maturational and environmental issues and with the patients' type of reactions to the growing awareness of their peculiarities.

All of them used some speech before the age of 5 years. This in itself cannot be taken as an all-valid prognostic sign because many who had done likewise have failed to reach a similar degree of emergence. What characterizes our group is a steady succession of stages: No initiative or response — immediate parroting — delayed echolalia with pronominal reversals — utterances related to obsessive preoccupations — communicative dialogue with the proper use of personal pronouns and greater flexibility in the use of prepositions.

Not one of them had at any time been subjected to sojourn in a state hospital or institution for the feebleminded. This seems to be significant in view of our experience that such an eventuality has invariably cut short any prospect for improvement (Kanner, 1965). All of our eleven patients here considered have remained at home at least before school age and some quite a few years longer. Three still live with their families, the others — whether in foster homes or boarding schools — had regular contact with their relatives. However, many other autistic children who stayed at home did not advance as those eleven did.

One recurrent theme, though, could be noted as specific for our group in clear contrast with the non-emerging autistic children: a chronicle of gradual changes of self-concept and reactions to them along the road to social adaptation.

In the first few years of life, there was in this respect no difference between any of our 96 patients now over 20 years old. Their isolation with all its corollaries — neither chosen nor imposed from without — was a form of existence which was had, lived, experienced rather than contemplated or reacted to. It was part of an innate illness not perceived as such by the ill child who was contentedly (though pathologically) "adjusted" unless threatened by external interference with the status quo. There was a minimum of centrifugal reaching out and a minimal response to centripetal incursions. As time went on, some of the incursions began to be tolerated in varying degrees. Unless they became too overwhelming and the child was pushed, back into self-incapsulation until his status was barely distinguishable from extreme mental retardation, he was making compromises to the extent of verbal interplay, demanding parental assistance with his rituals, falling in line with I-You identification, superficially going through the symbolic acts of shaking hands, hugging and kissing, and generally yielding to the rudiments of domestication. This carried over to nursery school and kindergarten, at least in terms of joining mechanically in routine activities, first on invitation and then more or less spontaneously.

Our eleven children went through the same stages. It was not until the early to middle teens when a remarkable change took place. Unlike most other autistic children, they became uneasily aware of their peculiarities and began to make a conscious effort to do something about them. This effort increased as they grew older. They "knew," for instance, that youngsters were expected to have friends. Realizing their inability to form a genuine buddy-buddy relationship, they — one is almost tempted to say, ingeniously — made use of the gains made by their obsessive preoccupations to open a door for contact.

Thomas G. joined the Boy Scouts and found recognition by teaching astronomy and playing the piano; he also joined a swimming and athletic club. Sally S. utilized her good memory, of which she was fully aware, to merit acceptance in high school and college; when she failed as a student nurse because the maintenance of a genuine relationship with the patients was beyond her capacity, she became a laboratory technician and has made a reputation for "excelling in chemistry." Edward F. enjoys an active social life belonging to hiking clubs, and his knowledge of plants and wild life brings him respect. Clarence B. "obsessively tries to make social contacts; he is awkward socially but can make a superficial adjustment." Henry C. enlisted in the Army, had several well-paying jobs and "has an uncontrollable urge to gamble." George W. is "over-concerned about pleasing people." Walter P. satisfies his social needs as bus boy in a restaurant and "pleases his employers." Bernard S. is a member of a street car museum where he lays tracks, paints cars, and goes on trips. Fred G. is respected by his schoolmates because of his academic prowess.

Again and again we note a felt need to grope for ways to compensate for the. lack of inherent sociability. Out of this developed a paradoxical use of the previously self-serving, isolating obsessions which instead come to serve positively as a connecting link with groups of people.

The contacts thus established led to the discovery that the boy-meets-girl issue was paramount in the talks of the companions. Again, there was a vaguely felt obligation to "conform." Those attempts were sporadic and short-lived. The "explanations" offered indicated that there was not too much displeasure with the absence of any real involvement.

Henry C. reported that he was single, that several girls "had hoped to change that" but that he had "no desire to get tied down for a good long time." Thomas G. declared categorically that girls "cost too much money." Clarence B., who "socialized" with a girl for a short time in college, stated that he "ought to get married but can't waste money on a girl who is not serious." Bernard S. was said to have approached a girl once for a date "in a very negative way" (inviting rebuff). Fred G. "experimented" once with a double date arrangement (never repeated).

George W. made things easy for himself by deciding a priori that girls were not interested in him. Sally S., the only girl in our group, once asked seriously at 23 years of age what she ought to do if ever she fell in love with someone, an experience she had never had before. She said: "I have never had the interest in boys most girls my age have." At 30 years, she dated a man for a few months but gave this up because she was "frightened by any intimacy."

COMMENT

On the basis of the recorded and discussed observations, the question raised in the title of this paper can be answered with reasonable certainty. Not counting the gifted student of mathematics killed accidentally and the young man whom we have so far lost track after 1962 when he was in college, eleven of the 96 autistic children known to our Clinic since before 1953 are now in their twenties and thirties, mingling, working, and maintaining themselves in society. They have not completely shed the fundamental personality structure of early infantile autism but, with increasing self-assessment in their middle to late teens, they expended considerable effort to fit themselves — dutifully, as it were — to what they came to perceive as commonly expected obligations. They made the compromise of being, yet not appearing, alone and discovered means of interaction by joining groups in which they could make use of their preoccupations, previously immured in self-limited stereotypies, as shared "hobbies" in the company of others. In the club to which they "belonged," they received — and enjoyed — the recognition earned by the detailed knowledge they had stored up in years of obsessive rumination of specific topics (music, mathematics, history, chemistry, astronomy, wild life, foreign languages, etc.). Reward came to them also from their employers who (as confirmed in statements sent to us) remarked on their meticulousness and trustworthiness. Life among people thus lost its former menacing aspects. Nobody has shoved them forcibly through a gate which. others had tried to unlock for them; it was they who, at first timidly and experimentally, then more resolutely, paved their way to it and walked through. Once inside, they adopted some of the values they found there. Material possession became an object of ambition. Those who are not with their families (eight of the eleven) live by themselves; one (Thomas G.) even owns a house which he bought several years ago. All drive automobiles and there is no record of accidents or traffic violations.

There have been equally duty-bound, though haphazardly pursued attempts to form personal friendships. These were far less successful. Failure apparently was not met with major frustration, self-reproach or accusation of others. There even was a sense of relief in matters of dating; ready rationalizations were: "a waste of money," "cost too much,"; Sally had a dread of "intimacy," Henry did not feel like being tied for a long time. No one in the group has seriously thought of, or is now contemplating, marriage.

This, then, is the profile of eleven autistic children, now adults, whose social adaptation does not run counter to the general run of the populace. It differs essentially from that of at least 83 of the 96 other autistic children in the series. Fascinating as it is, it does not offer a definite clue for the cause of the difference. The presence of speech before the age of 5 years and the fact of being kept out of state institutions are helpful hints but, being shared with some of the non-emerging children, they can only be viewed at best as straws in the wind pointing to prognostic probabilities.

Hence, at least for the time being, there is no alternative to the idea expressed at the close of our 1971 follow-up: "It is well known in medicine that any illness may appear in different degrees of severity, all the way from the so-called formes frustes to the most fulminant manifestation. Does this possibly apply also to early infantile autism"?

It must be kept in mind that our "emergers" grew up in the days before the introduction of therapeutic techniques especially intended to remedy. the autistic illness, be they based on circumscribed psychotherapeutic, psycho-pharmacological, or behavioristic orientation. Would any of those have in any way altered the outlook for our 96 children? Will any of those increase the ratio of "emergers" in the future? What can we make of the fact, documented in this study, that almost 11 to 12 percent "got there" without any of those techniques? Now that a number of state hospitals have divisions for the personalized care and treatment of children, can we look upon admission of autistic patients to them with better expectations than' before? Will the biochemical research now vigorously under way uncover early indications pointing to prognostically reliable assessments of the degree of severity of the autistic illness?

All these are justifiable curiosities with' important practical implications. It will take time to satisfy them. Continual follow-up or even better follow-along, will — as we hope that this study does — prove in the long run to be of great importance. Our astute readers have undoubtedly noticed that this paper is being presented with a twofold purpose. One is, of course, patently announced in its title. The other, more implicit aim is an attempt to set up a sample for follow-along and follow-up studies hopefully to be conducted in clinical and research centers as the intervals between childhood and adulthood of autistic patients keep lengthening.

(1) Requests for reprints should be sent to Dr. Alejandro Rodriguez, The Johns Hopkins Hospital, Division of Child Psychiatry, CMSC335, 601 North Broadway, Baltimore, Maryland 21205.
(2) For the sake of accuracy, we must point out that we have so far been unable to trace the whereabouts of one patient since 1962, at which time he was doing exceptionally well in college; we have not given up the search but cannot include him in this report. Another patient, who excelled in mathematical physics on a scholarship at Columbia University, might well have figured in our account had he not been run over by a truck on New York's Broadway and killed several years ago.
(3) The onset of epileptic phenomena is not too uncommon in the lives of autistic persons. even when earlier EEG's had shown no abnormalities.

REFERENCES

Cottington, F. Treatment of schizophrenia in childhood. Nervous Child, 1942, 1, 172-187.
Kanner, L. Problem children growing up. American Journal of Psychiatry, 1937, 94 691-699. (a)
Kanner, L. Prognosis in child psychiatry. Archives of Neurology and Psychiatry, 1937, 37, 922-928. (b)
Kanner, L. Autistic disturbances of affective contact. Nervous Child, 1943, 2, 217-250.
Kanner, L. Children in state hospitals. American Journal of Psychiatry, 1965, 121, 925-927.
Kanner, L. Follow-up study of eleven autistic children originally reported in 1943. Journal of Autism and Childhood Schizophrenia, 1971, 1, 119-145. Kanner, L., & Eisenberg, L. Notes on the follow-up studies of autistic children. In P. H. Hoch and J. Zubin (Eds.), Psychopathology of childhood. New York: Grune & Stratton, 1955.
Lourie, R. S., Pacella, B. L., & Piotrowski, Z. A. Studies on the prognosis in schizophrenic-like psychoses in children. American Journal of Psychiatry, 1943, 99, 542-552.

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