Tribute to Grunya Efimovna Sukhareva, the Woman who First Described Infantile Autism

Dear Sir,

More than 20 years have passed since the release of the English translation of the original paper by Grunya Efimovna Sukhareva (Kiev, 1891–Moscow, 1981) entitled “Die schizoiden Psychopathien im Kindesalter,”[1] but the international literature on autism has not yet given the right acknowledgment to this child psychiatrist who remains still unknown to many authors.

According to the official history of autism, the first descriptions of individuals, who today we would diagnose as having autism spectrum disorder (ASD), respectively, date from the work of Leo Kanner and of Hans Asperger. In 1943, Kanner, an American child psychiatrist of Austrian-Hungarian origin, described a clinical picture in 11 children that later has been considered the classical early infantile autism.[2] In 1944, Hans Asperger, an Austrian pediatrician, described “autistic psychopathy”[3] in four boys that, many years later, took the name “Asperger syndrome,” finding a full acknowledgment in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (1994).[4]

However, already in 1926, Grunya Efimovna Sukhareva (surname sometimes transliterated as “Ssucharewa” from Cyrillic), who was then active in the Union of Soviet Socialist Republics, had described six boys presenting with a clinical picture that, as for the clinical features and evolution, is fully compatible, according to the modern criteria, with ASD and that today we would call “high functioning.” The description of these cases is of an amazing precision and modernity: just think of the fact, for example, that Grunya Efimovna Sukhareva emphasized the importance of the presence of sensory abnormalities, which only recently regained their proper weight in the description of ASD in the DSM-5.[5] Despite all these, the work of Sukhareva remains even today a kind of curiosity and it is only sporadically cited in literature.[6] The misfortune of Sukhareva probably lies in the fact that her description was released in a journal (the “Monatsschrift für Psychiatrie und Neurologie”) that at least at that time did not have a diffusion so as to allow a unanimous recognition among scientists. We do not know if Kanner was aware of Sukhareva's work when he wrote his article in 1943; we know that then, in 1949, in the article entitled “Problems of nosology and psychodynamics of early infantile autism,”7 he cited another paper by Sukhareva published in 1932, so obviously he was aware of her existence, but this does not mean that he in 1943 was inspired by Sukhareva's work.

Of course, today, we know that ASDs are more complicated than the original description given by Sukhareva (we know, for example, that an intellectual disability, which can be severe or profound, is often associated with ASD), but denying the originality and the accuracy of her report, more than 90 years after its release, would be a historic mistake, which we hope will be not perpetual.

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