Itard's 1828 mémoire on "Mutism caused by a lesion of the intellectual functions": a historical analysis

Abstract

Objective: To demonstrate that Itard was one of the first clinicians to describe autism (which Itard named "intellectual mutism") and effectively separate these cases from mental retardation. Known for his attempts at rehabilitation of the Wild Boy of Aveyron, Itard wrote a largely unacknowledged paper in 1828 on the different causes of "intellectual mutism," the result of 28 years of observations at the Institut des Sourd-Muets in Paris.

Method: Itard emphasized a complete examination of the child's faculties including attention, memory, and imitative capacity. He also described the behavior of these children as unsocialized, with poor peer relationships, superficial contact with adults in order to satisfy their own needs, and difficulties in language, especially with pronouns.

Results: He then described his various diagnostic and treatment approaches to determine whether the child can regain language and is educable. His description of the key features of intellectual mutism is compared to Kanner's classic description of autism.

Conclusion: Itard rejected the overly inclusive diagnosis of "idiocy" and offered a way to distinguish children with mental retardation from those with pervasive developmental disorders, described key clinical features, and offered an assessment and treatment of these cases, all before 1830. His contribution should be recognized in textbooks of child psychiatry and developmental disorders.