The term, Broader Autism Phenotype (BAP), is not a diagnosis. Instead, it’s used to refer to sub-diagnostic traits of autism in family members of those with the condition. Symptoms can include:

• Minor impairments in socialization and communication
• Obsessive, rigid, or inflexible behaviors
• Problems with anxiety or depression

Although research into BAP really only started to take off in the 1990s, the study of it is as old as the study of autism itself.

Leo Kanner.

The psychiatrist and father of autism, Leo Kanner, was a phenomenal observer of human behavior. Not only did he provide intimate detail of each of the autistic children he studied, he also provided background on the children’s parents, their siblings, and often times even their grandparents, aunts, and uncles.

It has been acknowledged that Kanner’s early cases presented with a certain level of ascertainment bias, in that it was typically white, well-educated families who were able to seek help from Kanner in the first place. In fact, quite a few of the parents were either psychiatrists or psychologists themselves who already knew of Kanner in a professional capacity and so one might mistakenly assume that in the 1940s there was a rash of autism occurrences in families of psychiatrists!

Nevertheless, in spite of that bias, we do know nowadays that BAP occurs at an unexpectedly high rate in family members of those with autism and is especially prominent in multiple incidence families in which two or more children are on the spectrum [1]. Given that scientists (as opposed to those educated in the humanities) tend to score higher on the Autism Quotient (AQ), the higher occurrence of BAP amongst psychiatrists in Kanner’s day is hardly surprising [2].

Kanner’s 11 Families

Below are descriptions of the families of each of Kanner’s original 11 case studies. Details have been drawn exclusively from Kanner’s original manuscript, “Autistic Disturbances of Affective Contact” published in 1943.

Case No. 1: Donald T.

According to Kanner, Donald’s father was a “successful, meticulous, hard-working lawyer” who was prone to occasional nervous breakdowns under strain of work. Donald’s mother said of her husband, “When he walks down the street, he is so absorbed in thinking that he sees nothing and nobody and cannot remember anything about the walk.” The mother was described as “calm” and “capable” and was a college graduate.

Case No. 2: Frederick W.

It appears that Frederick’s family was rife with intellectual oddballs. His father was a plant pathologist who traveled extensively for his work. Kanner described him as a “patient, even-tempered man, mildly obsessive” who himself was speech-delayed as a child. And a recurring theme amongst the mothers of Kanner’s kids, Frederick’s mother was also a college graduate.

Frederick’s paternal grandfather had a varied background, described as a “genius type.” He “organized medical missions in Africa, studied tropical medicine in England, became an authority on manganese mining in Brazil, was at the same time dean of a medical school and director of an art museum . . . and is listed in Who’s Who under two different names.” He disappeared to Europe, abandoning his family, where he subsequently married a novelist.

Frederick’s aunt and uncles all had extensive intellectual and creative backgrounds. In addition, one uncle in particular didn’t speak until he was six years of age, his first words being, “When a lion can’t talk he can whistle.”

Case No. 3: Richard M.

Richard’s father was a professor of forestry, almost completely immersed in his work at the expense of social relationships. Meanwhile, his mother had a college degree and is described by Kanner as being prone to obsessiveness. Her father was a physician and the remainder of her family, and her husband’s family, is described as consisting of intelligent professionals. Richard’s younger brother is described as a “normal, well developed child.”

Case No. 4: Paul G.

There is little information provided on Paul’s parents, except that Kanner reports his father was a mining engineer and that his mother, a college graduate, was a “restless, unstable, excitable woman.”

Case No. 5: Barbara K.

Like several of the children in Kanner’s original group, Barbara’s father was a psychiatrist and her mother well educated. Her younger brother is described as “healthy, alert, and well developed.”

Case No. 6: Virginia S.

Sadly, it is probably the parents of Virginia who are most responsible for the inspiration of the Refrigerator Mother Theory of Autism. While Kanner said nothing of the sort in his original manuscript, it is clear according to his descriptions that Virginia’s parents fit the theory to a “T.”

Virginia’s father was a psychiatrist and is reported to have said of himself, “I have never liked children, probably a reaction on my part to the restraint from movement (travel), the minor interruptions and commotions.”

Meanwhile the husband described his wife as ” . . . not by any means the mother type. Her attitude [toward a child] is more like toward a doll or pet than anything else.”

Virginia’s older brother experienced severe stuttering at the age of 15 and, upon interview, said of his father whilst sobbing, “The only time my father has ever had anything to do with me was when he scolded me for doing something wrong.” Kanner reports that the young man had “felt that all his life he had lived in a ‘frosty atmosphere’ with two inapproachable strangers.”

Case No. 7: Herbert B.

Herbert’s father, like so many others, was a psychiatrist and was described by Kanner as “a man of unusual intelligence, sensitive, restless, introspective, taking himself very seriously, not interested in people, mostly living within himself, at times alcoholic.”

Herbert’s mother, meanwhile, was a physician and described herself as “energetic and outgoing, fond of people and children but having little insight into their problems, finding it a great deal easier to accept people rather than try to understand them.”

Herbert’s older sister is described as experiencing a plateau in sociocommunication skills at 18 months of age, initially diagnosed with intellectual disability (termed “feeblemindedness” in the day), later as schizophrenic, but she eventually gained enough skills and was able to attend school.

Case No. 8: Alfred L.

Alfred’s father was a chemist and a law school graduate. He was described as “. . . not [getting] along with people, is suspicious, easily hurt, easily roused to anger, has to be dragged out to visit friends, spends his spare time reading, gardening, and fishing.”

Alfred’s mother was an obsessive and excitable clinical psychologist. Likewise, her father was a psychologist, “was severely obsessive, had numerous tics, was given to ‘repeated hand washing, protracted thinking along one line, fear of being alone, cardiac fears.'” Meanwhile, her mother had published several books, performed public speaking, and was incessantly worried over money.

Case 9: Charles N.

While Charles’ father and his paternal relatives were all described as “ordinary simple people,” his mother’s side of the family was markedly more eccentric. His mother had a successful theatrical booking office in New York; her mother was an amateur writer and composer; a sister was also a poet and songwriter; and a brother was a psychiatrist and musician.

Case No. 10: John F.

John’s father was also a psychiatrist, described as a “very calm, placid, emotionally stable person, who is the soothing element in the family.” John’s mother worked as a secretary to a pathology laboratory prior to marriage and was a very nervous, apprehensive woman. John’s paternal grandmother was “obsessive about religion and [washed] her hands every few minutes.”

Case No. 11: Elaine C.

Elaine’s father studied law and liberal arts at three different universities, including the Sorbonne, and at the time of the first interviews was an advertising copy writer, although had previously been a magazine editor. He was described as “one of those chronically thin persons, nervous energy readily expended.”

Elaine’s mother had also done some editorial work for a magazine prior to marriage, and her father had been a newspaper editor; meanwhile, her mother was described as “emotionally unstable.”

BAP in the Families

In spite of the ascertainment bias discussed above, the Broader Autism Phenotype is apparent in Kanner’s original families by means of career selection (doctors, scientists, etc.); the level of education of both the fathers and mothers as well as the extended family; the social challenges of some of the parents (e.g., a tendency towards asociality); a propensity for obsessive-compulsiveness, anxiety, and occasionally depression; and general eccentricity and other features associated with high intelligence.

While the literature has often accentuated the romantic side of BAP, such as high intelligence, advanced education, and successful careers in science and technology– individuals with features of BAP can also experience notable challenges. And though they may not meet the diagnostic cut-off for autism, sociocommunication difficulties, obsessive-compulsiveness, anxiety, and depression can still present significant obstacles to personal success and happiness.

It’s individuals like these that therefore make one wonder where does autism end and normality begin?