In the winter of 1938, a group of Jewish doctors and therapists fled Vienna, reassembled in northern Scotland, and founded an intentional community for the care of children with disabilities called Camphill Special School. In an era when shame, blame, and institutionalization were the response to disability, they founded Camphill on the principle that disabled children could enrich communities and that doctors should abandon the search for cures. Their radical position was rooted in their unusual approach to medicine. They were followers of the Austrian occult philosopher, Rudolf Steiner, whose philosophy, called Anthroposophy, spawned alternative medical, educational, and agricultural movements. In spite of these unorthodox credentials, Camphill soon grew into an international movement; there are over 100 communities around the world today. Though the Camphill movement is now headquartered in the US, I argue that its roots as a Central European medical subculture remain definitive today. The movement originated in the era of eugenics and as Douglas Baynton has noted, eugenicist concerns about disability were inseparable from concerns about race. In fact, German racial thinking structured the founders’ thinking about ability and disability. I use writings by the founders and oral history interviews with older community members to reconstruct and analyze Camphill’s unusual approach to disability. In the process, I shed light on current historiographic discussions about the roots of the disability rights movement and the ways in which countercultural thinkers, movements, and communities have forged diverse and sometimes uncomfortable alliances among people with common concerns about health.

In 1967, Clara Claiborne Park published The Siege: The First Eight Years of an Autistic Child, her memoir tracing the experiences of symptoms, diagnosis, treatments, uncertainty, and advocacy that became the dominant narrative of parenting a child with autism. The Siege initiated the genre of parent memoirs of autistic children, building upon an existing literature of parent memoirs of children with disabilities, most notably Down syndrome. For autism and Down syndrome, parent memoirs served as a site for the construction of imagined communities of the afflicted, using the imagery and narratives that parents created in these works to shape the meaning of these disorders along with the identity of parents as caretakers, advocates, and experts on behalf of their children. 

Using parent memoirs along with medical literature, archival research, and oral history, this paper will argue that the imagined community surrounding autism used parent memoirs to construct the disorder in opposition to Down syndrome, shaping autism’s ability to replace Down syndrome as the paradigmatic childhood disability of note. The tropes of the autism spectrum as established and reified by parent memoirs capitalized on the opportunities for autism’s ascendance offered by changing diagnostic criteria, medical research, and cultural controversies surrounding the disorder. Despite the increasing prevalence and improved life expectancy of individuals with Down syndrome since the 1970s, the genre of memoirs of Down syndrome has not produced a similarly useful meaning of the syndrome to maintain its cultural prominence.

Over 90% of children on the autism spectrum have sensory challenges.  But sensory difficulty is not recognized as one of criteria for an autism diagnosis until DSM V released in 2013.  This late recognition of sensory processing raises several critical questions: What symptoms are required for a diagnosis?  What is the core of autism?  For some, sensory integration is a crucial lens to understand children’s social difficulty and delays in language development.  Some even argue that sensory integration disorder should be a distinct category in DSM.
 
Therapies targeting on sensory problems have existed since the 1950s.  Occupational therapist Jean Ayres proposed sensory integration therapy (SIT) to treat children with learning disorders and autism in the 1950s.  Around the same time, psychologist Newell Kephart utilized perceptual-motor therapy to help children with minimum brain injury.  But sensory processing has remained a marginal perspective in defining and treating autism. Why?
 
We will trace the evolvement of sensory integration as concepts and practices from the 1950s till now.  We will use this history as a way to examine the development of occupational therapy and the understanding of autism.

 
In a 1977 Science article, psychiatrist George Engel critiqued the “biomedical model” approach to disease. Engel argued that this biomedical model, which accounted for disease based on somatic and molecular traits, lacked an examination of equally important psychological and social aspects. Engel proposed an alternative “biopsychosocial model” for understanding the challenges of disease. Many science and health professionals joined Engel in his critique of the biomedical model as an overly reductive worldview. Molecular approaches to understanding chronic disease and disability were becoming increasingly prominent in the 1970s, but offered limited perspectives on causes, classification, and management. In this paper, I argue that critiques of the “biomedical model” were an important vehicle by which alternative narratives of disability entered the classification systems of biomedical professionals.
 
Historians have described biomedical classification as a fraught arena where social, moral, and biological assumptions intersect. I draw on archives, published literature, and interviews to examine evolving conceptions of disability in multiple editions of the World Health Organization’s International Classification of Impairments, Disabilities, and Handicaps (ICIDH). The first edition of ICIDH, in 1980, was an early response to biomedical model critiques. ICIDH added a focus on the social consequences of disease, but was widely criticized for maintaining a biomedical perspective on the somatic origins of disability. In response, the second edition in 2001 adopted Engel’s “biopsychosocial model”. Nonetheless, disability advocates continued to critique the WHO disability classification, as part of their ongoing efforts to encourage the uptake of alterative social and minority group models of disability.