Autism's first child
John Donvan & Caren Zucker
As new cases of autism have exploded in recent years—some form of the condition affects about one in 110 children today—efforts have multiplied to understand and accommodate the condition in childhood. But children with autism will become adults with autism, some 500,000 of them in this decade alone. What then? Meet Donald Gray Triplett, 77, of Forest, Mississippi. He was the first person ever diagnosed with autism. And his long, happy, surprising life may hold some answers.
In 1951, a Hungarian-born psychologist, mind reader, and hypnotist named Franz Polgar was booked for a single night’s performance in a town called Forest, Mississippi, at the time a community of some 3,000 people and no hotel accommodations. Perhaps because of his social position—he went by Dr. Polgar, had appeared in Life magazine, and claimed (falsely) to have been Sigmund Freud’s “medical hypnotist”—Polgar was lodged at the home of one of Forest’s wealthiest and best-educated couples, who treated the esteemed mentalist as their personal guest.
Polgar’s all-knowing, all-seeing act had been mesmerizing audiences in American towns large and small for several years. But that night it was his turn to be dazzled, when he met the couple’s older son, Donald, who was then 18. Oddly distant, uninterested in conversation, and awkward in his movements, Donald nevertheless possessed a few advanced faculties of his own, including a flawless ability to name musical notes as they were played on a piano and a genius for multiplying numbers in his head. Polgar tossed out “87 times 23,” and Donald, with his eyes closed and not a hint of hesitation, correctly answered “2,001.”
Indeed, Donald was something of a local legend. Even people in neighboring towns had heard of the Forest teenager who’d calculated the number of bricks in the facade of the high school—the very building in which Polgar would be performing—merely by glancing at it.
According to family lore, Polgar put on his show and then, after taking his final bows, approached his hosts with a proposal: that they let him bring Donald with him on the road, as part of his act.
Donald’s parents were taken aback. “My mother,” recalls Donald’s brother, Oliver, “was not at all interested.” For one, things were finally going well for Donald, after a difficult start in life. “She explained to [Polgar] that he was in school, he had to keep going to classes,” Oliver says. He couldn’t simply drop everything for a run at show business, especially not when he had college in his sights.
But there was also, whether they spoke this aloud to their guest or not, the sheer indignity of what Polgar was proposing. Donald’s being odd, his parents could not undo; his being made an oddity of, they could, and would, prevent. The offer was politely but firmly declined.
What the all-knowing mentalist didn’t know, however, was that Donald, the boy who missed the chance to share his limelight, already owned a place in history. His unusual gifts and deficits had been noted outside Mississippi, and an account of them had been published—one that was destined to be translated and reprinted all over the world, making his name far better-known, in time, than Polgar’s.
His first name, anyway.
Donald was the first child ever diagnosed with autism. Identified in the annals of autism as “Case 1 … Donald T,” he is the initial subject described in a 1943 medical article that announced the discovery of a condition unlike “anything reported so far,” the complex neurological ailment now most often called an autism spectrum disorder, or ASD. At the time, the condition was considered exceedingly rare, limited to Donald and 10 other children—Cases 2 through 11—also cited in that first article.
That was 67 years ago. Today, physicians, parents, and politicians regularly speak of an “epidemic” of autism. The rate of ASDs, which come in a range of forms and widely varying degrees of severity—hence spectrum—has been accelerating dramatically since the early 1990s, and some form of ASD is now estimated to affect one in every 110 American children. And nobody knows why.
There have always been theories about the cause of autism—many theories. In the earliest days, it was an article of faith among psychiatrists that autism was brought on by bad mothers, whose chilly behavior toward their children led the youngsters to withdraw into a safe but private world. In time, autism was recognized to have a biological basis. But this understanding, rather than producing clarity, instead unleashed a contentious debate about the exact mechanisms at work. Differing factions argue that the gluten in food causes autism; that the mercury used as a preservative in some vaccines can trigger autistic symptoms; and that the particular measles-mumps-rubella vaccine is to blame. Other schools of thought have portrayed autism as essentially an autoimmune response, or the result of a nutritional deficiency. The mainstream consensus today—that autism is a neurological condition probably resulting from one or more genetic abnormalities in combination with an environmental trigger—offers little more in the way of explanation: the number of genes and triggers that could be involved is so large that a definitive cause, much less a cure, is unlikely to be determined anytime soon. Even the notion that autism cases are on the rise is disputed to a degree, with some believing that the escalating diagnoses largely result from a greater awareness of what autism looks like.
There is no longer much dispute, however, about the broad outlines of what constitutes a case of autism. The Diagnostic and Statistical Manual of Mental Disorders—the so-called bible of psychiatry—draws a clear map of symptoms. And to a remarkable degree, these symptoms still align with those of one “Donald T,” who was first examined at Johns Hopkins University, in Baltimore, in the 1930s, the same boy who would later amaze a mentalist and become renowned for counting bricks.
In subsequent years, the scientific literature updated Donald T’s story a few times, a journal entry here or there, but about four decades ago, that narrative petered out. The later chapters in his life remained unwritten, leaving us with no detailed answer to the question Whatever happened to Donald?
There is an answer. Some of it we turned up in documents long overlooked in the archives of Johns Hopkins. But most of it we found by tracking down and spending time with Donald himself. His full name is Donald Gray Triplett. He’s 77 years old. And he’s still in Forest, Mississippi. Playing golf.
The question that haunts every parent of a child with autism is What will happen when I die? This reflects a chronological inevitability: children with autism will grow up to become adults with autism, in most cases ultimately outliving the parents who provided their primary support.
It’s a question that has yet to grab society’s attention, as the discussion of autism to date has skewed, understandably, toward its impact on childhood. But the stark fact is that an epidemic among children today means an epidemic among adults tomorrow. The statistics are dramatic: within a decade or so, more than 500,000 children diagnosed with autism will enter adulthood. Some of them will have the less severe variants—Asperger’s syndrome or HFA, which stands for “high-functioning autism”—and may be able to live more independent and fulfilling lives. But even that subgroup will require some support, and the needs of those with lower-functioning varieties of autism will be profound and constant.
How we respond to those needs will be shaped in great measure by how we choose to view adults with autism. We can dissociate from them, regarding them as tragically broken persons, and hope we are humane enough to shoulder the burden of meeting their basic needs. This is the view that sees the disabled in general as wards of the community, morally and perhaps legally, and that, in the relatively recent past, often “solved” the “problem” of these disabled adults by warehousing them for life—literally in wards.
Alternatively, we can dispense with the layers of sorrow, and interpret autism as but one more wrinkle in the fabric of humanity. Practically speaking, this does not mean pretending that adults with autism do not need help. But it does mean replacing pity toward them with ambition for them. The key to this view is a recognition that “they” are part of “us,” so that those who don’t have autism are actively rooting for those who do.
Donald Triplett, the first person cast in the story of autism, has spent time in the worlds shaped by each of these views.
Donald drives his car with a light, percussive rhythm. After pressing on the gas pedal for a second, he lets up briefly, and then presses back down again. Down. Release. Down. Release. The tempo doesn’t vary. It’s late afternoon, and Donald is guiding his coffee-colored 2000 Cadillac, in hardly perceptible surges and glides, south along Mississippi’s Route 80. Though his forward posture and two-fisted grip on the wheel are those of an old man, his face beams like a boy’s. He wears the expression, at once relaxed and resolute, of a man who is doing precisely what he wants to be doing.