Donald Triplett, Autism 'Case 1', Passes Away at Age 89

The Centers for Disease Control and Prevention (CDC) estimates that about one in 36 children are on the autism spectrum. But the history of autism spectrum disorder (ASD) began with a single child described in a 1943 study. He died last week at the age of 89. 

Case 1

As one of the original individuals diagnosed with ASD, Donald Triplett is often referred to as “Case 1.” 

Triplett was born in 1933 in Forest, Mississippi. In the late 1930s, at the age of three, he began displaying behaviors that were considered atypical. His parents described him as having social withdrawal, repetitive behaviors, and language difficulties. They sought medical help, and eventually Triplett was evaluated by child psychiatrist Leo Kanner, MD at Johns Hopkins Hospital in Baltimore.

In 1943, Kanner published his groundbreaking paper, Autistic Disturbances of Affective Contact in the journal Nervous Child. The study documented the cases of 11 children with similar behavior and social issues considered out of the ordinary. Triplett’s case was the first to be detailed. It is widely regarded as one of the earliest descriptions of autism as a distinct developmental disorder.

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Diagnostic History

The inclusion of Triplett’s case in Kanner’s study was instrumental in raising awareness about autism and initiating further research into the condition. It played a crucial role in establishing autism as a recognized diagnostic category in psychiatry.

However, autism wasn’t officially recognized as a unique diagnostic category until the revised DSM-III was published in 1980. Prior to this pivotal moment, autism had been obscured within a broader clinical classification, often misunderstood and misdiagnosed. 

The update of the manual, regarded as the bible of psychiatric conditions, included a diagnosis of “Infantile Autism,” as a unique developmental disorder characterized by impaired social interaction, communication challenges, and restrictive and repetitive behaviors. This crucial revision marked a turning point, leading to better recognition, understanding, and support for individuals with ASD.

A Quiet, Important Life

Growing up in Forest, Mississippi, Triplett’s parents provided him with extensive support and opportunities despite the limited understanding of autism at the time. He attended a regular school, participated in extracurricular activities, and eventually graduated from the University of Southern Mississippi. He maintained a quiet and private existence, residing in his hometown until his death from cancer last week. 

Triplett spoke about his autism diagnosis on a few occasions. Notably, in a 2010 interview with The New York Times, he expressed his gratitude for the love and support he received from his family, particularly his parents, who he said were committed to providing him with a fulfilling life despite the challenges posed by his condition. 

Triplett acknowledged that growing up in a small town shielded him from some of the potential difficulties faced by many others with autism. His willingness to discuss his diagnosis helped inspire and inform others about the importance of accepting neurodiversity.

Continued Evolution

The understanding of autism has evolved significantly since Triplett’s initial diagnosis. At first, it was viewed as a rare condition caused by cold and unemotional parenting. Subsequent research has debunked these misconceptions, presenting a more nuanced and multifaceted understanding of the condition. Researchers now understand the strengths and unique perspectives that individuals on the spectrum possess.

Over the decades, the diagnostic criteria for the condition has been expanded and refined. ASD now encompasses a broader and more diverse spectrum of presentations. Experts now accept the notion of autism as a lifelong condition, emphasizing the importance of early intervention and resources. 

Moreover, the focus in the autism community has shifted from an exclusively medical model to embracing neurodiversity. Advances in genetics and neuroscience have deepened the understanding of the biological underpinnings of autism, highlighting the complex interplay between genetic factors and environmental influences. 

Triplett’s legacy is proof that individuals with autism can lead meaningful and productive lives. His remarkable story serves as a reminder of the resilience and potential for individuals with ASD, while also acknowledging the progress made in recent years. He will be remembered for paving the way for advancements in diagnosis, treatment, and the overall acceptance of autism.