“Joey, when we began our work with him,” wrote psychiatrist Bruno Bettelheim in 1959, “was a mechanical boy.” Thus began a Scientific American article that is widely regarded as one of the first accounts of autism in popular American media. Bettelheim's provocative narrative described a delicate 9-year-old boy with an empty gaze who, Bettelheim claimed, had “converted himself into a ‘machine’ because he did not dare to be human.” Although able to speak in a mechanical tone, he seemed lost in a world of ritual. Joey began every meal by stringing an invisible wire from an imaginary wall outlet to the table, “insulating” himself with paper napkins, and then “plugging himself in” before taking his first bite. He regularly connected himself to a “car machine” made of cardboard, tape, and wires and drew pictures of himself as a robot (Fig 1).

Joey's story illuminates how autism was...

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