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The paediatrician and special needs teacher Hans Asperger in 1944: How autistic children ended up in the Nazi euthanasia programme at Spiegelgrund via the Vienna special needs education system.

Hans Asperger and National Socialism: The paediatrician, the ‘autistic psychopaths’ and the children of Spiegelgrund

A diagnosis that millions of people use to describe themselves has origins that were long absent from the textbooks of paediatrics and autism research. In 1944, the Viennese paediatrician Hans Asperger completed his habilitation thesis in the Department of Special Education at the Vienna University Children’s Hospital on “autistic psychopaths” in childhood, within a system that killed children with behavioural difficulties at the “euthanasia” facility in Spiegelgrund.

Who was the paediatrician Hans Asperger in a historical context?

Hans Asperger (1906–1980) was a Viennese paediatrician and special needs teacher who spent his entire career at the Vienna University Children’s Hospital, part of the Faculty of Medicine at the University of Vienna. Asperger became a senior registrar there in 1932; in 1934, he spent a study visit in Leipzig, where he deepened his understanding of special educational concepts that would later shape his postdoctoral thesis. Back in Vienna, he worked as head of the special education ward under Franz Hamburger, the director of the Vienna Children’s Hospital, a fervent Nazi and anti-Semite. At the time, the Vienna University Children’s Hospital was one of the most influential institutions in paediatrics in the German-speaking world.

In contemporary perception, Asperger is regarded as a pioneer of autism research, the humane observer who discovered the ‘little professors’: autistic children, highly intelligent and socially unconventional, whose peculiarities he described and acknowledged. This self-portrayal was cultivated by Asperger himself after 1945 and introduced into the international specialist literature by Lorna Wing in the 1980s, when Asperger’s syndrome was established as a distinct form of autism in Western classification systems.

What was the significance of the Department of Special Education at the Vienna University Children’s Hospital?

From the 1920s onwards, the Department of Special Education at the Vienna University Children’s Hospital was a central institution in Austrian paediatrics and child health. It dealt with children whose behavioural abnormalities, cognitive peculiarities or social difficulties were to be examined from both medical and educational perspectives. Here, paediatrics was combined with social pedagogy, and conventional medicine with educational science. Asperger was head of the special education ward from 1935 until the late 1940s and was thus one of the central figures in Austrian special education of his time.

During the Nazi era from 1938 to 1945, the special education department became part of an administrative apparatus that distinguished between children deemed ‘worthy of life’ and those deemed ‘unworthy of life’. This selection had concrete consequences. Children classified as unfit for integration could be referred to the Am Steinhof psychiatric and nursing home, whose children’s ward “Am Spiegelgrund” became one of the central sites of Nazi child euthanasia.

How did Asperger come to write his habilitation thesis on “autistic psychopaths” in 1944?

Asperger’s postdoctoral thesis “The ‘Autistic Psychopaths’ in Childhood” was published in 1944, the final year of the Nazi regime, amidst an academic landscape that operated entirely in the service of racial hygiene. The term “autistic psychopaths” does not originate from later, destigmatising autism research, but from a language of personality classification that was established in the interwar period and fitted seamlessly into the differential diagnostics of the Nazi era.

In his postdoctoral thesis, Asperger described a group of autistic children whose intellectual peculiarities fascinated him and whom he regarded as capable of integration if their special talents were cultivated. This diagnostic focus was triage-oriented. Asperger tacitly distinguished between children whose peculiarities were deemed useful to the national community and those whom the system considered unworthy of life. The second group was not published by him, but managed.

What was the ‘Am Spiegelgrund’ sanatorium?

The Spiegelgrund was the children’s ward of the ‘Am Steinhof’ sanatorium and nursing home in Vienna. During the Nazi era, from 1940 to 1945, around 800 children were murdered there through deliberately induced pneumonia, malnutrition, overdoses of sedatives and targeted killings. The mortality rates were so high that, after 1945, the clinic became a symbol of the systematic murder of disabled, mentally ill and socially challenging children in the Nazi state. To this day, brain specimens from the murdered children are kept in research institutes; this, too, is part of the process of coming to terms with the past.

Asperger did not work at Spiegelgrund himself. He worked at a precursor institution, the Department of Special Education at the Vienna Children’s Hospital, from which referrals were made. This distinction is legally and institutionally relevant, but it does not exonerate him in substance. Anyone who had children referred to a system that killed them was part of that system, even without having administered the final injection themselves.

What role did Asperger play in the practice of referring children to Spiegelgrund?

The documentary evidence is clear. The medical historian Herwig Czech has reconstructed several referrals in the Vienna City and Provincial Archives in which Asperger, acting as a consultant for the City of Vienna, referred children for observation to institutions directly linked to Spiegelgrund. At least two girls whose names are known, both of whom died at Spiegelgrund, were referred there on Asperger’s recommendation because he deemed them unfit for school. These recommendations followed the logic of Nazi child euthanasia, in which children deemed “unable to be educated” were regarded as a burden on the national community.

Asperger was simultaneously a member of the Society for Special Education and an expert for the City of Vienna on matters of special education and child psychiatry. He was not a formal member of the NSDAP, but belonged to several professional associations with close ties to the Nazis. This constellation—no party membership, but functional collaboration—was typical of many academics during the Nazi era. After 1945, it enabled them to portray themselves as “apolitical”, a claim that does not stand up to historical reality.

Who is Herwig Czech, and what has the research into his life revealed?

Herwig Czech is a medical historian and Professor of the History of Medicine at MedUni Vienna, working at the Josephinum, the University’s collection and history of medicine. In 2018, Czech published the most thorough examination to date of Asperger’s relationship with National Socialism in the journal Molecular Autism: “Hans Asperger, National Socialism, and ‘race hygiene’ in Nazi-era Vienna”. The study analyses Asperger’s own publications from the Nazi era, combined with previously overlooked documents from Austrian archives, personnel files, patient records and expert reports.

Czech’s conclusion is clear: Asperger actively conformed to the Nazi regime and was rewarded with career opportunities as a result. An analysis of the sources shows that his self-portrayal as an active opponent of the regime cannot be sustained. In parallel, the American historian Edith Sheffer has presented an independent analysis of the archives in her book "Asperger's Children: The Origins of Autism in Nazi Vienna" (2018), which reaches similar conclusions. Sheffer calls Asperger an "agent of extermination", a phrase that is controversial in academic debate but strikes at the institutional heart of the matter.

What does Hans Asperger’s relationship with National Socialism reveal today?

According to Czech and Sheffer, three key aspects are documented. Firstly, Asperger worked in a department of special education whose director, Franz Hamburger, was a militant Nazi and who shaped the ideological profile of paediatrics in Vienna during the Nazi era. Secondly, Asperger actively participated in discussions on issues of racial and sterilisation legislation and defended the application of this legislation in his own publications. Thirdly, in his capacity as a consultant for the City of Vienna, Asperger referred children for observation who subsequently perished in Nazi euthanasia institutions.

These three points do not prove that Asperger was a Nazi ideologue. They mean that, as a competent, ambitious paediatric researcher, he advanced his career within the Nazi system, thereby complying with the logic of that system. In "In a Different Key: The Story of Autism" (2016), Donvan and Zucker still painted the older picture of Asperger as a humanitarian. The Czech-Sheffer research has fundamentally corrected this picture.

How did the reappraisal proceed in Vienna and internationally?

The process of reappraisal was slow and institutionally hesitant. Until the 2010s, the image of Asperger that he himself had established dominated autism research. Czech and Sheffer published their findings independently in 2018, and their conclusions met with considerable resistance from the international academic community. However, the Medical University of Vienna has since openly stated that Asperger’s role during the Nazi era can no longer be portrayed as “uninvolved”.

The autism community has reacted with mixed feelings. Some advocate removing the term ‘Asperger’s’ from self-descriptive language and replacing it with more neutral terms such as ‘autistic’, ‘on the spectrum’ or ‘neurodivergent’. This position is frequently held in English-speaking self-help groups. Another section defends the historical term because it has enabled identity formation over decades. According to Czech-Sheffer’s analysis, both positions are a conscious choice.

Why is Asperger’s syndrome now called autism spectrum disorder?

DSM-5 (2013) and ICD-11 (2022) have reclassified Asperger’s syndrome into the umbrella category of autism spectrum disorder. The official separate category no longer exists in the current classifications. The rationale was primarily nosological; the diagnostic boundaries between Asperger’s syndrome and other forms of autism had proved to be blurred, and a spectrum concept better reflected clinical reality. The Czech-Sheffer review occurred in parallel and further strengthened the institutional legitimacy of this step.

In everyday usage, the term “Asperger” continues to be used as a self-description, in self-help groups, in book titles, and in mainstream media contexts. Anyone who today describes themselves as an “Aspie” or “Asperger” is effectively adopting a self-description that is historically linked to a system that killed children with behavioural differences.

What does this history mean for modern autism diagnosis and practice?

In psychotherapeutic practice, it is worth remaining alert to history. Patients who describe themselves as ‘Aspies’ or as autistic are not primarily seeking a historical explanation for their diagnostic labels; they are seeking support with their specific difficulties. However, if a patient has described herself as an ‘Asperger’s woman’ for twenty years and casually touches upon the Viennese history during a conversation, the therapist can differentiate between the label as an identity marker and the label as an institutional trace. Both may coexist. Neither need be abandoned. But neither should be confused.

In *Madness and Civilisation*, Foucault described how psychiatric classifications are always also administrative acts. The history of Asperger’s is a particularly dark illustration of this thesis. It shows how a later humane meaning can emerge from an earlier murderous one without truly overcoming the earlier one. Anyone who uses psychiatric language is using a language with layers, and it is also a professional duty to be aware of them.

Summary: Hans Asperger and National Socialism

·         Hans Asperger (1906–1980), a Viennese paediatrician and special needs teacher, completed his habilitation thesis in 1944 on ‘autistic psychopaths’ in childhood at the Department of Special Needs Education at the Vienna University Children’s Hospital.

·         In 1934, Asperger spent a study visit in Leipzig; from 1938 to 1945, he worked within the Nazi scientific establishment under Director Franz Hamburger.

·         Asperger was NOT a member of the NSDAP, but belonged to several professional associations with links to the Nazis and served as an expert consultant to the City of Vienna on matters of special education and child psychiatry.

·         At least two girls, whose names are known, were referred to Nazi euthanasia institutions on his recommendation and perished at Spiegelgrund.

·         The “euthanasia” facility at Spiegelgrund was responsible for the murder of around 800 children between 1940 and 1945.

·         Medical historian Herwig Czech (MedUni Vienna, Josephinum) published a study in 2018 in Molecular Autism based on sources from the Vienna City and Provincial Archives: Asperger actively cooperated with the Nazi regime.

·         Edith Sheffer published the book “Asperger’s Children: The Origins of Autism in Nazi Vienna” in 2018 and describes Asperger as an “accomplice to the extermination”.

·         In 2016, Donvan and Zucker still painted the older, humanitarian picture of Asperger in "In a Different Key"; the Czech-Sheffer research has fundamentally corrected this.

·         DSM-5 (2013) and ICD-11 (2022) have reclassified Asperger’s syndrome into the umbrella category of autism spectrum disorder; the official separate category no longer exists.

·         The autism community is divided: one section advocates for the removal of the term, another for its historical right within the language of identity.

·         Therapeutically, it is worthwhile to distinguish between identity markers and institutional traces without conflating them. The obligation to use diagnostic terms in an informed manner has increased following this re-evaluation.

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