UNDERSTANDING

Neurologist who researched biological causes of autism

Isabelle Rapin, a Swissborn child neurologist who helped establish autism’s biological underpinnings and advanced the idea that autism was part of a broad spectrum of disorders, died on 24 May in Rhinebeck, New York, at 89. The cause was pneumonia, said her daughter Anne Louise Oaklander, who is also a neurologist.

“Calling her one of the founding mothers of autism is very appropriate,” said Dr Thomas Frazier II, a clinical psychologist and chief science officer of Autism Speaks, an advocacy group for people with autism and their families. “With the gravity she carried, she moved us into a modern understanding of autism.”

Rapin taught at the Albert Einstein College of Medicine in the Bronx and over a halfcentury there built a reputation for rigorous scholarship. She retired in 2012 but continued working at her office and writing journal papers. The neurologist Oliver Sacks, a close friend and colleague, called her his “scientific conscience”.

In his autobiography, On the Move: A Life (2015), Sacks wrote: “Isabelle would never permit me, any more than she permitted herself, any loose, exaggerated, uncorroborated statements. ‘Give me the evidence,’ she always says.”

Rapin’s focus on autism evolved from her studies of communications and metabolic disorders that cause mental disabilities and diminish children’s ability to navigate the world. For decades she treated deaf children, whose difficulties in communicating limited their path to excelling in school and forced some into institutions.

“Communications disorders were the overarching theme of my mother’s career,” Oaklander said.

In a short biography written for the Journal of Child Neurology in 2001, Rapin recalled a critical moment in her work on autism. “After evaluating hundreds of autistic children,” she wrote, “I became convinced that the report by one-third of parents of autistic preschoolers, of a very early language and behavioural regression, is real and deserving of biologic investigation.”

Along the way, she helped debunk the myth that emotionally cold mothers were to blame for their children’s autism, and advocated early educational intervention for autistic children, with a focus on their abilities, not their disabilities. She also popularised the use of the term “autism spectrum disorder,” which refers to a wide range of symptoms and their severity.

“She would never let us say that autism is a single disorder,” Dr Mark Mehler, chairman of the department of neurology at Einstein, said. “She always said there were a thousand different causes.”

Isabelle Martha Juliette Rapin was born on 4 December 1927, in Lausanne, Switzerland, to René Lapin, a professor of English and American literature at the University of Lausanne, and the former Mary Coe Reeves, a Connecticut-born housewife.

Fascinated by science, Isabelle decided at age 10 that she would be a doctor. And when she entered medical school at the University of Lausanne in 1946, she was one of about a dozen women in a class of 100 students. After six weeks of study at the Hopital des Enfants Malades in Paris in 1951, she left, determined to be a child neurologist.

She moved to the United States in 1953 to work in pediatrics at Bellevue Hospital in Manhattan. A year later she started a residency at the Neurological Institute of New York at Columbia-presbyterian Hospital. In 1958, she moved on to Einstein.

Subverting convention, her husband, Harold Oaklander, subordinated some of his career ambitions – he is a former associate dean at Pace University’s graduate school of business – to let his wife advance hers. “Rather than taking an industrial or teaching job outside of New York after he got his PHD from Columbia University,” she wrote, “my husband accepted a faculty position in the graduate school of a less prestigious university than mine because he knew I could not bear the thought of leaving Albert Einstein College of Medicine.”

Over the years, Rapin became a mentor to other female neurologists. “She was the person to turn to to get your grounding in how to start and what to do,” said Dr. Martha Denckla, a professor of neurology at the Kennedy Krieger Institute in Baltimore. “You’d just go to a national meeting and listen to her.”

Dr Nina F Schor, chairwoman of the pediatrics department at the University of Rochester Medical Centre, recalled: “She looked and comported herself as the very dignified professor. Old-school with a European persona. She stood ramrod straight, looked down her wire-rim glasses at you, and you thought, ‘Oh, no, I’m in trouble now.’ ”

But in meeting Rapin over coffee, Schor said, she found her “quite delightful; she’d just had a new grandchild and was eager to show off the pictures”.

Dr Mark Mehlman, a former student of Rapin’s, said: “She was surrounded by intellectual giants, who were all men, and she always paid them deference,” he said.

In addition to Anne Louise, Rapin is survived by Harold; sons Stephen and Peter; a second daughter, Christine; and four grandchildren. © New York Times 2017. Distributed by NYT Syndication Service

“She would never let us say that autism is a single disorder. She always said there were 1,000 different causes”