In several cases, children identified as autistic had already been found to have "reactive attachment disorder," a condition that resembles autism in that children struggle with social interactions. But unlike autism, which has a strong genetic basis, it is by definition caused by disregard for the child's emotional needs.
The diagnosis resembles "refrigerator mother" theories embraced in the U.S. decades ago: the idea that bad mothering made children detached and unable or unwilling to communicate. It inflicted enormous guilt on mothers. But in Korea, it is more palatable than the possibility that the condition was inherited.
"They don't want to see it as genetic, because it's damaging to the family," Grinker said. Instead, "the mother can take the bullet and say, 'I failed with this child.' "
Yun-Joo Koh, head of the Rudolph Child Research Center in Seoul and a co-author of the study, estimated that less than 10% of children diagnosed by the researchers received help immediately, because parents didn't seek it or it was unavailable.
Still, there are signs of change. A rock star, Kim Tae-won, recently announced that his son had autism, some family support groups have started up and a 2005 Korean movie about an autistic man who runs a marathon remains popular.
An hour away at the Rudolph child center, clinicians have been trained by the U.S. researchers to recognize autism in all its forms.
Several parents whose children were being helped there but were not involved in the study agreed to talk with a reporter anonymously. One said that her son often disrupted class but that until he was diagnosed with Asperger's the best answer any doctor provided was that the teacher was too lax. Now 12, the boy has improved with social skills lessons, his mother said.
"It's like hearing you have cancer," she said, describing what it was like to get the diagnosis.
But "after six months you grow to accept it. Then you start educating yourself and finding people who are in a similar situation."
Choi, a news assistant in The Times' Seoul bureau, reported from Ilsan. Times staff writer Zarembo reported from Los Angeles.