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The American historian Edith Sheffer, in her 2018 book, Aspergers Children: The Origins of Autism in Nazi Vienna, wrote, In Nazi psychiatry, a child needed to demonstrate conformity, educability and ability to work. She noted that family and class factors played a role in a childs survival: Chances of death were greater if the child was born out of wedlock, had an absent father, or a mother suspected of being unable to cope, with other children at home. Under the Reichs T-4 program, the killing of institutionalized adults with disabilities had happened in gas chambersthe first instance of their use