London born James Henry Pullen (1836-1915) was admitted to Essex Hall in Colchester, an institution catering for learning disability, at the age of 13. Here his artistic talent was spotted before he moved two years later to Earlswood Asylum for Idiots, where he was apprenticed to woodworking. Such was his manual skill he was eventually employed making furniture for the asylum. His artistic propensity was similarly encouraged and although he never mastered coherent speech he has left a pictorial autobiography of some distinction. At observation he underwent detailed examination by Frederich Sano (1871-1946), particular attention being paid to tokens of arrested development. The clinical and pathological evidence of a pervasive developmental disorder points to a retrospective diagnosis of autism.