Autism is a disease that occurs as a result of impaired development of the brain and nervous system. As a result, the child develops unusual, strange behavior, which makes it much more difficult to communicate with other people. In order to adapt to society, a child with autism needs to go through a long and difficult path of learning, and it is important for adults to support and help him. The fact is that, despite the urgency of the problem (about 1 child out of 60 suffers from autism), we still know very little about the disease. And our incompetence can only do harm. Let’s correct this unfortunate misunderstanding and find out what medicine knows about autism and what other discoveries need to be made.
A little history of autism research
The first mention of autism was published in 1943 by an American doctor of Austro-Hungarian originLeo Kanner. In his work “Autistic disorders of emotional contact” he described the results of his long-term observations of children with similar behavioral characteristics – isolation, avoidance of peers, monotonous movements and games, good memory, and others. Kanner first suggested that such children come into the world with an innate inability to connect with the people around them.
The following year, the world saw an article by an Austrian pediatrician and psychiatristHans Asperger’s ” Autistic psychopathy in childhood”, where the doctor describes the unusual features of such children. Unwillingness to socialize, limited speech (correct, but very poor), strange facial expressions and gestures, and at the same time the presence of normal intelligence.
Autism was isolated as a separate disease in 1980. At the same time, the disease can not be called young, just before autism was considered a form of schizophrenia. The isolation of this disease into a separate unit was a real breakthrough in psychiatry and allowed us to form an idea about this disease, classify it and formulate diagnostic signs of autism. However, to date, much is still beyond understanding.
The works of Kanner and Asperger were almost forgotten for several decades, and were revived only in 1981. English psychiatristLorna Wing, after studying the work of doctors, suggested naming the syndromes characterized by the described signs. So there was Asperger’s syndrome and Kanner’s syndrome.
Since the causes of autism were not clear, scientists began to put forward various assumptions. In the 1950s and 1960s, a very popular theory was the lack of parental love, from which young children, not finding support and responsiveness in the outside world, were allegedly forced to”withdraw into themselves”. The theory of “cold mothers” had a great resonance in society, caused a lot of negativity and emotions. Later it turned out that this theory has nothing to do with autism.
Further studies have shown that the substrate of the disease is the brain, which in autism processes information received from the senses in a slightly different way than normal. Why this happens, we will talk further.
Now the development of knowledge about autism is taking leaps and bounds. Large-scale studies of the causes and methods of treatment of this disease are being conducted. It is too early to talk about success, but the prospects are obvious.
Causes of autism in children
The cause of autism is a breakdown of genes. That is, the child is born with certain gene mutations, which subsequently lead to the appearance of the disease. But the degree of manifestation of symptoms depends on many factors, such as:
- Social environment – first of all, the atmosphere in the family.
- Timely detection of symptoms and the beginning of corrective therapy.
- Food – some dietary supplements aggravate the course of the disease.
- Taking certain medications (for example, anticonvulsants) during pregnancy, birth injuries, prematurity, low birth weight.
Genetics in 90% of cases is the cause of the development of autism. The only non-genetic cause of autism studied to date is rubella transmitted during pregnancy. About a third of women who have had rubella have children with autism.
Almost half of autism cases are caused by a first-generation gene mutation. This means that the mutation for some reason occurred in the child, and the parents do not have it.
Currently, more than 239 genes have been identified, the breakdown of which leads to autism. But apparently there are more of them. Therefore, research continues to be conducted in this direction. This question is fundamental in the study of the disease. After all, without understanding the mechanisms of development of the disease, it is impossible to develop effective methods of prevention and treatment of autism.
The relationship between autism and vaccinations
In recent years, a part of society has taken up arms against vaccinations. Opponents of vaccination are finding more and more arguments to defend their point of view. A few years ago, the theory of the connection between autism and vaccinations was actively cultivated. The fact is that the generally accepted vaccination calendar coincides with the manifestation of the first symptoms of the disease. And since autism is a mysterious disease, because its causes are still not exactly known, it was convenient to blame everything on routine vaccinations. However, scientific studies have refuted this theory, proving it untenable.
In fairness, it is worth noting that in rare cases, vaccinations cause neurological disorders, but they definitely have nothing to do with autism. As they say, this is a completely different story.
The relationship between gluten and autism
There is a theory that says that foods with gluten can lead to the development of autism. Gluten is the gluten found in four cereals – rye, oats, wheat, and barley. Under certain conditions, gluten sticks together the intestinal villi, blocking the absorption of nutrients, including the formation and absorption of B vitamins. As a result, the nerve tissue does not receivethe substances necessary for functioning and formation, which leads to a number of neurological disorders.
To date, the theory of the dependence of autism and gluten-free food remains at the level of assumptions. The claim that a gluten-free diet relieves the symptoms of autism was also not confirmed. If everything was so simple, the disease would be easily corrected. Unfortunately, this does not happen in practice.
Signs of autism in children
Autism is a complex of symptoms that can be grouped into two groups:
- Disruption of social interaction
- Repetitive behavior
Psychological disorders in autism in medical language are called autism spectrum disorders or abbreviated AS ASD.
Consider the most characteristic signs of autism:
- They are sparse, and do not always correspond to what is happening. For example, the touch of the mother causes tears and aggression, and physical trauma — violent laughter.
- Children with autism may selectively ignore speech addressed to them. Sometimes it seems that the child is just deaf.
- More often slow, formal. Monosyllabic answers or inappropriate repetition of what adults say. It happens that the speech is not related to the events that are taking place.
- They are not able to conduct a dialogue, ask questions, or listen to the interlocutor.
- In 60% of cases, children with autism suffer from speech disorders associated with impaired coordination of the structures involved in its formation — the tongue, lower jaw and lips. Therefore, speech can be slurred and incomprehensible to others.
- Sometimes the child speaks of himself in the third person – ” Masha has eaten and is going for a walk.”
- Grimaces are pretentious facial expressions that do not correspond to internal experiences. Most often, grimaces appear at a time when the child is completely alone.
Reaction to stimuli
- Avoid eye contact, do not look into the eyes.
- They are afraid of bright lights and unfamiliar sounds. Sometimes the most common stimuli-the noise of a boiling kettle, the ringing of the phone, a burning light bulb cause alarm and anxiety.
- They are able to process a limited amount of information.
- They record and remember information in pieces – smell, sound, color, voice, manner of movement, facial expressions. At the same time, they do not perceive the object or the person as a whole. The child may not recognize the grandmother, who yesterday was in one dress, and today came in a new one.
- It takes a long time to adapt to new stimuli.
- Children with autism are characterized by stereotypical movements. They can sit swaying for a long time, twirl their fingers in front of their eyes and perform other similar, often repeated and meaningless movements.
- Such a child loves the daily routine, accurate algorithms and routes of movement. It is difficult for him to go for a walk in an unfamiliar park, even holding his mother’s hand. Sometimes it is impossible to persuade a child to go for a walk in other clothes, because he agrees to go out only in a specific T-shirt.
- Some children with autism are characterized by increased mobility-hyperkinesis. The child can not sit still and is forced to constantly move.
Relationships with others
- Children with autism like to be alone. They avoid people.
- There is no interest in peers, there is no desire to communicate and play together.
- Relationships with your mother can develop in different ways-from absolute coldness to excessive affection.
- They may show aggression towards others. At the same time, it is not necessarily meaningful. For example, a child liked someone else’s toy. He does not hesitate to push away her master, in order to achieve his cherished goal. The screams and tears of an offended toddler usually do not affect a child with autism.
Style of play
- They focus their attention on the details of the object and do not pay attention to the whole object.
- Lay out the toys one after another in a certain sequence.
- An unusual game material. They can choose to play any items that are not intended for this purpose. Some doctors note that children with autism lack imagination. You can argue with this statement. Most likely, the imagination is still present, but it is unusual – such children can play for hours with some sticks, stones, clothes hangers, staying in their own special world.
- There is no desire to play with peers. There is no interest in the conversation and joint actions.
- A third of children with autism have normal intelligence, and about the same number have above average intelligence, which gives them the opportunity to study in general education schools and subsequently take their place in society.
- 40% of children with autism have a lower-than-average IQ, which complicates the adaptation process.
Symptoms and their combination in children with autism can be very diverse. After analyzing the behavior of your child, close people can assume the presence of the disease, which is the reason for contacting a specialist. Children’s psychiatrists and psychologists deal with autism problems. The role of these specialists in identifying the diagnosis and correction of autism manifestations will be discussed later.
Portrait of a child with autism
It is difficult for us to understand how a child with autism lives and feels, because we have a completely different way of perception. The brain of such children can perceive much more information than we do, but it is completely different to process it. Imagine that the whole world around you consists of unrelated fragments – pictures, music, speech, smells, etc. Everything is fragmented, and because of your perception, it is impossible to determine the cause-and-effect relationship.
For an ordinary child, a trip with his mother to a new playground is a joy. He sees familiar objects – slides, swings, a sandbox and knows how to use it. And there are a lot of kids around, with whom it will be interesting. He does not even doubt that he will have fun. And for a child with autism – this is a real stress, because he does not know the rules of the game. Everything is unfamiliar, alien, and therefore frightening. He does not perceive himself as a whole, what can we say about other objects and people! The only way out is not to communicate and avoid.
It happens that a child up to a year and a half develops quite normally – walks, talks, communicates with other children. And suddenly, for some unknown reason, there is a regression – speech disappears, there is “shyness”, isolation, stereotypical movements and other symptoms of autism. Unfortunately, the disease can develop in this way. Maybe this is another form of autism and it will later be separated into a separate disease. Scientists are working on it.
What specialist should I contact if I suspect a disease?
An important question is where to run after you suspect that the child has any psychological disorders? Unfortunately, not every pediatrician is knowledgeable about autism, and understands how to properly diagnose it first. Although there are various tests for behavioral disorders, which are widely used in civilized countries and allow you to determine various disorders in children of 1.5-2 years. In our country, many people have not even heard of such things.
It is better not to waste time and turn to a child psychiatrist (not a psychologist!). The specialist will determine the presence of violations and, if necessary, refer you to a neurologist or a sign language specialist to check your hearing and exclude neurological diseases. After the diagnosis is made and recorded in the medical documentation, you can make a decision – either stay under the supervision of a psychiatrist, or contact a psychologist. Why should such an algorithm be followed? The fact is that only a psychiatrist has the right to diagnose ” autism” and give recommendations for the possibility of visiting a children’s group and the method of training. Otherwise, you may not be accepted to school or kindergarten.
If we discard the issues of bureaucracy, then an important fact is the qualification of a specialist. A psychiatrist is a doctor, that is, a person with a higher medical education, and a psychologist is not always. It can help you at the stage of correction, conduct a number of classes, help parents understand the problem and learn to understand the child. But your interaction with official medicine is only possible through a psychiatrist. This is the registration of certificates, documents on disability, referral to other specialists and other important points.
As a rule, parents notice the first symptoms of autism at the age of 1.5-2 years. Often, they do not attach any importance to them, blaming everything on shyness and other characteristics of the character. An experienced specialist can identify violations even in 3 months. So do not hesitate to ask your questions. This will allow you to identify the symptoms and start working with them. The sooner you do it, the better.
Diagnostic criteria for autism
The difficulty in diagnosing autism is that the disease has no biological markers. That is, it can not be determined on the basis of a blood test, urine, computed tomography or ultrasound. In some cases, it helps to determine the genetic analysis, but since not all genetic mutations are deciphered, most often this method of diagnosis will not be informative. Sometimes electroencephalography reveals a pathology of the temporal lobe, in some patients the level of serotonin in the blood is increased. But these are again indirect signs, on the basis of which they will not make a diagnosis.
To date, brain scanning techniques have been developed that can in some cases determine autism in children older than 2 years. These are expensive procedures that cannot yet be used in clinical practice. Scientists are looking for an opportunity to make the study more convenient and accessible, as well as to find ways to diagnose autism early in children under 1 year old.
In the help of the experts, there are specific diagnostic criteria for autism. These are essentially behavioral signs, the presence or absence of which helps to diagnose and determine the severity of the disease. Diagnosis of autism comes down to collecting an anamnesis, so be prepared to answer questions from a psychiatrist. How the child behaves, how he plays, what changes in his mood are associated with, whether he speaks or not, whether he interacts with his peers, and so on.
For parents there is a simple test of the M-CHAT-R, developed in Spain. It allows you to determine the possible risk of autism in a child aged 16-30 months. It consists of 20 questions that parents need to answer. The test will not take much time, and will help you find out whether you should worry or not.
With medium to high risk, you should contact a specialist who will help you deal with the problem. Maybe it’s not so sad after all. There are many cases when a child was withdrawn in childhood, learned to speak late and with difficulty, had poor contact with peers, and in the end turned out to be a completely normal person. By the way, it is for this reason that the diagnosis of “autism” is not made until the age of 3.
April 2-World Autism Awareness Day
Imagine how global and important the problem of autism is, that it was the UN in 2008 that proposed to allocate a special day for discussing and revealing this disease! This applies to every person without exception. We need to understand the essence of autism and know how to behave with such children and adults in order to help them adapt to society.
On April 2, a number of events are held-specialized conferences and seminars for doctors, where colleagues share their experience and discuss new research, diagnostic methods, classification and other points that are necessary in practice. Information booklets, articles and lectures are also published for relatives of autistic patients and just people who care about them.
Since not all parents agree to send a child with autism to specialized children’s institutions, an inclusive child may well end up in a comprehensive school. It’s good for everyone. Children with autism tend to adapt better to society, get used to a different environment and team. And other children learn to behave correctly with people who are not like themselves. Useful practice. At the same time, it is very important to tell children about the disease and what can and can not be done with such a child in the correct form.
Methods of autism correction
Let’s be clear-there is no cure for autism today. Various charlatans, who are happy to profit from human misfortune, will offer you miracle devices and no less magical supplements and medicines. We do not wake them up to analyze them, because from the point of view of practical medicine – all this sounds like nonsense. Be careful and don’t waste your precious time.
There is also good news. Autism can be corrected. And the sooner you start it – the better your chances are. If your child still has speech and intelligence, then the chances are even greater.
Another important point. We already know that the substrate of autism is the brain. Unfortunately, no one can really explain what processes underlie the disease. This is difficult due to the diversity of the clinical picture. In some cases, inhibition prevails, while in others, arousal prevails. Some children are quiet and withdrawn, while others show aggression towards themselves and others. With a bright clinic, the doctor may prescribe glycine, psychotropic and sedative drugs. They will not cure autism, but they will correct the child’s behavior.
There are various methods of correcting disorders in autism. They can be divided into behavioral and gaming. There is no universal method. So you may have to apply several of them. Once every 3 months, the child is examined in order to understand whether the technique works or not.
We will analyze one of the methods with scientifically proven effectiveness of ABA (applied behavioral analysis). The purpose of the method is primarily to teach a person with autism to serve themselves. This is important, because such children may not understand that you need to wash your hands before eating, in order to eat you need to sit at the table, use a spoon, and so on. To consolidate the acquired skill, the author of the method offers encouragement – pleasant words, sweets, toys, etc.
Depending on what skills the child lacks, an ABA therapy specialist will make an individual program. Important attention is paid to the elimination of unnecessary habits – for example, shouting loudly in a public place, or running from corner to corner. This is also achieved through rewards and punishments.
Some experts criticize the ABA method and other methods similar to it, since such training, although it allows you to consolidate useful skills accepted in society, but does not give you the opportunity to develop and learn. For children of preschool age, and primary school, too, need a game. Thanks to the game skills, thinking, imagination, speech, counting, emotions, understanding of relationships in society and other important characteristics are developed. Therefore, in recent years the practice of behavioral techniques along with the game. Or are limited only to game methods. As a rule, the result is much better than using only the ABA method.
Rules of behavior of parents with an autistic child:
- Make your daily activities predictable. This is a kind of routine routine. Wake up, clean the bed, get dressed, wash, have breakfast, etc. – everything should be in a certain sequence and at the same time. Everything is clear and predictable. The child is comfortable in this mode.
- Implement changes gradually and slowly. You will have a very long time to explain that soon a friend will come to visit us, bring gifts. It is necessary to tell about it in as much detail as possible and it is desirable to show its photo.
- You need to be able to recognize the signs of sensory overload and prevent mood changes in time.
- Minimize the number and intensity of annoying stimuli – loud sounds, bright objects, strangers, etc.
- Speak slowly and clearly. Children with autism need more time to process information.
Correcting the behavior of a child with autism is quite a difficult task. So do not despair if something does not work out. Your efforts will bear fruit sooner or later. Be prepared for the fact that you will have to work with your child for at least 5 hours a day. It is unlikely that you will find a specialist who will devote so much time to you. And this means that you will have to do a lot yourself. Parents of children with autism should wish them success in their hard work.
May your children never get sick!