Autism in children
The content of the article:
- Causes of Autism in Children and Risk Factors
- Forms of the disease
- Symptoms of Autism in Children
- Diagnostics
- Treatment for autism in children
- Possible complications and consequences
- Forecast
- Prevention
Autism in children is a disorder characterized by impaired child mental development, speech, motor, behavior and communication disorders. The disease is more common in boys (about three times more often than in girls). Autism is widespread throughout the world, regardless of social class.
Autism is a congenital disease
The term "autism" was first introduced into practice in 1920 by E. Blair to describe a symptom observed in patients with schizophrenia, which consisted in a violation of interaction with the real world. With autism, children are observed not only with mental disorders, but also with impaired perception of the surrounding reality. Symptoms of early childhood autism appear already at the age of 2-2.5 years, the incidence of the disease is 2-4 cases per 10 thousand children. In about 0.2% of cases, early childhood autism is combined with mental retardation.
In recent decades, the diagnosis of autism has been made more often, but it remains unclear whether this is due to a real increase in the prevalence of pathology or to a change in diagnostic criteria.
A synonym is infantile autism.
Causes of Autism in Children and Risk Factors
The causes of autism in children are not fully understood.
Among the probable reasons are the older age of parents, pathologies of pregnancy, trauma to the child during childbirth, infectious processes in the body of both a pregnant woman and a child at an early age, craniocerebral trauma, congenital anomalies of brain development, genetic predisposition, metabolic disorders, immune and hormonal disorders of the mother and fetus. In addition, the causes of autism in children include the influence of unfavorable environmental factors on the woman's body in the early stages of pregnancy, which can lead to biological damage to the nervous system.
Identical twins have a higher risk of developing autism
Teratogenic factors, i.e., capable of affecting the body of a pregnant woman and thereby provoking autism in a child, include:
- some components of food, especially industrially manufactured (nitrates, preservatives, stabilizers);
- alcohol;
- nicotine;
- narcotic substances;
- some medications;
- stressful situations;
- unfavorable environmental conditions in the area of residence (exhaust gases, increased background radiation, the presence of heavy metal salts in water and soil, etc.).
The risk of developing autism in both identical twins is estimated at 60–90%.
Forms of the disease
Depending on the IQ score and the level of care the patient needs in daily life, autism in children is classified as follows:
- low-functional;
- medium functional;
- highly functional.
In addition, the disease can be syndromic and non-syndromic.
Depending on the etiological factor, early childhood autism can be:
- endogenous hereditary;
- associated with chromosomal aberrations;
- exogenous organic;
- psychogenic;
- unclear etiology.
One of the forms of autism in children - with detachment from the outside world
According to the classification of K. S. Lebedinskaya, depending on the prevailing nature of the violation of social adaptation, the following forms of autism in children are distinguished:
- with detachment from the outside world (situational behavior, lack of self-service skills, complete absence of the need for social contacts);
- with rejection of the surrounding world (speech, sensory, motor stereotypes, impaired sense of self-preservation, hyperexcitability, hypersensitivity);
- with the substitution of the surrounding world (the presence of peculiar interests and fantasies, weak emotional attachment to loved ones);
- with overbraking in relation to the surrounding world (rapid mental and physical exhaustion, fearfulness, vulnerability, emotional lability).
According to the classification of O. S. Nikolskaya, depending on the severity of the manifestations of autism in children, the main psychopathological syndrome and long-term prognosis, 4 groups are distinguished:
- It is characterized by the most profound disorders, field behavior, lack of need to interact with people around, mutism, lack of active negativism, inability to self-service; the leading pathopsychological syndrome is detachment. The goal of treatment is to establish contact with the child, to engage in interaction with others, and to develop self-service skills.
- It is characterized by the presence of severe restrictions in the choice of the form of behavior, stamped speech, a pronounced desire for immutability, while any changes can cause a breakdown, which is expressed in aggression, auto-aggression, negativism; the child is able to develop and reproduce everyday skills, in a familiar environment he is quite open; the leading psychopathological syndrome is the rejection of reality. The goal of treatment is to develop contacts with loved ones, to develop more stereotypes of behavior.
- It is characterized by more complex behavior when absorbed by one's own stereotypical interests, a weak ability for dialogue, an unwillingness to compromise, try and / or take risks to achieve a set goal, while the patient may have encyclopedic knowledge in a specific area against the background of a fragmented understanding of the world, it is noted interest in dangerous antisocial entertainment; the leading psychopathological syndrome is substitution. The goal of treatment is to teach dialogue, develop skills in social behavior, and expand the range of ideas.
- Real voluntary behavior is characteristic, however, children get tired quickly, they have difficulties in concentrating and following instructions; they can behave timidly, fearfully, but with adequate treatment, they demonstrate better results in comparison with other groups; vulnerability is the leading psychopathological syndrome. The goal of treatment is to improve social interaction skills, teach spontaneity, and develop individual abilities.
Symptoms of Autism in Children
In some cases, the signs of autism in children appear already in infancy, but more often the manifestations of the disease become noticeable by the age of three.
The most obvious symptom of autism in children is an inadequate response to external stimuli. Minimal discomfort can cause fright and crying. Children with autism do not show positive emotions when interacting with adults, although they can become animated when interacting with inanimate objects. Such patients avoid games with peers, may practically not talk, show no interest in current events, tolerate loneliness well. One of the characteristic features is the repeated repetition of the same action, concentration exclusively on one thing for a long time. In addition, the symptoms of autism in children include atypically calm behavior, the inability to adopt a comfortable position in the parent's arms, avoidance of eye contact, and a prolonged lack of reaction to their name,an inadequate response to the emotions of loved ones (for example, laughter in response to crying), often in autistic patients there is a lack of their own opinion.
One of the main manifestations of autism in children is an inadequate response to external stimuli.
The main types of repetitive or restricted behaviors that are common in children with autism are divided into the following groups:
- rejection of changes (new people, surroundings, things), the need for uniformity;
- stereotypy (aimless monotonous actions, for example, a child can swing, wave his arms, rotate his head);
- ritual behavior (the child performs certain actions at the same time and in a strictly defined order);
- limited behavior (the child focuses on a single object or is active only in relation to a single object);
- Autoaggression (the child shows aggression directed at himself).
Approximately 1-10% of children with autism have special abilities or skills - a talent for music or the visual arts, the ability to remember dates and / or facts, perform complex mathematical calculations in their minds, etc.
In early childhood autism, a child's strong attachment to one of the parents (more often to the mother) is sometimes observed, while, without showing his attachment outwardly, the patient physically cannot do without a parent, while he is indifferent to the second parent and his absence. At the same time, other patients with autism do not have any attachment to their parents for a long time.
In early childhood autism, the formation of speech skills is often delayed (primarily, the lack of babbling at the age of 6-7 months). It is difficult for children with autism to combine speech with gestures. Many of them have problems with sleep (fall asleep poorly, often wake up), in addition, their development of awareness of the boundaries of their own body is delayed.
Children with autism often have better peripheral vision. Fine motor skills are often underdeveloped, and a child with autism may avoid certain colors (do not wear clothes of any color, do not use some colors when drawing, in applications, etc.). Autistic people tend to have unpleasant experiences for a long time. They may be frightened to the point of panic by certain quiet sounds, while the child may not react at all to loud sounds. Games usually do not have a plot basis and consist in placing objects in a certain sequence. Autism is often associated with generalized learning disabilities.
Signs of autism in children, which should alert parents
More than 50% of children with autism have deviations in eating behavior, which may consist in preference for strictly certain foods or unreasonable refusal from them.
Diagnostics
Diagnosing autism in infancy is difficult.
Among the non-instrumental methods in diagnosing autism in children, observation and conversation with the patient, as well as taking anamnesis, are usually used. Specially developed diagnostic techniques are used in the form of games, tests, construction, actions according to a model, etc.
If autism is suspected, an instrumental examination is also carried out. It can include the following methods:
- electroencephalography (assessment of the bioelectrical activity of the brain, as well as the state of its functional systems);
- rheoencephalography (assessment of the vascular system of the brain, detection of cerebral blood flow disorders);
- echoencephalography (determination of intracranial pressure, detection of neoplasms);
- magnetic resonance and / or computed tomography (allows you to obtain a layer-by-layer image of brain structures);
- cardiointervalography (assessment of the state of the autonomic nervous system).
Instrumental diagnostics of brain structures in patients with autism reveals disorders in different parts of the brain. At the same time, the specific cerebral localization of pathology, which would be characteristic only of autism, has not yet been determined. The inter-brain disorders that are common in children with autism are usually difficult to detect on routine examination.
Instrumental diagnostics of children with autism reveals disorders in different parts of the brain
For the diagnosis of childhood autism, questionnaires and rating scales are used, including:
- a questionnaire for the diagnosis of social diseases and impaired ability to communicate;
- Autism Diagnostic Questionnaire (adapted version);
- scale of social maturity;
- an observation scale for diagnosing autism;
- a behavioral questionnaire for diagnosing autism;
- scale for determining the severity of autism in children;
- questionnaire on spectral developmental disorders of the child; and etc.
Differential diagnosis is carried out with mental retardation, mental retardation, schizophrenia, congenital deafness, regressive psychosis, speech disorders.
Treatment for autism in children
Timely initiation of autism correction increases the likelihood of a child's successful adaptation to a normal life. The main goals of treatment for autism in children are the development of self-care skills and social adaptation. For this purpose, apply:
- behavioral therapy;
- play therapy;
- occupational therapy;
- classes with a speech therapist;
- art therapy;
- animal therapy.
Techniques are selected depending on the individual characteristics of the child. Non-drug corrective work, if necessary, be accompanied by the intake of anticonvulsant and / or psychotropic drugs.
The main goals of treatment for autism in children are the development of self-care skills and social adaptation
In the treatment of autism in children, physiotherapeutic techniques can be effective, in particular, microcurrent reflexology, which makes it possible to selectively stimulate certain areas of the brain.
Children with autism who do not speak should be involved in educational games and activities that do not require the use of speech (for example, jigsaw puzzles, puzzles, jigsaw puzzles). Such activities contribute to the establishment of contact with the child, as well as introduce him to individual or joint activities.
When using play therapy, it is recommended to choose games with clear rules, rather than role-based play activities. Since it is difficult for autists to differentiate the emotions of other people, to watch cartoons, one should select those where the characters have well-defined facial expressions. At the same time, it is necessary to encourage children to guess the emotional state of the character. In addition, it is helpful to encourage children with autism to participate in theater performances.
Autism correction in children includes audio teaching and audio vocal training techniques. The method of audio-vocal training consists in the sound effect on the child through a special device through which the sound of certain frequencies arrives. As a result, the autistic patient learns to listen and perceive sounds that they have not previously absorbed. The main goal of the method is to improve the ability to perceive and process information that enters the brain through hearing. During the sessions, the child can play, paint, or engage in other quiet activities.
For the treatment of children with autism, holding therapy is used, which consists in the fact that at a certain time the mother picks up the child and hugs the child, despite his possible resistance, while the father takes the same part in the session. This method, after some time of practice (determined individually for each child), allows parents to establish close emotional contact with the child. During the initial holding therapy sessions, there is usually a psychologist who explains to the parents what is happening and gives situational recommendations, but he himself does not participate in the session and is not able to replace the parents. Each holding therapy session has three stages:
- Confrontation stage (a child with autism usually resists starting a session, although he often waits for it throughout the day, while patients may look for any excuses to avoid holding).
- The stage of rejection (the child is trying to escape from the embrace, while the parents, showing patience, try to calm the child).
- Resolution stage (child stops resistance, makes eye contact with parents, relaxes).
It should be noted that some experts consider holding therapy to be an overly stressful method, both for a sick child and for his parents, and therefore do not recommend resorting to it.
One of the methods of treating autism in children is holding therapy
To improve the patient's interaction with the outside world, the method of animal therapy is recommended, during which children come into contact with animals (horses, cats, dogs, dolphins). The method is based on the observation that children with autism often find it much easier to establish contact with an animal than with another person. However, it should be borne in mind that a number of patients have outbursts of aggression towards animals or panic fear of them. In these cases, animal therapy is not indicated.
Physical therapy is indicated to improve the child's ability to control his body. Also, patients with autism are prescribed a diet, foods with a high content of casein and gluten (dairy products, products from wheat, rye, oats, barley) are excluded from the diet.
Patients of the first and second groups (according to the classification of O. S. Nikolskaya) are taught at home, patients of the third and fourth groups can attend a special or mass general education school.
Possible complications and consequences
Autism in children leads to impaired social interaction. In adulthood, the disease can cause problems related to career choices, interpersonal relationships, social skills, etc.
Forecast
Failure to cure autism in childhood causes the disease to persist into adolescence and adulthood. With timely adequate treatment and correction work with children with autism, it is possible to achieve acceptable social adaptation in about 30% of cases. In the absence of appropriate treatment, autistic patients remain disabled who are incapable of social interaction and self-care.
The intelligence quotient (IQ) of patients with autism is greater than 50 and the development of language skills before the age of six are favorable prognostic signs. Early diagnosis and early initiation of therapy increase the chances of cure.
Prevention
Since the exact reasons for the development of autism in children have not yet been established, prevention of this disease comes down to the usual measures to preserve and promote health that a woman should take during pregnancy:
- prevention of infectious diseases;
- timely treatment of diseases;
- regular check-ups with an obstetrician-gynecologist observing pregnancy;
- exclusion of the influence of unfavorable environmental factors on the body of a pregnant woman;
- balanced diet;
- rejection of bad habits;
- avoiding excessive physical exertion;
- regular walks in the fresh air.
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Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
