Autism. Advice To Everyone Who First Encountered This Diagnosis

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

These are just a few of the possible symptoms of autism, and their combination and severity may vary from person to person. Adaptation of the schema by Professor Rendel-Short, Australia.

Fashion diagnosis

There has been a lot of talk and writing about autism lately. Journalists love to go out to the public with vivid paradoxical hypotheses: autism is a progressive disease of all mankind, a price to pay for disunity, for abandoning live interactivity, for transferring social life to computer networks. Psychologists often argue that autism is not a disease at all, but a certain state of detachment, withdrawal into oneself, which loving parents - provided that they really love the child correctly - are able to overcome with the warmth of their soul and unconditional acceptance. Psychiatrists consider autism to be a mental illness, and you can still find the opinion that it is nothing more than childhood schizophrenia.

If your interest in autism is not idle, if you want to understand this phenomenon, then there is only one way out - "learn the materiel." For an inquisitive mind, the everyday texture of autism and its physiological foundations are an object much more exciting than humanitarian abstractions like "indigo children", "aliens", "rain people" or "the prototype of the man of the future."

Actually

In fact, there is still no definitive scientific evidence to explain the origin of autism. Moreover, if we consider the totality of studies linking it with a variety of physiological factors related to the fields of genetics, immunology, biochemistry, neurology, gastroenterology, endocrinology, if we add to them a variety of external factors that could play a negative role during the intrauterine development of the child and in period of infancy, then you involuntarily come to the conclusion that, most likely, this disease arises from a combination of several reasons that led to the disorder, and it is possible that in each particular case autism may have its own combination of both internal prerequisites and external triggers.

Treatment

In Russia and in a number of other countries (for example, in France), autism is considered a mental illness, in the United States it runs through neurology. In fact, there is no strict distinction between the two branches, and both work with patients who suffer from the central nervous system in one way or another.

A neurological diagnosis is made if the disease has pronounced physical manifestations (movement disorders, visual and speech disorders, pain), mental - if the problem is "in the head", that is, the emotional and cognitive (cognitive) spheres are impaired. There is such a medical joke: neurologists have taken away everything that can be treated, and what cannot be treated - they gave it to psychiatrists. And all would be fine, even if autism remained in the field of psychiatry, if both doctors and patients' parents did not forget that science and practice do not stand still, and that what was considered incurable yesterday is being treated today.

It is necessary to immediately make a reservation that in Russia there is no diagnosis of "autism" as such. We have early childhood autism (EDA) and Asperger's syndrome. RDA is given to children, but upon reaching the age of majority, this diagnosis is removed, replacing it with another, which seems to be the most suitable for the treating psychiatrist. The most surprising thing is that an adult in our country is not supposed to have "Asperger's syndrome" either, although this diagnosis is recognized and widely used all over the world.

First signs

Typically, parents start to worry about their child's development when they approach the age of two. Before that, any lags and deviations can be explained by the individual characteristics of the baby, and one can hope that they will gradually smooth out. By the age of two, an ordinary child, as a rule, has mastered the simplest skills, but even when this does not happen, he still understands what adults want from him. The same is with the language: if he does not yet speak himself, he understands the speech addressed to him quite well, which can be judged by his reactions.

Let's try to list the oddities in the development and behavior of a child that cause fears in parents:

- the child does not look into the eyes;

- speaks about himself in the third (he) or in the second (you) person;

- repeats words, phrases all the time;

- the child began to speak the first words, but the speech disappeared;

- does not utter a word, hums;

- is not interested in toys, peers, does not play with other children;

- the child is suspended, ignores his mother, does not respond to requests, does not respond to his name;

- shakes his head, hands, sways;

- walks on tiptoes;

- gnaws fingers, hands;

- hits himself in the face;

- the child has hysteria, bouts of aggression;

- afraid of strangers / strangers;

- frightened by sounds, shudders;

- is afraid of the light, turns it off all the time.

If any of these traits are inherent in your child, it is not necessarily autism. However, it is worth taking care.

There is such a short diagnostic test, which consists of three questions:

- Does your child look in the same direction as you when you are trying to draw his attention to something interesting?

- Does the child point to something to get your attention, not with the aim of getting what you want, but in order to share your interest in the subject?

- Does he play with toys, imitating the actions of adults? (Pours tea into a toy cup, puts the doll to sleep, does not just roll the car back and forth, but carries cubes to the construction site in the truck).

If the answer to all three questions is negative, the parents of a 2-3-year-old child have reason to show it to a specialist. If, on the contrary, it is positive, then, most likely, the delay in the development of speech and mastering of skills has another reason, not autism.

Little Autistic Behavior

Autism is, first of all, a violation of the communicative function, the child's contact with the people around him. The child lives in the world of visual images, sounds, tactile sensations, but at the same time impressions are valuable in themselves, he does not seek to share them with mom or dad, who perform an exclusively instrumental function for him, being a source of food, warmth, comfort. For such children, repetitive, obsessive actions are characteristic: someone for hours twists all the rotating objects that come to hand, from a small ball to the lid of a large saucepan, watches the water pouring from the tap, someone arranges cars or cubes in a row, someone plays with a thread, winding it around your finger or shaking it in front of your eyes. They can spin in one place for a long time or walk around the room on tiptoe in circles.

Often, young autistic people are extremely musical: they clearly enjoy their favorite pieces of music, melodies, and even individual sounds. A three-year-old child can completely indifferently walk past a peer with a remotely controlled machine, but come into indescribable delight at the sound of the striking clock at the cathedral.

The little autistic person looks confident and independent. Walking, he walks alone, resists trying to take his hand, and only being frightened of something, for example, a large dog, hides behind an adult. But his fears are not always explainable from the point of view of ordinary logic: he is afraid of a vacuum cleaner, he is afraid of noisy, crowded places, but, as a rule, he is not aware of the danger associated with heights or traffic, he can jump out onto the roadway and even lie down across.

As a rule, he stops his mother's attempts to calm him down, to caress him, to hug him, pushing her away from him. Needless to say about physical contact with strangers, a doctor or hairdresser, for example. A medical examination or a haircut becomes stressful for everyone involved in the process due to the violent resistance. Feeding is also a problem. The child is so selective in food that sometimes his diet consists of only three or four dishes (for example, cottage cheese, porridge, banana), everything else is unconditionally rejected.

It is very difficult to persuade a little autistic person to interrupt the lesson, if he is passionate about something, to convince to try something new, and parental volitional actions (to remove from the swing, take home from a walk, feed, put on a potty) cause violent hysteria, and sometimes aggression …

Children who are neurotypical (that is, do not have developmental disabilities) happily imitate the actions of adults. The girl takes a comb and runs it over her head; looking at mom, after eating, he wipes his mouth with a napkin, picks up the phone and says something. A three-year-old boy is spinning around his first-grader brother doing his homework, and if you give him a pencil and paper, he will start scratching with pleasure. Following his mother, a one-year-old child strokes a teddy bear that has fallen from the sofa, pitying him only formally at first, but gradually becoming imbued with the emotional content of the action. Imitation is an evolutionary mechanism underlying the learning of socially essential skills and social support. By imitating, the child gives us a signal of readiness to master skills, formal actions, which are gradually filled with socially significant content.

Autistic children and their parents find themselves in a vicious circle: the child sometimes does not imitate even the simplest, ordinary actions, the mother does not receive a signal of readiness, the skill does not develop. When parents catch up and urgently begin to teach the child what his peers have long mastered (eating with a spoon, using a pot, putting on socks), their volitional actions, as a rule, cause an active rejection in the child: firstly, he has no motive (standard the system of rewards / punishments does not work with such a child); secondly, he wants to return as soon as possible to an occupation that brings him deep satisfaction - for example, opening and closing drawers of a writing desk or cabinet, slamming doors, looking at pictures in his favorite book for the hundredth time.

Speech and communication

As a rule, autistic speech appears later than the usual terms, but it's not so much a matter of timing as of its specifics. The first word of an autistic child, as a rule, is not "mom", "dad", or "give" (the traditional triad of a neurotypical child), but, for example, "lawnmower", that is, the name of an object that for some reason produced a special impression, and most often it is an inanimate object (in parentheses, we note that autists learn to distinguish between living and nonliving later than neurotypes). When a small autistic person moves from individual words to sentences, they are also more of a nominal character. The child likes to repeat names, pieces of text from poems or advertisements, he often does not understand the meaning of the spoken sentences. Knowing the right words, he cannot make a request and does not always understand the requests made to him. When meeting a new person, he considers his appearance for a long time and at this time does not at all perceive the words addressed to him. A small autistic person does not know how to communicate in a dialogue. He does not ask questions himself, cannot answer the question, repeating it after the interlocutor. "What is your name?" - "What is your name?" - "You do not repeat, you answer!" - "You do not repeat, you answer!" etc. This phenomenon is called echolalia. The child does not use the pronoun “I”, saying about himself “you don’t want to go by tram” or “he will watch a cartoon”. Speech, as a rule, develops, and echolalia can pass by 4–5, sometimes by 7–8 years, but it can be delayed seriously and for a long time. Sadly, some of the autistic people still do not master oral speech, although over time they learn to use alternative methods of communication.

Echolalia is an uncontrolled automatic repetition of words heard in someone else's speech. Speech is not really analyzed in terms of its meaning, it is only stored in memory and subsequently reproduced. Echolalia is characteristic of children and adults suffering from various mental illnesses, but it also occurs in normally developing children as one of the early stages of the formation of speech. The difference between neurotypical children and children with autism is that in the latter group, echolalia persists for months or even years.

When the diagnosis is made

What can parents do for their child diagnosed with early childhood autism? What happens to an autistic child as they get older? How should society view autists and autism?

With due parental attention, autistic children do not stand still; they develop or, as doctors say, "give a positive trend." There are a number of methods of upbringing and teaching, developed specifically for autistic children, and here a lot depends on the qualifications of the specialists who will work with the child and the willingness of the parents to selfless work to rehabilitate the child.

Examinations and preparations

Parents of a little autistic person cannot avoid a visit to a psychiatrist. The prescriptions of a specialist, as a rule, include a standard set: taking medications (among which there is usually a nootropic drug to stimulate brain activity and an antipsychotic drug as a behavior corrector) and classes with a speech therapist, defectologist and psychologist. Unfortunately, parents do not always understand that prescribed medications are not, in the full sense of the word, treatment. There are no pills for autism. Antipsychotics, antidepressants, and other psychotropic drugs stop symptoms such as excessive excitability, hyperactivity, aggressiveness, but do not cure them. Moreover, all drugs of this plan have negative side effects. The psychiatrist may prescribe examinations of the brain, vessels of the neck and head (electroencephalogram, Doppler ultrasonography, computed tomography).

Sensory overload and sensory integration

Neither psychiatrists nor neurologists usually discuss with parents in detail, although it is one of the main components of autistic disorder. The signal perceived by a child with normal hearing, vision, tactile function is incorrectly converted during its transmission to the brain and enters in a distorted form: the touch of a certain type of tissue to the body can cause a painful sensation, and vice versa, a blow or an insect bite that is painful for an ordinary person is not cause pain. In a supermarket, an amusement park, or a holiday where there is a lot of noise, movement, bright lighting, and colorful objects, an autistic person can experience a state of sensory overload, which often results in tantrums. However, sensory hunger is also characteristic of such children: the need for certain sensations makes them reproduce the same movements or sounds. It is very important for parents and people around them to understand this feature of young autistic people, and also keep in mind that there is such a type of corrective therapy as sensory integration.

Effective rehabilitation

The rehabilitation of autistic children is a field of constant debate, in which parents and professionals with very different points of view, sometimes irreconcilable opponents, take part. For example, a therapy called Applied Behavior Analysis (other names: Applied Behavioral Analysis, Behavioral Therapy), in the original Applied Behavior Analysis or ABA for short. In the English-speaking world, ABA is considered the gold standard for autistic correction, but here we have to overcome a completely erroneous point of view on this therapy as a form of training. Such an opinion can be formed only with a very superficial acquaintance with this technique. It is very difficult, largely through the efforts of parents-activists, for the ABA to make its way in Russia. However, if 10 years ago parents who read English-language Internet resources devoted to autism (and there were practically no Russians then) could only dream of such a service for their child, now, at least in Moscow, it has become a reality.

ABA Therapy (Applied Behavioral Analysis) - Applied Behavioral Analysis or Lovaas Method) is a treatment system for autism spectrum disorder pioneered by Dr. Ivar Lovaas at the Department of Psychology at the University of California in 1987. The idea behind the method is that social behavioral skills can be imparted even to children with severe autism through a system of rewards and consequences. ABA therapy is the most well-researched treatment for autism spectrum disorders.

Biomedical correction

It is even more difficult with biomedical correction methods. Vitamins, amino acids, fatty acids, minerals, probiotics, enzymes, individually selected on the basis of analyzes for a particular child, are capable of producing significant positive changes in the physical condition and development of the child, but many are confused by the lack of evidence of the effectiveness of certain drugs obtained in large-scale clinical tests. The problem is that autism, as we have already said, is a multifactorial disease, and therefore what actually improves the condition of one autistic child may be useless for another. Sometimes you have to act by trial and error, but the good thing here is that the above types of supplements, when used wisely, do not give such serious complications as can be expected from psychotropic drugs.

Diets are hotly debated. The very formulation of the question - the treatment of autism with a diet - seems to many to be a zealous idea in the spirit of Gennady Petrovich Malakhov. In fact, by introducing a particular diet, we are not treating autism, but we are trying to cope with a number of metabolic disorders, which are one of the physiological causes, and sometimes the main cause of autism. There are several types of diets practiced for autism: Gluten-free, Casein-free diet, Specific Carbohydrate Diet, Low Oxalate Diet, and others. It should be noted that diet is a method that requires significant efforts from parents, and improvements, with rare exceptions, come only after 6-8 months, with strict adherence to restrictions. It happens that disappointed parents abandon it after 2-3 months, convinced that it is a waste of time and energy. However, a huge number of parents note positive changes in their children, and over time they enter a rhythm and cease to be burdened by the need to prepare "special" food.

Choosing a specialist

In addition to the already mentioned ABA and sensory integration, there are other types of corrective therapies: dolphin therapy, occupational therapy, art therapy, play therapy, various types of psychotherapy. All of them can help the autistic child overcome his limitations. It is very important to choose what is right for your child, and most importantly, this is the choice of a specialist who can establish contact with a little autistic person, take him by the hand and lead him forward. Here are some tips on how to do it:

- Pay attention to how the specialist listens to you, whether he gives you answers to questions that he himself asks or interrupts without hearing, whether he answers your questions accurately and definitely.

- Does the specialist formulate specific goals? If not, is it asking you to formulate them in order to work on them? If he calls the goal "curing autism", or states something like "well, let's play, draw with him, and we'll see," then most likely you need another specialist.

- If he does not have a ready-made action plan, is he going to present it, say, after 2-3 introductory sessions?

- Does your child like this person? A professional working with autistic children, as a rule, has an arsenal of tools that allow him to grab the attention of a child, to establish contact with him.

A few important tips

And a few more important things, without which the article on childhood autism for parents will be incomplete.

Do not trust either overly optimistic or overly pessimistic forecasts.

Treat an autistic child not as a hopeless disabled person, not as a hidden genius who will “show everyone else,” and not as an alien. Autism is still a disease, and it is not a reason for inaction, shame, or pride.

Do not listen to the advice "just love, accept as is, do not torment the child with activities and diets." There is no dilemma here: love and accept the child, fight his illness.

Try to start the child's rehabilitation as early as possible, the result will depend on this. It is highly likely that a small autistic person will not become a completely neurotypical adult (although this is not excluded), but the future quality of his life, his ability to enjoy meaningful and useful activities, to be independent, to share joy with other people largely depends on your today's effort.

Don't look for an “autism pill”, don't count on the short and easy way.

Keep a diary. Write down everything that you do with the child, record any changes.

Try to always have a plan of concrete actions for the near future.

Try not to think that you are the hardest. It is here that the danger of falling into despondency, if not into pride, of losing friends lurks.

Communicate with parents of special children, exchange information and experience. Join parenting communities, read online resources on autism.

Accept help, especially if you are just at the beginning of the journey. Over time, you will be able to help others.

Your health and mental strength is your child's main resource. Try to take care of yourself.

Finally, keep in mind that those who give you advice (including the author of this article) may not always be able to follow them exactly, but it should be treated with humor and due humility.