Childhood autism is a disorder that occursCause of violations in the development of the brain, marked by a pronounced shortage of social interaction, communication and repetitive, limited interests and actions. To children's autism include infantile autism, autistic disorder, infantile psychosis, Kanner's syndrome. The prevalence of this disorder reaches 5 cases per 10 000 children. Among autochthonous children, autistic children predominate 5 times more often than girls, but in girls, autism is more severe and occurs frequently in families where cases of cognitive impairment have already been reported.
Causes of Childhood Autism
At present, the causes of this disorder are not clear. There are a number of experimentally and clinically confirmed hypotheses of the development of autism:
- weakness of instincts and affective sphere;
- blockade of information related to perception disorders;
- a violation associated with the processing of auditory impressions, which leads to a blockade of contacts;
- violation of the activating influence of the reticular formation of the brainstem;
- a violation in the functioning of the fronto-limbic complex, which provokes a disorder of planning and behavior;
- a violation in the exchange of serotonin and the functioning of serotonergic brain systems;
- disorders in the paired functioning of the cerebral hemispheres.
At the same time, there are psychoanalytic andPsychological causes of the disorder. Genetic factors play a significant role, since in families with autism, this disease is more frequent than among the general population as a whole.
Early childhood autism is associated with cerebralOrganic disorder, often in anamnesis there are data on complications during childbirth and during fetal development. According to some data, there is a connection between childhood autism and epilepsy, as well as with diffuse neurological anomalies.
Symptoms of Childhood Autism
Symptomatic of children's autism is notedStereotype in behavior. For the baby is inherent in the absorption of monotonous actions: shaking, rocking, jumping, waving his hands. One subject for a long time becomes the object of manipulation, the baby shakes it, twists, taps, twists. Characteristic stereotyped movements with books: the kid rhythmically and quickly flips through the pages. The same theme prevails in the child during drawing, in conversation, in game scenes. The kid avoids any vital innovations, adheres to established rules of behavior, actively resists all changes.
Disorders in an autistic child reveal themselvesIn the delay and violation of speech development, as well as communicative functions. Mutism is often noted, the speech is stamped. The kid avoids talking, does not respond to questions, and privately with himself enthusiastically recites poems, comments on his actions.
The main signs of autism:
- the disorder detects itself up to 2.5-3 years;
- often these are beautiful babies with a sleepy, brooding, detached face;
- children are not able to establish emotionally warm relations with people;
- Kids do not respond to caresses with a smile, they do not like being hugged and taken in their arms;
- Practically remain calm during separation from loved ones, as well as in unfamiliar surroundings;
- the absence of eye contact is typical;
- speech often develops with a delay or is completely absent;
- Occasionally speech develops up to 2 years of age, and then partially disappears;
- the constant presence of monotony, ritualOr stereotypical behavior, the desire to keep everything the same (children like to wear the same clothes, eat the same food, walk the same road, play repeated monotonous games);
- typical also bizarre mannerisms and behavior (the child is constantly swinging or spinning, clapping hands or fingering his fingers;
- Deviations in the game (games are often stereotyped,Are not social, not functional, atypical are the prevalence of manipulation of toys, there are no symbolic features and imagination, there are notes of addiction to the games of unstructured material - water, sand);
- children respond to sensory stimuli (pain, sounds) either too weakly or extremely;
- The kids ignore the speech addressed to them selectively, showing an interest in mechanical sounds, non-verbal;
- the pain threshold is often lowered, an atypical reaction to pain is noted.
With children's autism, other symptoms can also be noted: sudden
, Fear, irritation, not caused by obviousReasons. Sometimes these babies are confused, hyperactive, and behavior is marked by self-damaging head blows, scratching, biting, tearing hair. Occasionally, there is enuresis, sleep disorders, eating problems, encopresis. In 25% of cases there are convulsive seizures in puberty or prepubertal age.
Early Childhood Autism
The primary signs of the disorder in early childhood autism are characterized by a weak energy potential and increased emotional sensitivity.
Secondary signs of the disorder includeAvoidance of the external world's influence, stereotyping, weakening on close emotional reactions, sometimes ignoring them, inhibited or insufficient reaction to visual and auditory stimuli.
Early childhood autism is noted in the following manifestations:
- stereotyped behavior (repetition of optional movements and actions);
- lack of desire to make contact, while ignoring all attempts of others to attract the attention of the baby;
- a feeling that the baby does not see or hear well;
- lack of desire to attract the child with a gesture, the word of other people to the interested subject;
- small circulation of the child for help;
- lack of long-term contact of the baby's eyes in the eyes;
- ignoring the adult and the lack of response to the name with the hearing preserved.
Children with early childhood autism experienceDifficulties in the moment of emotional contact with the outside world. For a baby it is a challenge to express your emotional states, as well as understanding other adults. Difficulties manifest themselves in the establishment of visual contacts with the child, as well as during interaction with adults through facial expressions, gestures, intonations. Even with native people, the child experiences difficulties in establishing emotional ties of complexity, but to a greater extent, childhood autism reveals itself in communication with outsiders.
Children with early childhood autism are characterized by echolalia, misuse of personal pronouns: the baby calls himself "he," "you," "she."
Classification of early childhood autism includesBy severity of the 4th development group. The first group is marked by a detachment from what is happening around, a manifestation of extreme discomfort when interacting with the baby, lack of social activity, it is difficult for the relatives to get a response from the baby: a look, a smile. Children of this group do not have common ground with the world around them, they ignore wet diapers, vital needs - hunger. It is hard for children to bear their eyes in the eyes, they avoid various physical contacts.
The second group is marked by active rejectionEnvironment, and is characterized by careful selectivity in contact with the outside world. The kid communicates with a limited circle of adults, often these are close people; Shows increased selectivity in clothes, food. Any violation and change in the usual rhythm of life leads to an affective strong reaction.
Children of this group experience a sense of fear, respond to
Very aggressively, taking the form of autoaggression. Motor and speech stereotypes are observed. Children of the second group are more adapted to life than the children of the first group.
The third group is marked by richesAutistic interests. The children of this group from the surrounding world take refuge in their personal interests, their employment is marked by stereotypedness and has no cognitive character. All hobbies are cyclical, the kid is able to talk for a long time on one topic, play or draw the same game story. The interests of the child are often frightening, gloomy, aggressive.
The fourth group is characterized by extremeDifficulty in interacting with the environment. It is considered the easiest version of the manifestation of child autism. The main feature of such children is increased vulnerability, vulnerability, sensitivity to someone else's assessment, avoidance of relationships.
Properly organized remedial work can allow effective promotion of the baby through the stages of social interaction, as well as make rapid adaptation to the environment.
Early childhood autism and its causes are associated with one of the following theories. In the brain of each
, There is a department that is responsible for removingUnnecessary information. The work of this department is responsible for our memory. One person quickly and permanently memorizes the information, the other is not very, and the third remembers for life. Because the brain resource is not unlimited, so the brain and strive to get rid of unnecessary information.
In children with autism, the brain department stops working, or it does not work correctly, without erasing the information, so that the baby keeps all the events that occur with him.
Beginning with infancy, when the child is not yetSees all the diversity of the world around him, he gradually feels more and more interesting and new, and it is stored in his head. And in order to prevent the brain from breaking, the department responsible for erasing memory blocks the perception of new information. It starts to happen in a year and a half of the baby's life. By this time the brain is full of information and it has nowhere to go.
Further, the brain does not allow the reception of information,Channels of which are hearing and sight. As a result, there is a defocusing of the view, as well as a change in the perception of the hearing. Therefore, the autistic child begins to use lateral (peripheral) vision and does not look into the eyes.
What happens with hearing? The baby listens, not naturally unfolds his head. The lines of perception of information with the help of hearing and vision do not coincide. This leads to the fact that the child is not able to perceive information from one source at the same time from one source by sight and hearing, just as ordinary people do.
The organs of touch also undergo a change,The baby becomes less sensitive to pain. However, at the same time, the child develops hypersensitivity: he does not like smells, touches, bright flashes, sounds, sometimes extraneous speech. His perception of new information decreases.
Children's autism and the parent's forum on this issue are often overcrowded with adult visits because of fear of crumbs.
The syndrome of child autism is amenable to correction by the psychologist, and also with the direct participation of relatives.
The forum of parents of autism gives psychological,Explanatory and corrective help to adults in communication with their children. Parents need to understand, first of all, because of which there is a delay in the intellectual development of their children. In comparison with an ordinary child, an autist does not have an interest in the new, he is calm, he does not climb anywhere, he is not curious, which inhibits the development of thinking. Such a child shuns everything new and wishes to live according to the old schemes known to him.
The autist normally develops up to a year and a half. For this age is characterized by a subject, schematic memory, marked by a low level and allows you to remember individual schemes and pictures, in which there is no need to apply thinking.
For example, consider eating a child. Autenok goes into the kitchen, sits at the table, which is already covered and begins a meal. If suddenly mom forget to put one of the cutlery, the authenticator will insistently demand that she do it, despite the fact that he knows where he is stored. Since this was always done by my mother, this scheme was postponed in the head of the child-authenticator and he can not leave it, the usual child would have put the missing device on himself for a long time.
Children with autism are very well developed lowLevel memory, and it is much easier for them to memorize the text than to repeat it in their own words. This is because when you retell you should involve thinking, and this causes them complexity. Moreover, the schematic, subject memory is very good in authits and they remember everything perfectly, but they can not associate and compare.
Often parents are puzzled why the baby does notRemembers letters, although from the first time I remembered where the spoons lay or the way to the new store. Most likely, the kid remembered well those pictures with letters, but he is not able to compare the picture with the name of the letter. For example, a picture with an orange and the orange itself, for a child these are completely different objects, he does not associate them with each other, since here one should include thinking.
It is important for parents to understand that a child autistic lives on the machine (subconscious mind) and as soon as a new situation arises, he experiences discomfort,
And other manifestations.
Autism must be differentiated from Asperger's syndrome, childhood psychosis, child
, Hearing disorder, speech development disorder, mental retardation. Occasionally
Accompanied by delirium or hallucinations, convulsive seizures.
Diagnosis of children's autism includes two stages - diagnostics using a scale and dynamic monitoring of children's condition.
How to recognize children's autism? The evaluation scale of children's autism consists of 15 positions that describe the significant areas of the child's manifestations: the ability to imitate, the desire to communicate with others, the characteristics of emotional reactions, the use of non-game and play subjects, motor skills, adaptation to changes, auditory responses, visual reactions; Taste, olfactory, tactile reaction; Presence of anxiety and fears, nonverbal interaction, features of speech, degree and productivity of activity, features and level of development of intellectual activity, assessment of the general impression of the clinician. During testing, the examined child is compared with normal indicators and the behavior is subject to an assessment that goes beyond the norm. Along with the evaluation of the child at the reception of a psychiatrist, it is allowed to use information from the parents, the results of a psychologist's survey, the observations of teachers.
Treatment of childhood autism
More and more urgent and acute is the task
Children with autismSpectrum. According to the opinion of many authors, such babies can be referred to children with special educational needs, and their integration into the education system is most difficult. Social rehabilitation of such children is possible when implementing a model of integrative (inclusive) education. Successful integration of autism occurs when several conditions are met:
- manifestations of the autism spectrum should be identified as early as possible;
- Such children need to monitor the mental state during the training period, to provide timely medical and psychological assistance;
- educators of inclusive education should have a sufficient level of knowledge about psychopathology in order to be professionally regulated by the pedagogical approach to such children.
In Israel in the medical center "Hadassah" doctorsBegan in depth to deal with prenatal prevention of autism at the stage of intrauterine development of the baby. Doctors are working on the problem of reducing the risk of children with this deviation in families who already have such a child. At present, scientists can not recognize the disorder in utero, so they try to apply known medicine to signs.
Knowing that boys are prone to breakdown four times more often, clinic doctors recommend to know the sex of the future child with the help of IVF and strive to give birth to a girl.
Doctors believe that premature birth andToxicosis during pregnancy increase the likelihood of developing autism. Therefore, prospective mothers are strongly recommended to take drugs that will reduce the manifestation of these factors, as well as to do tests to determine the content of certain substances in the blood. Most scientists suggest a connection between the hormone of love-oxytocin and children's autism. One of the main symptoms of autism is the violation of the baby's contact with other people.
Scientists have found that children suffering fromAutism, the level of oxytocin in the blood is significantly lower than in healthy people. Referring to these results, some doctors try to treat the disorder with the help of this substance.
The specialists of the Hadassah clinic are investigating the impact ofOxytocin at the stage of intrauterine development. And although the results of the study are not yet final, doctors are already offering preventative measures: do not prescribe to mothers of autistic children medications that will inhibit the production of oxytocin.
Treatment of childhood autism occurs in three ways:
- treatment of behavioral disorders;
- Family therapy;
- medical-psychological-pedagogical correction.
Treatment of childhood autism needsVersatility, diversity, complex treatment and rehabilitation activities in the unity of psychological and biological methods. Psychological and medico-pedagogical assistance is productive up to 7 years (at the main stages of personality formation). Drug treatment is effective before the age of 7, after which the drugs have a symptomatic effect. The most recommended Amitriptyline, which is the main psychotropic drug in infants of preschool age (up to 50 mg / day), a course of 4-5 months. Researchers of the disorder allocate an effective therapeutic role to vitamin B6 (up to 50 mg / day), atypical neuroleptics Rispolept (Risperidone) in a dose of up to 0.5-2 mg / day for 2 years. After their reception, behavioral disorders are reduced, stereotypes, hyperactivity, isolation, fussiness are reduced, training is accelerated. Children suffering from an autism spectrum disorder are prescribed Fenfluramine, which has antiserotonergic properties.
Substitution therapy (Aminalon, Nootropil, Pyracetam, Pantogam, Phenibut, Baclofen) is applied by repeated courses for a number of years.
Prospects for drug treatment depend on the regularity of the admission, the timing of the beginning, the individual validity, as well as the inclusion in the system of medical and rehabilitation work.
Properly organized remedial work can allow effective promotion of the baby through the stages of social interaction, as well as make rapid adaptation to the environment.