In almost every class and in every kindergarten group today you can meet a child with signs of one of the mild forms of autism. Many parents do not recognize autism spectrum disorder (ASD) in their children: “These are the modern kids these days!” - they say, and it is clear that admitting to yourself that your child is somehow different is very difficult. The range of feelings experienced by parents ranges from anxiety to complete denial and rejection of their own child.
Research confirms that early, intensive intervention leads to better outcomes for the child and family. It is important to notice and recognize the signs of autism early, since pediatricians often fail to diagnose ASD in the early stages. Parents are the best experts for their children, so the following test is recommended by 18 months.
Autism Test
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Risk SharingHigh risk group for autism: answers “NO” in paragraphs 5, 7. Average th autism risk:“NO” answers to item 7, but no other high-risk items. Low risk of autism: all others “NO”, with the exception of the first and second groups. If all the answers are “YES”, the child is normal. Average th autism risk, strong suspicions - do as stated above, weak suspicions - repeat the test in a month. Low th risk: Even with one answer “NO”, repeat the test in a month. |
Behavioral signs of autism
In addition to the fact that by the age of 18 months a normally developing child should point to what he wants, look where you show him, and play with objects “make-believe”, he should have formed social and communication skills, developed gross and fine motor skills, sensory perception and a sense of security. If a child lacks certain skills, this may be a sign of autism. Let's list some of them.
Socialization problems
Communication problems
Stereotypy or repetitive behavior
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Gross and fine motor skills
Sensory overload
Self-harm
Safety
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Gastrointestinal disorders as a sign of autism
Dr. Tim Buie, a gastroenterologist at Harvard University and Boston General Hospital, has performed endoscopies on more than 1,000 children with autism and found gastrointestinal problems in 400 of them. Children with ASD have stomach problems much more often than typical children. Esophagitis (inflammation of the esophagus) was found in 20% of children, gastritis in 12%, inflammation of the duodenum in 10%, colitis in 12%, and lactase deficiency in 55%. These children often have undigested food in their stool and experience constipation or diarrhea. If necessary, you should consult a gastroenterologist.
A blow to the family
Autistic people may stay awake for days, not know day from night, or have difficulty falling asleep and constantly waking up. They can sleep for a short time - 1-2 hours a day, while parents do not get enough sleep. These children have a low or absent pain threshold, frequent seizures, and unexplained spontaneous bouts of crying or laughing. A family raising an autistic child is limited in visiting public places, cinemas, shops, cafes, and cannot fully travel and relax in nature. To rehabilitate a family with a child suffering from autism, you should contact specialized centers where early intervention specialists will provide speech, occupational or physical therapy assistance.
Unfortunately, many professionals working with autistic children still do not have the new information and continue to rely on older and more pessimistic information. This leads to the two most common scenarios. So, for example, the psychiatrist to whom autistic Justin was taken by his parents when he was still a child said: “He has autism, and you need to be prepared for the fact that when he grows up, he will be institutionalized.” Parents who have heard such sentences know the despair they can lead to. Clinicians often justify such words by saying that it is better to prepare parents to face reality than to allow them to hide behind denial. However, they forget that it is the denial of such a verdict that makes hope possible. Denying the future, choosing not to see it now, is fundamentally important for the healing process and for getting rid of the sadness that goes hand in hand with the awareness of the fact that your child is not at all like the child you dreamed of, with whom you had hopes and births. which you have been patiently waiting for. New evidence about the effectiveness of interventions (both early and throughout childhood) does not allow for doom and gloom, especially for high-functioning groups such as children with Asperger's syndrome.
The psychiatrist Tom's parents consulted took a different, now more common approach: he avoided making a diagnosis for as long as possible because the clinical manifestations of the disorder were not "classic." He didn't know that there was no such thing as "classic" autism anymore. The realization that the variety of clinical manifestations of autism is enormous, that the clinical picture changes over time, and that there are other forms of autism that are similar but distinct from “classic” autism are perhaps the most important advances in autism science. over the past two decades. Most parents notice something not quite normal in their child's development during the first two years of his life. However, they often find out the diagnosis when he is five or six years old. Diagnosis at an earlier age is difficult, but we are learning more and more about the earliest signs of the disorder. One can only hope that as new information flows from researchers to clinicians on the front lines of the fight against this disorder, such delays in diagnosis will be eliminated. Perhaps the most important finding is that early diagnosis primarily depends on assessing young children's social-communication skills.
Early diagnosis: the key to successful treatment
Preschoolers with ASD do not often demonstrate the repetitive, stereotyped behaviors (rocking, rituals, resistance to change, circling, etc.) more common in middle-aged and older children. Too often, the diagnosis of Asperger's syndrome is made at eight or nine years of age or even older. Family doctors, not yet familiar with this new information, try to reassure parents that their concerns about the social and communication skills of infants and preschoolers are the result of excessive anxiety, inexperience associated with being a first child, or a complete lack of knowledge about children's development. This lack of readiness to receive a diagnosis at an early age results in a significant delay in the child's entry into early intervention programs. Some children who start these programs at age five or six are less likely to improve than they would have been if they had started much earlier. It is difficult to imagine greater despair than that of parents who were first told that they were too worried about the fact that their child did not speak, and two years later they were told that he had autism and that they would not soon get treatment because the waiting list was too long. great.
Clinicians tend to ignore the fact that we have been hearing for decades that some children with autism are getting good results. Kanner titled one of his latest articles: “How far can children with autism advance in social adaptation?” In this article, published in 1972, he wrote about the "best results" among the first 96 patients seen at his clinic. Of these 96 people, he identified 11 who, in his opinion, “functioned at a high level in society.” Indeed, specific sociological studies have revealed significant progress, but also demonstrated difficulties in adult intimate relationships. What is perhaps most striking about the development of adults with different forms of autism is the enormous variation in results. Some (our data suggests about 20% of people with Asperger's syndrome and 10% of people with autism) cope very well in life, their social and communication skills are rated as "average", and they have either mild or no symptoms of autism. are missing. Perhaps another 15-20% cope well enough to live independently with little help. However, the new generation of children with whom early intervention programs began has not yet reached adulthood, and therefore it is possible that even these data will need to be revised in the future.
Limits of Achievement
The reality is that most children with autism and Asperger's syndrome will improve with age. There is a tendency that each subsequent year of their life turns out to be better and less stressful than the previous one. The most difficult years are the first years when the diagnosis is first made and when all efforts should be directed towards starting intervention as early as possible. But some time passes, the situation “settles down”, and children develop according to their own “schedule”. Different skills will develop differently, each at their own speed; sometimes a step back will be taken, sometimes two steps forward, which will bring great relief. Sometimes what seems like a regression actually turns out to be a reaction to a new challenge that the child is not yet quite ready to answer; in time, with a little help, he will do it.
We do not know how the development of this or that child will end; no one can predict the end result. The achievements of a child with one form or another of autism can only be disappointing if you look at them from the outside and approach them with a general yardstick. “I'm afraid he's not living up to our expectations,” Justin's teacher once told his parents, and they were immediately disheartened by his son's progress. It is much better to evaluate the child's achievements from the point of view of his own world. What obstacles did he have to overcome to reach this level? The victories of a child with ASD are often of a purely personal nature: persistently continuing to go to school despite constant ridicule and bullying, trying to talk to another child in the cafeteria, working at the computer for the first time with his brother. Many of these victories are known only to parents, but this does not make them any less significant. In families where ordinary children grow up, these achievements are often taken for granted, as something taken for granted. Parents of children with some form of autism cannot take anything for granted; every step towards “typical development” is a victory that illuminates everyday events like a guiding star. You need to evaluate the success of a child with autism by comparing him not with other children, but with himself, with how he was last year or the year before.
When I began to become interested in autism about two decades ago, one of the things that struck me most was that the literature on the consequences of autism said virtually nothing about adults who were coping well in life. The published studies are clearly outdated and were conducted at a time when autism was thought to be a consequence of poor parental performance. Back then, social workers often subjected parents to long-term psychotherapy and children to years of play therapy. This literature is no longer relevant because the studies described in it were conducted before the advent of more effective forms of behaviorally based early intervention. However, new information did not reach the general public. Moreover, there were no data on the effects of other forms of autism, such as Asperger's syndrome.
Since many children were diagnosed this way, this was a significant information gap. Can I help replenish it?
My first experience in research work was a long-term outcome study conducted in 1987. along with the West End Creche Center in Toronto. At the time, Creche was known as a center that treated children with autism. The chief physician was Dr. Milada Havelkova, a Czech anesthesiologist who emigrated to Canada after the war. She was only able to find work in the field of child psychiatry and was given the Creche Center as her clinical base. She became very interested in the problem of autism, and from the early 50's, Creche became a children's therapy center in Toronto.
I wanted to meet adults who were diagnosed with high-functioning autism as children by Dr. Havelkova. She was very kind and very enthusiastic that her work could continue. I remember spending one very snowy Christmas Eve in the basement of the Creche Center, going through the files of all of its old patients. I was sitting in the basement of an old building, where there had once been a laundry and where hopelessly outdated laundry presses still remained. There were cabinets and boxes everywhere, filled with old files. The room was damp, cold and dusty. I had to look through at least five hundred folders. Reading these old case histories with their outdated terminology (childhood psychosis, traumatic brain injury, commensal psychosis) was extremely helpful and provided insight into Toronto and how children with special needs used to be treated. It was disconcerting to think that at the same time that I was growing up in this city, dramatic events and real tragedies were unfolding in families living within a few miles of my home.
I was able to contact twenty autistic adults who in the 50s. were treated at Creche. They were considered “high functioning” as children and still lived in Toronto. I visited their home and talked with them and their parents. I was amazed at how good life was for some of these kids. Of the twenty people, four were just fine: they lived independently, worked or studied (librarian, salesperson, teacher's assistant, university student), went on dates and had friends. One of them was even married. But during their childhood there were no effective treatment methods yet! The first thing I realized was this: real-life stories of high-functioning people with autism reveal remarkable possibilities for personal improvement, even without any treatment.
Stories of Fred and Herschel
Fred's story illustrates one of the best results I have encountered. I agreed to meet him in the evening near his house. Acutely aware of how punctual many people with autism are when it comes to their routines, I arrived on time, which is unusual for me. From what I knew, I knew that Fred had a special schedule and that he would be very upset if I was late. However, there was no one at the appointed place. I waited, not understanding what could have stopped him. I was about to leave when a young man appeared, very elegant, in a suit and tie, and, breathless, began to apologize for his lateness. Could this be Fred, the autistic man I was supposed to meet? Yes, it was him. He explained to me that he was studying geography with a middle school student and that the lesson lasted longer than he expected. He politely asked if I had lunch, and, having received a negative answer, suggested we have lunch somewhere together. I was shocked. He was not just polite, he was worried about whether I was hungry! It would never have occurred to me that this young man had autism if I had not read in the medical history about the terrible symptoms that he had as a child. It was written about outbursts of irritation, rigid behavior, lack of social contacts with adults and children, and active resistance to change. Is this really the same person?
We drove to the restaurant in my car. It was one of those small Italian restaurants that serve homemade pasta. We talked for a long time about his childhood, his current life and what he expects from the future. He remembers almost nothing about his autism, and he doesn’t remember anything at all about what happened before the age of five. He was in the same class with other children with autism, and it was an unpleasant experience. He was always interested in geographical maps; you could say that as a child he was simply obsessed with them. It seemed significant to me that geography became his profession, that he was able to turn an “obsession” into a useful specialty. He earned his living by giving private lessons, but hoped for a more promising career in teaching. Anyone who saw us sitting at the table eating our pasta could easily assume that we were talking about girls, about sports and about the latest gossip in our office. However, we talked about what it means to be autistic, how it is perceived from the inside and what remains of the disorder as part of his personality. It seemed to him that the only reminder of her was the excitement he felt in social situations. He dated girls, was planning to eventually get married, but felt slightly nervous in public. He was animated, cheerful, made jokes about himself, constantly gesticulated. Yes, he was slightly constrained and formal, but he was hardly different from many of his peers. Was Fred normal? How different was he from the millions who grew up as healthy children? Truly, its development turned out to be triumphant. It should be recognized that such a result is very rare, but it is not excluded. According to the results of many studies, this is only possible in very capable individuals. The most amazing thing about Fred's story was that he was treated disgustingly as a child, and therefore I could not even imagine how his situation had changed. However, one guess came to me thanks to the story of Herschel.
Herschel's result may not be as impressive as Fred's, but it is also admirable in its own way. He lived alone with his mother in the suburbs and was enrolled in a local university. He took a history course and several humanities courses, but had difficulty completing the program and took extra classes. I was with him. A modest one-story house with a veranda among massive trees on a quiet street. I realized very quickly that Herschel's family was deeply religious. Herschel was a quiet young man. He wore a yarmulke. He spoke little and answered my questions politely but succinctly. He led a secluded life, but regularly attended the synagogue. Herschel had several friends with whom he communicated only in the synagogue. He had practically no special hobbies or interests. He had little idea of his future, but he was very concerned about the grades he received at the university. Perhaps he was even too preoccupied with graduating from university to the detriment of everything else. For him, the marks were not milestones on the path to completion, but they themselves marked the end.
However, I was amazed at how much it has changed for the better over the years. There was no possibility that the early diagnosis was wrong: I became convinced of this later when I re-read his medical history. It said that as a child Herschel had many symptoms of autism and a pronounced learning disability. This made his academic achievements even more remarkable.
However, it was Herschel's mother who made the strongest impression on me during the visit. She was a short, but very strong-willed woman. We sat in the dining room at a table surrounded by family photographs of children and relatives from the “historical homeland.” She spoke vividly about Herschel's early childhood, about her pain and her worries about his future. Noticing that something was wrong with the boy, she took him to a specialist in a large clinic at a medical higher education institution. The specialist said that the boy had autism and advised the mother to prepare for the fact that her son would not be able to study with normal children and would end up in a specialized medical institution. Herschel’s mother listened to this verdict with stoic calm, thanked the doctor for his advice and tried to quickly put everything he said out of her head. She looked at me seriously and said, “When I left his office, I swore that I would make a man out of this boy, even if it cost me my life.”
After the visit to the clinic, Herschel’s mother enrolled Herschel in a regular kindergarten at a nearby school and in all local events in which a child from a religious family was not prohibited from participating. She recalled fighting with experts in the local government school department, with minor officials who were in charge of children's recreation programs, with doctors who thought they knew better. No one could shake her determination to help her son. She may be ostracized, she may be laughed at, but who can say how his life would have turned out if she had not fought so decisively and fearlessly for him? She had an inhuman will that almost no one could resist. What she was doing was not at all accepted in Toronto at the time. Unlike now, there was no evidence that being around healthy children was better for autistic children than being in special schools and being isolated from healthy peers. There is no doubt that the specialists in their offices, with two and a half children of their own at home, thoughtfully nodded their heads at each other during the “five-minute meetings” and said that she was interfering in something other than her own business and was mistaken about her son’s mental abilities. But what almost none of them seemed to understand was that it was thanks to her actions that Herschel’s life changed radically.
Susan's Story
Susan's life is a completely different story, no less magnificent in its own way, despite the terrible poverty in which she and her father lived. She lived in the very center of Toronto, in a very run-down area. I remember standing on the porch of her house and ringing the doorbell. The house was in disrepair, the paint was peeling and there were warped screens sticking out of the windows. Finally Susan appeared on the threshold. She looked at me in surprise, but then remembered that we had agreed to meet, and invited me into the house. She said she was upstairs doing some calculations on the calendars. She led me into a small living room. All the walls were haphazardly covered with calendars for different years, open for the same month. An elderly and, apparently, very decrepit gentleman was sitting in a chair in front of the TV, watching some kind of show; The sound was turned up almost at full volume. I politely introduced myself, but soon realized that the old man could hardly hear anything. Susan told me that her mother died several years ago and now she is looking after her father. They are visited periodically by social workers who provide some help around the house, but Susan does the daily household chores herself: shopping, cooking and cleaning. She does not work or study, but spends time in her room, looking at calendars and film magazines. This life suits her quite well, and she doesn’t need anything else.
Many years ago, Susan was taught by her mother to cook and do light housework. It took a long time, but she must also have been a strong-willed person, because in the end she managed to teach her daughter to take care of herself and the house. Once formed, these skills began to live on their own, and now that her mother is gone, it is the established order and routine that allows her to care for her father and live in her own home. Her victory is that, despite her own limitations, she was able to care for her father. One of the benefits of autistic inflexibility is that it makes established routines part of his life. She may not consider caring for her father such a big burden, but I could only wonder how she manages to live in such conditions. What saved this family was the inherent ability of autistic people to strictly follow routine. Susan went about her business calmly and efficiently, but I understood the enormous amount of effort and training that had gone into establishing this routine in the first place. Her mother must have had the same unyielding will that I have so often met in other families.
Autism means that a person develops differently and has problems communicating and interacting with others, as well as unusual behaviors such as repetitive movements or very specialized interests. However, this is only a clinical definition and is not the most important thing to know about autism.
So...what should the average person know about autism? There are a huge number of misconceptions, important facts that people are not even aware of, and several universal truths that are always ignored when it comes to disability. So let's list them.
1. Autism is diverse. Very, very diverse. Ever heard the saying, “If you know one autistic person, then you know... only one autistic person”? This is true. We like completely different things, we behave differently, we have different talents, different interests and different skills. Get a group of autistic people together and look at them. You will find that these people are just as different from each other as neurotypical people. Perhaps autistic people are even more different from each other. Every autistic person is different, and you can't make any assumptions about them based on their diagnosis other than, "This person probably has problems with communication and social interaction." And, you see, this is a very general statement.
2. Autism does not define a person's personality... but it is still a fundamental part of who we are. Someone kindly reminded me of the missing second item on this list, so I just added it! I miss something every now and then... especially if it's something like "If it says it's a list of ten items, then there must be ten items." The thing is that I have a hard time seeing the big picture, and instead I find myself constantly focusing on details like, “Did I make a spelling mistake?” If I didn't already have a pervasive developmental disorder, I would have been diagnosed with an attention disorder like ADHD - it's not just autism in my head. In reality, autism is just one of many things, and most of them are not diagnoses. I'm autistic, but I also have huge problems with organizing my actions and switching to a new task, which people with ADHD usually have. I am excellent at reading, but have serious problems with arithmetic, but not with counting. I am an altruist, an introvert, I have my own opinion on any subject, and I hold moderate views in politics. I am a Christian, a student, a scientist... So many things go into identity! However, autism colors it all a little, as if you are looking at something through stained glass. So if you think that I would be the same person without my autism, then you are definitely mistaken! Because how can you remain the same person if your mind starts thinking differently, learning differently, and you have a completely different view of the world? Autism is not just some additive. This is the very basis for the development of the personality of an autistic person. I only have one brain, and "autism" is just a label that describes the way that brain works.
3. Having autism does not make your life meaningless. Having a disability in general does not mean that your life is meaningless, and in this respect autism is no different from any other disability. Limitations in communication and social interaction, coupled with learning difficulties and sensory issues that are common to us, do not mean that an autistic person's life is worse than that of a neurotypical person. Sometimes people assume that if you have a disability then your life is inherently worse, but I think they are just too inclined to see things from their own point of view. People who have been neurotypical their entire lives begin to think about how they would feel if they suddenly lost their skills... when in reality they should imagine that they never had these skills, or that they have developed different skills and a different view of the world. Disability itself is a neutral fact, not a tragedy. In relation to autism, the tragedy is not autism itself, but the prejudices associated with it. No matter what limitations a person has, autism does not prevent them from being part of their family, part of their community, and a person whose life has inherent value.
4. Autistic people are just as capable of love as any other person. Loving other people doesn't depend on your ability to speak fluently, understand other people's facial expressions, or remember that when you're trying to make friends with someone, it's best not to talk about wild cats for an hour and a half non-stop. We may not be able to copy other people's emotions, but we are capable of the same compassion as everyone else. We just express it differently. Neurotypicals usually try to express empathy, autistics (at least those who look like me, as I said before - we are very different) try to fix the problem that upset the person in the first place. I see no reason to believe that one approach is better than the other... Oh, and one more thing: although I myself am asexual, I am in the minority among people on the autism spectrum. Autistic adults, with any form of autism, can fall in love, get married and have families. Several autistic people I know are married or dating.
5. Having autism does not prevent a person from learning. Doesn't really bother me. We grow and we learn throughout our lives, just like any other person. Sometimes I hear people say that their autistic children have "recovered." However, in reality they are only describing how their children grow, develop and learn in an appropriate environment. They actually devalue the efforts and achievements of their own children, chalking them up to the latest drug or other treatment. I've come a long way from the two-year-old girl who cried her eyes out almost 24 hours a day, constantly ran in circles and threw violent tantrums at the touch of woolen fabric. Now I'm in college and I'm almost independent. (I still can’t stand wool fabric, though). In a good environment, with good teachers, learning will be almost inevitable. This is what autism research should focus on: how best to teach us what we need to know about a world that is not designed for us.
6. The origin of autism is almost entirely genetic. The hereditary component of autism is about 90%, which means that almost every case of autism can be traced back to some combination of genes, whether it's the "nerd genes" that were passed down from your parents or new mutations that just arose in your generation. Autism has nothing to do with the vaccines you received, and it has nothing to do with what you eat. Ironically, despite the arguments of anti-vaxxers, the only proven non-genetic cause of autism is congenital rubella syndrome, which occurs when a pregnant (usually unvaccinated) woman gets rubella. People, get all the necessary vaccinations. They save lives - the millions of people who die every year from vaccine-preventable diseases would agree.
7. Autistic people are not sociopaths. I know you probably don't think so, but it still bears repeating. “Autism” is often associated with the image of a person who absolutely does not care about the existence of other people, when in reality, it is simply a problem of communication. We don't care about other people. Moreover, I know several autistic people who are so terrified of accidentally saying “something wrong” and hurting other people’s feelings that as a result they are constantly embarrassed and nervous. Even nonverbal autistic children show the same affection for their parents as non-autistic children. In reality, autistic adults commit crimes much less often than neurotypical adults. (However, I don’t think that this is due to our innate virtue. After all, very often crime is a social activity).
8. There is no "autism epidemic." In other words: the number of people diagnosed with autism is growing, but the total number of autistic people remains the same. Studies of adults show that the rate of autism among them is the same as among children. What are all these new cases related to? Just because diagnoses are now being made for milder forms of autism, including the recognition that Asperger's syndrome is autism without a speech delay (previously there was no diagnosis if you could speak). In addition, they began to include people with mental retardation (as it turned out, in addition to mental retardation, they very often also have autism). As a result, the number of diagnoses of "mental retardation" has decreased, and the number of diagnoses of "autism" has correspondingly increased. However, the “autism epidemic” rhetoric has also had a positive effect: it has taught us about the true prevalence of autism, and we know that it is not necessarily severe, and we know exactly how it manifests itself, which allows children to get the support they need from a very early age.
9. Autistic people can be happy without healing. And we are not talking about some second-rate happiness according to the principle “something is better than nothing.” Most neurotypical people (unless they are artists or children) will never notice the beauty in the arrangement of cracks in the asphalt of the pavement, or how beautifully the colors play on spilled gasoline after the rain. They will probably never know what it's like to commit completely to a certain topic and learn everything they can about it. They will never know
the beauty of the facts that were brought into a certain system. They'll probably never know what it's like to wave your hands in happiness, or what it's like to forget everything because of the feel of a cat's fur. There are wonderful aspects to the lives of autistic people, just as there are likely to be wonderful aspects to the lives of neurotypicals. No, don't get me wrong: it's a hard life. The world is not designed for autistic people, and autistic people and their families face the prejudices of others every day. However, happiness in autism is not a matter of “courage” or “overcoming.” It's just happiness. You don't have to be normal to be happy.
10. Autistic people want to be part of this world. We really want it... just on our own terms. We want to be accepted. We want to go to school. We want to work. We want to be listened to and heard. We have hopes and dreams for our future and the future of this world. We want to contribute. Many of us want to start a family. We are different from the norm, but it is diversity that makes this world stronger, not weaker. The more ways of thinking there are, the more ways will be found to solve a particular problem. A diverse society means that when a problem arises, we will have different minds on hand and one of them will come up with a solution.
Autism is a diagnosis that many parents perceive as a kind of death sentence. Research into what autism is and what kind of disease it is has been going on for a very long time, and yet childhood autism remains the most mysterious mental illness. Autism syndrome manifests itself most clearly in childhood, which leads to the isolation of the child from family and society.
Autism - what is it?
Autism in Wikipedia and other encyclopedias is defined as a general developmental disorder in which there is a maximum deficit in emotions and communication. Actually, the name of the disease determines its essence and how the disease manifests itself: the meaning of the word “autism” is within oneself. A person suffering from this disease never directs his gestures and speech to the outside world. There is no social meaning in his actions.
At what age does this disease appear? This diagnosis is most often made in children aged 3-5 years and is called RDA , Kanner's syndrome . In adolescence and adulthood, the disease manifests itself and, accordingly, is rarely detected.
Autism is expressed differently in adults. Symptoms and treatment of this disease in adulthood depend on the form of the disease. There are external and internal signs of autism in adults. Characteristic symptoms are expressed in facial expressions, gestures, emotions, volume of speech, etc. It is believed that types of autism are both genetic and acquired.
Causes of autism
The causes of this disease are associated with other diseases, psychiatrists say.
As a rule, autistic children are in good physical health and have no external defects. The brain of sick babies has a normal structure. When talking about how to recognize autistic children, many note that such babies are very attractive in appearance.
Mothers of such children proceeds normally. However, the development of autism is still in some cases associated with the manifestation of other diseases:
- cerebral palsy ;
- infection mothers during pregnancy;
- tuberous sclerosis ;
- disturbed fat metabolism (the risk of having a baby with autism is greater in women suffering from).
All of these conditions can have a negative impact on the brain and, as a result, provoke symptoms of autism. There is evidence that genetic disposition plays a role: signs of autism are more likely to appear in people who already have autism in their family. However, what autism is and what the causes of its manifestation are are still not completely clear.
An autistic child's perception of the world
Autism in children manifests itself with certain signs. It is generally accepted that this syndrome leads to the fact that the baby cannot combine all the details into a single image.
The disease manifests itself in the fact that the child perceives a person as a “set” of unrelated body parts. The patient hardly distinguishes inanimate objects from animate ones. All external influences - touch, light, sound - provoke an uncomfortable state. The child tries to withdraw inside himself from the world that surrounds him.
Symptoms of Autism
Autism in children manifests itself with certain signs. Early childhood autism is a condition that can manifest itself in children at a very early age - both at 1 year and at 2 years old. What is autism in a child, and whether this disease exists, is determined by a specialist. But you can independently figure out what kind of illness a child has and suspect him based on information about the signs of such a condition.
This syndrome is characterized by 4 main signs. In children with this disease, they can be determined to varying degrees.
Signs of autism in children are:
- impaired social interaction;
- impaired communication;
- stereotypical behavior;
- early symptoms of childhood autism in children under 3 years of age.
Disturbed social interaction
The first signs of autistic children may appear as early as 2 years of age. Symptoms can range from mild when eye-to-eye contact is impaired to more severe when it is completely absent.
The child cannot perceive as a whole the image of the person who is trying to communicate with him. Even in photos and videos, you can recognize that such a baby’s facial expressions do not correspond to the current situation. He does not smile when someone tries to cheer him up, but he can laugh when the reason for this is not clear to anyone close to him. The face of such a baby is mask-like; grimaces appear on it from time to time.
The baby uses gestures only to indicate needs. As a rule, even children under one year of age sharply show interest if they see an interesting object - the baby laughs, points, and demonstrates joyful behavior. The first signs in children under 1 year of age can be suspected if the child does not behave this way. Symptoms of autism in children under one year of age are manifested by the fact that they use a certain gesture, wanting to get something, but do not strive to capture the attention of their parents by including them in their play.
An autistic person cannot understand other people's emotions. How this symptom manifests itself in a child can be tracked already at an early age. While normal children's brains are designed in such a way that they can easily determine when looking at other people whether they are upset, happy or scared, an autistic child is not capable of this.
The child is not interested in peers. Already at the age of 2, ordinary children strive for company - to play, to meet peers. Signs of autism in 2-year-old children are expressed by the fact that such a child does not participate in games, but is immersed in his own world. Those who want to know how to recognize a child 2 years old and older should simply take a closer look at the company of children: an autistic person is always alone and does not pay attention to others or perceives them as inanimate objects.
The child finds it difficult to play using imagination and social roles. Children 3 years old and even younger play, imagining and inventing role-playing games. For autistic people, symptoms at 3 years old may include not understanding what the social role is in play and not perceiving toys as whole objects. For example, signs of autism in a 3-year-old child may be expressed by the child spinning a car wheel for hours or repeating other actions.
The child does not respond to emotions and communication from the parents. Previously, it was generally accepted that such children did not become emotionally attached to their parents at all. But now scientists have proven that when the mother leaves, such a child at 4 years old and even earlier shows anxiety. If family members are nearby, he seems less obsessive. However, in autism, signs in 4-year-old children are expressed by a lack of reaction to the fact that parents are absent. The autistic person exhibits anxiety, but he does not try to get his parents back.
Broken communication
In children under 5 years of age and later, speech delay or her complete absence (mutism ). With this disease, the signs in children 5 years old in speech development are already clearly expressed. The further development of speech is determined by the types of autism in children: if a severe form of the disease is observed, the child may not master speech at all. To indicate his needs, he uses only some words in one form: sleep, eat, etc. The speech that appears is, as a rule, incoherent, not aimed at understanding other people. Such a child can say the same phrase for several hours, which has no meaning. Autistic people talk about themselves in the third person. How to treat such manifestations, and whether their correction is possible, depends on the degree of the disease.
Abnormal speech . When answering a question, such children repeat either the entire phrase or part of it. They may speak too quietly or loudly, or intonate incorrectly. Such a baby does not react if he is called by name.
No “age issues” . Autistic people do not ask their parents many questions about the world around them. If questions do arise, they are monotonous and have no practical significance.
Stereotypical behavior
Gets fixated on one activity.
Among the signs of how to identify autism in a child, one should note obsession. A child can spend many hours sorting cubes by color and making a tower. Moreover, it is difficult to return him from this state.
Performs rituals every day. Wikipedia shows that such children feel comfortable only if the environment remains familiar to them. Any changes - a rearrangement in the room, a change in the route for a walk, a different menu - can provoke aggression or pronounced withdrawal.
Repeating meaningless movements many times (manifestation of stereotypy) . Autistic people tend to self-stimulate. This is a repetition of the movements that the child uses in an unusual environment. For example, he can snap his fingers, shake his head, clap his hands.
Development of fears and obsessions. If the situation is unusual for the child, he may develop seizures aggression , and self-injury .
Early onset of autism
As a rule, autism manifests itself very early - parents can recognize it before the age of 1 year. In the first months, such children are less mobile, react inadequately to external stimuli, and have poor facial expressions.
Why children are born with autism is still not clearly known. Despite the fact that the causes of autism in children have not yet been clearly identified, and in each specific case the reasons may be individual, it is important to immediately report your suspicions to a specialist. Is it possible to cure autism, and is it curable at all? These questions can only be answered individually, after conducting an appropriate test and prescribing treatment.
What do parents of healthy children need to remember?
Those who do not know what autism is and how it manifests itself should still remember that such children are found among your children's peers. So, if someone's toddler is having a tantrum, it could be an autistic child or a toddler suffering from other mental disorders. You need to behave tactfully and not condemn such behavior.
- encourage parents and offer your help;
- do not criticize the baby or his parents, thinking that he is simply spoiled;
- try to remove all dangerous objects located near the baby;
- don't look at it too closely;
- be as calm as possible and let your parents know that you perceive everything correctly;
- Do not draw attention to this scene and do not make noise.
Intelligence in autism
Autistic traits also appear in a child's intellectual development. What it is depends on the characteristics of the disease. As a rule, such children have a moderate or mild form of mental retardation . Patients suffering from this disease have difficulty learning due to the presence of brain defects .
If autism is combined with chromosome abnormalities , microcephaly , then it can develop profound mental retardation . But if there is a mild form of autism, and the child’s speech is developing dynamically, then intellectual development may be normal or even above average.
The main feature of the disease is selective intelligence . Such children can demonstrate excellent results in mathematics, drawing, and music, but fall far behind in other subjects. Savantism is a phenomenon where an autistic person is very clearly gifted in one specific area. Some autistic people are able to play a melody accurately after hearing it only once, or calculate complex examples in their head. Famous autists of the world - Albert Einstein, Andy Kaufman, Woody Allen, Andy Warhole and many others.
There are certain types of autistic disorders, including: Asperger's syndrome
. It is generally accepted that this is a mild form of autism, the first signs of which appear at a later age - after about 7 years. This diagnosis requires the following features:
- normal or high level of intelligence;
- normal speech skills;
- problems with speech volume and intonation are noted;
- fixation on some activity or study of a phenomenon;
- lack of coordination of movements: strange postures, awkward walking;
- self-centeredness, lack of ability to compromise.
Such people lead relatively normal lives: they study in educational institutions and at the same time can make progress and create families. But all this happens provided that the right conditions are created for them, adequate education and support are present.
Rett syndrome
This is a serious disease of the nervous system, the causes of its occurrence are associated with disturbances in the X chromosome. Only girls suffer from it, since with such disorders the male fetus dies in the womb. The frequency of this disease is 1:10,000 girls. When a child has this particular syndrome, the following signs are noted:
- deep autism, isolating the child from the outside world;
- normal development of the baby in the first 0.5-1.5 years;
- slow head growth after this age;
- loss of purposeful hand movements and skills;
- hand movements - such as shaking hands or washing;
- loss of speech skills;
- poor coordination and poor motor activity.
How to determine Rett syndrome - this is a question for a specialist. But this condition is slightly different from classic autism. So, with this syndrome, doctors determine epileptic activity and underdevelopment of the brain. The prognosis for this disease is poor. In this case, any correction methods are ineffective.
How is autism diagnosed?
Externally, such symptoms in newborns cannot be determined. However, scientists have been working for a long time to identify signs of autism in newborns as early as possible.
Most often, parents notice the first signs of this condition in children. Especially early autistic behavior is determined by those parents whose family already has small children. Those who have autism in their family should take into account that this is a disease that should be tried to be diagnosed as early as possible. After all, the earlier autism is identified, the greater the chances of such a child to feel adequately in society and live a normal life.
Test with special questionnaires
If childhood autism is suspected, diagnosis is carried out through interviews with parents, as well as studying how the child behaves in his usual environment. The following tests are used:
- Autism Diagnostic Observation Scale (ADOS)
- Autism Diagnostic Questionnaire (ADI-R)
- Childhood Autism Rating Scale (CARS)
- Autism Behavioral Questionnaire (ABC)
- Autism Evaluation Checklist (ATEC)
- Checklist for Autism in Young Children (CHAT)
Instrumental research
The following methods are used:
- performing an ultrasound of the brain - for the purpose of exclusion brain damage , provoking symptoms;
- EEG – for the purpose of identifying seizures epilepsy (sometimes these manifestations are accompanied by autism);
- child hearing test – to exclude delayed speech development due to hearing loss .
It is important for parents to correctly perceive the behavior of a child who suffers from autism.
| Adults see | Is not | Perhaps it |
| Shows forgetfulness and disorganization | Manipulation, laziness, lack of desire to do anything | Lack of understanding of parents' or other people's expectations, high anxiety, reaction to stress and change, attempt to regulate sensory systems |
| Prefers monotony, resists change, gets upset by change, prefers to repeat actions | Stubbornness, refusal to cooperate, rigidity | Uncertainty about how to follow instructions, desire to maintain normal order, inability to assess the situation from the outside |
| Does not follow instructions, is impulsive, makes provocations | Selfishness, disobedience, desire to always be the center of attention | It is difficult for him to understand general and abstract concepts, it is difficult for him to process information |
| Avoids lighting and certain sounds, does not look anyone in the eye, rotates, touches, smells foreign objects | Disobedience, bad behavior | He has poor processing of bodily and sensory signals, high visual, sound, and olfactory sensitivity |
Treatment of autism
Whether this condition can be treated or not is of most interest to the parents of such children. Unfortunately, the answer to the question " Is autism curable?" unambiguous: " No, there is no treatment».
But, despite the fact that the disease cannot be cured, the situation can be improved. The best “treatment” in this case is regular classes every day And creating the most favorable environment for autistic people .
Such actions are actually very difficult for both parents and teachers. But with such means one can achieve great success.
How to raise an autistic child
- Realize who an autistic person is and that autism is a way of being. That is, such a baby is able to think, look, hear, feel differently than most people.
- To provide the most favorable environment for someone with autism so that they can develop and learn. An unfavorable environment and changes in routine have a bad effect on an autistic person and force him to withdraw even deeper into himself.
- Consult with specialists - psychiatrist, psychologist, speech therapist and others.
How to treat autism, stages
- Build the skills needed for learning. If the child does not make contact, gradually establish it, not forgetting who they are - autistic people. Gradually you need to develop at least the rudiments of speech.
- Eliminate forms of behavior that are unconstructive: aggression, self-injury, fears, withdrawal, etc.
- Learn to observe, imitate.
- Teach social games and roles.
- Learn to make emotional contact.
Behavioral therapy for autism
The most common treatment for autism is practiced according to the principles behaviorism
(behavioral psychology).
One of the subtypes of such therapy is ABA therapy . The basis of this treatment is to observe what the baby's reactions and behavior look like. After all the features have been studied, stimuli are selected for a particular autistic person. For some children this is their favorite dish, for others it is musical motives. Further, all desired reactions are reinforced with such encouragement. That is, if the baby did everything as needed, then he will receive encouragement. This is how contact develops, skills are consolidated and signs of destructive behavior disappear.
Speech therapy practice
Despite the degree of autism, such children have certain difficulties with speech development, which interferes with normal communication with people. If your child regularly works with a speech therapist, his intonation and pronunciation will improve.
Developing self-service and socialization skills
Autistic people lack the motivation to play and do everyday things. They find it difficult to adapt to maintaining personal hygiene and daily routine. To consolidate the desired skill, they use cards on which the order of performing such actions is drawn or written.
Medication therapy
It is permissible to treat autism with medications only if the destructive behavior of a young patient interferes with its development. However, parents need to remember that any reaction of an autistic person - crying, screaming, stereotypy - is a kind of contact with the outside world. It’s worse if the child withdraws into himself for whole days.
Therefore, any sedative and psychotropic medications can only be used according to strict indications.
There are some opinions that are more popular than scientific. For example, data on what helps to cure an autistic person has not been scientifically confirmed.
Some methods are not only not beneficial, but can also be dangerous for the patient. It's about application glycine , stem cells , micropolarization etc. Such methods can be very harmful for autistic people.
Conditions that mimic autism
SPD with autistic traits
The symptoms of this disease are associated with delayed psycho-speech development. They are in many ways similar to the signs of autism. Starting from a very early age, the baby does not develop in terms of speech in the way that existing norms suggest. In the first months of life, he does not babble, then he does not learn to speak simple words. At 2-3 years old his vocabulary is very poor. Such children are often poorly developed physically and sometimes hyperactive. The final diagnosis is made by the doctor. It is important to visit a psychiatrist or speech therapist with your child.
Attention Deficit Hyperactivity Disorder
This condition is also often mistaken for autism. Children with attention deficit are restless and have difficulty learning at school. Problems arise with concentrating; such children are very active. Even in adulthood, echoes of this condition remain, because such people find it difficult to remember information and make decisions. You should try to diagnose this condition as early as possible, practice treatment with psychostimulants and sedatives, and also visit a psychologist.
Hearing loss
These are a variety of hearing impairments, congenital and acquired. Children who are hard of hearing also experience speech delay. Therefore, such children do not respond well to their names, fulfill requests, and may seem disobedient. In this case, parents may suspect autism in their children. But a professional psychiatrist will definitely refer the baby for an examination of auditory function. A hearing aid can help solve problems.
Schizophrenia
Previously, autism was considered one of the manifestations in children. However, it is now clear that these are two completely different diseases. Schizophrenia in children begins later - at 5-7 years. The symptoms of this disease appear gradually. Such children have obsessive fears, talk to themselves, and later develop delusions and... This condition is treated with medication.
It is important to understand that autism is not a death sentence. After all, with proper care, the earliest correction of autism and support from specialists and parents, such a child can fully live, learn and find happiness as an adult.
There is no known cause for autism spectrum disorder, but the scientific community generally believes that it is caused by abnormalities in the structure and function of the brain. This has been found in studies that illustrate differences in the shape and structure of the brains of autistic children compared to typical children. There is also ample evidence to support the theory that some children are born with a predisposition to autism, but scientists still cannot determine what the trigger is. This is why researchers have suggested that irregular segments of the genetic code may be the main causes of autism.
Is it possible to determine the causes of autism?
In recent years, however, information has emerged that was not previously considered. Although the causes of autism are not fully identified, and it is likely that scientists will never find the main one, researchers suggest that autism may be a result of modern human life. There are a number of significant studies that should ring alarm bells in the scientific and medical communities.
It should be noted that autism represents a wide range of disorders, but they should not be perceived as a disability. Some may appear due to developmental defects at a critical stage. Others may be caused by a minor evolutionary leap. It is important to understand that the spectrum is truly vast, and many children diagnosed with autism have not had a brain scan. Their diagnosis was made after observations and taking into account social trends.
Toxins in the environment
Because autism is highly correlated with developmental defects during critical stages, especially during embryonic development, scientists have found that some of the strongest predictors of autism are environmental. At all stages of pregnancy, the fetus is extremely vulnerable to any toxins that affect the mother, such as prescription drugs or pesticides in the environment. 
So Andrei Rzhetsky, professor of genetic medicine and human genetics at the University of Chicago, points out that some substances significantly alter normal development. Several years ago, he published research showing that autism and intellectual disabilities are linked to fetal exposure to environmental hazards during development. Lead, drugs, and a huge number of other synthetic substances (pesticides, mercury, aluminum) have been found to have a negative effect on the fetus. These substances have also been linked to birth defects of the male genital organs, which are strongly correlated with autism.
This is just one of many important studies that should be a wake-up call to the scientific and medical community. It shows that preventive measures can be critical in the fight against autism. Parents who want to reduce the risk of having a child with autism should be aware of this risk.
Is it a genetic or environmental problem?
It should be clear that autism goes far beyond genetic problems. There are many toxins in our environment that affect the development of the nervous system and brain. Polychlorinated biphenyls, lead, mercury, aluminum, brominated pyrines, pesticides are just a few of many examples. Cases of autism have increased significantly over recent decades. So it's time to take a look at our environment. 
If we focus on even one of the many dozens of toxins we are exposed to every day, it is easy enough to understand why the risk of having a child diagnosed with autism is constantly increasing. Add in dozens of other toxins that are equally problematic, and the picture becomes clearer.
Exposure to pesticides
Let's look at pesticides, because billions of tons of these substances end up in our food supply and environment every year. It is important to understand that all pesticides are very complex mixtures of active ingredients. These components are designed to increase the economic benefit of the product. However, information about the composition of these components is not always publicly available.
A University of California study found that pregnant women who live close to land and farms where chemical pesticides are used have a two-thirds increased risk of having a child with autism or another developmental disorder. 
The study examines the link between pesticides, including organophosphates, that were used during study participants' pregnancies and later diagnosis of autism in children.
Thus, phosphates affect the course of pregnancy and increase the risk of developing autism. Exposure to pesticides for people who live in agricultural regions can be problematic, especially during pregnancy, since the developing brain of the fetus is more vulnerable to such substances than that of an adult.
Effect of other toxins
As can be seen, pesticides in the environment are a major concern. But we only talked about those that end up in food products. But there are also air fresheners, prescription drugs, fluoride, and a host of other pollutants that contribute to autism. This is probably why scientists still cannot determine the main cause of this disease. Considering the number of toxins we are exposed to every day, it is clear that we are dealing with several factors that, when combined, present a serious cause for concern. 
Vaccine?
There is a theory that vaccination may also be responsible for the rise in autism cases in recent years. Of course, we cannot say that we have discovered one direct cause of autism, but it remains important to identify the multiple factors that work together to make the disorder so common.
Despite skepticism, there are many doctors who believe that attitudes towards vaccination should be reconsidered.
There are many studies that have determined the dangers of vaccine ingredients. For example, aluminum, which is also used in vaccines, may be responsible for a large number of neurodegenerative disorders, one of which is autism. 
The question of vaccine safety becomes even more pressing given that no adequate clinical studies have been conducted to establish the safety of all its components.