Description of the nosology of early childhood autism, atypical autism. The basic principles of the diagnosis of the disease, the criteria for the diagnosis. Methods of psychotherapeutic correction of children with this disorder. Childhood autism is a rather rare disorder that is characterized by general social detachment, maladjustment, immersion in one's own experiences, impaired formation of personal contacts and stereotypical movements. Most often, the first signs of autism in a child appear before the age of 3 years.
Description and forms of the disease "autism" in children
Autism in children can manifest itself as early as the age of 1 year. Such babies deliberately distance themselves from physical contact with their mother and loved ones. Experiencing discomfort in the arms of relatives, they often cry, avoid looking directly into the eyes.
A characteristic of infants with autism is the ability to withdraw into oneself, not to respond to external stimuli. For an ordinary baby, it will be natural to react to a sound or a bright color, while a child with disorders will fence off such factors, going deeper into his inner world. In order to diagnose the disease in a timely manner and begin treatment, it is necessary to know how autism manifests itself in a child.
The kid in this case is not able to understand or at least realize the social interactions around him. Cognition of the external world and the formation of outlook occurs by reflecting everything that is happening around. Thus, the child analyzes and composes his own picture of what is happening.
It is very difficult for children with autism to reflect everything that happens outside their psyche, it is difficult for them to understand human emotions, to predict some steps. They rarely emotionally respond to good or bad actions towards them. Also, for such a child, non-verbal communication, the manifestation of a variety of feelings, is of particular difficulty. They are unable to respond to any emotion, reflect the emotional state of the interlocutor, empathize.
On the playground or at school, these children keep a little apart from everyone. They do not like outdoor games that involve contact with other kids. They never join the team, moreover, they don't need it. They feel much more comfortable alone than in the company of friends or loved ones.
They are not very sociable and very rarely start a conversation themselves. They try to finish conversations on everyday topics faster and retire. However, there is no impression that children lack communication. Kids are carried away by their inner world, their fantasies, and social interactions cause unpleasant sensations, discomfort.
Children with autism tend to choose one interest and concentrate all their attention only on that interest. They can be quite mentally developed, even brilliant, however, usually they are only interested in one area. They are not plastic in their own interests, they are often attached to some insignificant things that have, in fact, no value.
Usually, the child gets used to a certain arrangement of things, the daily routine, which he strictly adheres to, is not prone to impulsive actions, never takes the initiative. Frequent sequential repetition of the same words (echolalia) and stereotyped movements are observed.
It is also possible that children have a variety of phobias. Most often these are social fears, which can explain their autism (withdrawal). Such children often refuse food or prefer to eat the same thing every day. Specific tastes arise literally from a young age and rarely change.
There are distinct forms of autism in children that differ slightly from the typical disorder:
- Kanner autism … This subtype of childhood autism is its nuclear form, that is, the severe manifestation of all symptoms. Children feel especially acutely the emergence of discomfort when communicating with others, up to painful hyperesthesia to tactile stimuli. A characteristic feature of Kanner's disorder is the disharmony in the development of various spheres of the child's mental activity. The speech apparatus develops very slowly. These babies rarely speak like their peers. For them, it is considered very difficult to divide the environment into living and inanimate. Children with this form of autism treat one as well as the other.
- Asperger's autism … It is a mild form of early childhood autism. Such babies are very late paid attention to, since at a young age their behavior and development rarely cause anxiety. Mental abilities are preserved, they are successful in their chosen field of activity. The characteristic feature of autism in this variant is the inability to social contacts. Children are unable to engage in emotional dialogue, gesticulate or respond with facial expressions, so they often lack a sense of tact. Asperger's autism is clearly manifested in adolescence, when, against the background of hormonal changes, a child can react with depressive states and suicidal ideas.
The main reasons for the development of autism in a child
Despite the mass of studies conducted on this disorder, it has not been possible to identify the main causes of autism in children. Modern psychiatry recognizes several theories of its origin, but none of them fully explains all manifestations.
There is a version that at a very early age, the mechanism of perception of the external world, its reflection, and then understanding is disrupted. The child is unable to analyze what is happening and does not understand it. Thus, he gradually learns to find distraction in his own inner world. The genetic factor is not monitored, that is, it may not have a hereditary tendency (none of the relatives had mental illness), or it may be.
Statistics show that autistic children are often born into well-to-do families that belong to the upper strata of society. This is how the theory of overworking the child arose. Usually, these parents want to give their baby everything that is possible at this age. Having loaded the unformed child's psyche with your goals, you can only achieve the asynchronization of brain processes.
The causes of autism in children have nothing to do with the mother's reaction to the child. If the infant constantly shields her from her, avoids eye contact, her negative reaction will be completely natural. Coldness in communication begins to manifest itself very early, so the mother's attitude towards the child has nothing to do with the occurrence of this disorder.
There are many other theories of the origin of this disease: perinatal factors of damage to brain structures, neurochemical imbalance of the dopamine / serotonin / norepinephrine system. Due to the fact that the symptoms of autism are included in the schizophrenic spectrum, there is a theory of endogenous origin.
How to recognize autism in a child
According to the international classification of diseases ICD 10 and the American classification DSM-4, there are three main groups of symptoms that consistently indicate the development of autism in children. Some of them may vary and differ from baby to baby.
To verify the diagnosis, the characteristic triad is important:
- Violation of social interaction;
- Violation of the formation of contacts, communication;
- Repetitive limited behavior, stereotypy.
Parents may notice some of the behavior of the baby, but it is much more important to know in advance how to recognize autism in a child. The sooner the disease is diagnosed, the greater the chances of a successful treatment result. It is necessary to consult a doctor when the child starts to speak late, does not show his emotions with facial expressions, does not gesticulate. If these manifestations do not occur before a year, you should show it to your family doctor or child psychiatrist.
World-renowned researchers have developed special screenings that are able to identify autistic children in the early stages. Unfortunately, not all countries use these diagnostic methods, but they can still be used as an additional examination.
The list of tests for autism in children is very long. Psychologists around the world have jointly created several versions of similar techniques for different ages. It is believed that each age of the child is something remarkable, preferences and priorities change, so the test must be selected individually.
These tests are a set of questions or tables that help determine if a child is or is likely to develop autism. Behavior, social interaction, the rate of development of the speech apparatus, features of fine and gross motor skills are taken into account. The depth of the disorder can be established using special scales and questionnaires. The results are transformed into points that build the gradient of the depth of the pathological process.
Some tests are aimed at parents, since in some cases it is necessary to compare the subjective view and objective examination. They are also used in cases where the child is too small or the symptoms develop slowly.
An important part of the diagnostic process is an instrumental examination of the functions and structure of the brain. For this, the following methods are used: electroencephalography, rheoencephalography, echoencephalography, magnetic resonance imaging and computed tomography.
It is not necessary to use the entire list of methods. They are only needed to clarify the diagnosis and differential diagnosis. In the case of early childhood mental illness, the organic cause must be ruled out.
Features of the treatment of autism in children
Despite the huge arsenal of psychotherapeutic methods and pharmacological agents, there is currently no single treatment regimen for autism in children. The best option is an individual selection of methods, taking into account personal characteristics and dominant symptoms.
AVA therapy
Applied behavior analysis (ABA) is one of the most widespread methods in the world in this direction, which belongs to the section of behavioral therapy. The essence of this technique lies in the study of causal relationships in the behavior of a child.
First, the factors of the external world that are important for the behavior of children with autism are examined. The kid develops specific reflex reactions, changing his behavior when external factors change. By manipulating them, it is possible to form in him the appropriate behavior and reaction to various stimuli, to develop a response model.
In fact, the method is training. Healthy children learn a lot in this life themselves: contact with others, communicate and give out emotions. This is very difficult for a child with autism, so they need a teacher to teach. Correct pedagogical correction is at the heart of ABA therapy and is currently one of the most effective methods.
Only a certified specialist who owns this technique can engage in such therapy. There are many forums that can briefly describe the program, but it will not help, but only harm.
Structured learning method
This therapy is called Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH). This is a special education program that has been developed taking into account all the characteristics of the behavior of babies, and is designed for a wide age range of children - from the smallest to adulthood.
At its core, this is a school curriculum with adapted tasks for visualization, perception of the outside world and socialization. The material that the child must learn is presented in a special form. It helps prepare for adulthood.
The tasks are focused on sociability and social contacts. The toddler needs to interact with other children to solve the problem. At the same time, communication is unobtrusive so that children do not feel discomfort and do not experience negative reactions.
Sensory integration
The main mechanism of autism is the impossibility of perceiving the external world as a whole. The child sees a picture, hears a sound, but cannot compare these things together, analyze, generalize. This method is designed to connect these mental processes.
Special exercises help process sensory information that connects with other sensations. For this method, games are used in which it is necessary to use the senses and analyze the information received.
A child with autism is often unable to correctly understand the feelings of others, as well as to express their own feelings. To form his own impression, a person needs to integrate all the sensations that he received, process and pass through his own tastes, rules and assessment. Children with disabilities have significant difficulty doing this.
This method of therapy is based on the determination of the boundary permissible levels of sensations that are capable of causing a reaction in the child. Each event forms a response in the psyche, but only a few are able to break through the armor of autism. Understanding the limits of sensitivity helps to create certain conditions that will be comfortable for a child with autism and can help him adapt to interactions with other people.
Teaching basic principles of behavior
This is a method of behavioral psychotherapy, which is based on the formation of basic skills in the child. They are essential for self-care and a better quality of life. Particular attention is paid to the communication skills of children with autism.
With this therapy, the makings of basic communication skills are created. If the child has never shown initiative in a conversation, then in the future, perhaps, on occasion, he will not know with what words to start a conversation, how to behave more politely and tactfully.
The teacher explains in detail how to communicate with people, what are the rules of behavior and tactics in society. For example, silence or turning away at the wrong time can be misinterpreted. The task of the teacher is to teach such children the general rules of behavior. Even if they don't need communication too much, their reactions can create difficulties in routine life.
To avoid such situations, you should pay attention to teaching them those life principles that they cannot comprehend themselves.
Medication correction
At the moment, there is no effective pharmacological treatment for autism in children. There are treatment options based on combinations of antipsychotics, antidepressants and tranquilizers, but their effectiveness has not been proven. The possibility of drug correction is allowed with concomitant changes and manifestations.
Only the most serious manifestations of autism that are dangerous for the child and for others can be corrected with medication. If, for example, stereotyped behavior creates significant difficulties in performing routine tasks, the baby cannot serve himself and creates significant problems for his parents, you should think about including pharmacological agents in therapy.
To relieve aggression, an extreme degree of hyperactivity, which creates significant problems in a child's life, neuroleptic drugs are used for self-destructive behavior. Among the huge number of them, only a doctor can choose the right one, taking into account the individual characteristics of the child's body.
Ritalin, fenfluramine, and haloperidol are commonly used. These drugs, although not included in the main treatment regimens, are now quite successfully used to eliminate the extreme manifestations of autism.
Emotional disorders, including depression, can be quite serious. They are often disguised behind other signs of autism, manifestations of transitional adolescence, and therefore are not corrected at all. Pharmacological therapy for depressive disorders in autism includes inhibition of serotonin reuptake, which is achieved by taking fluoxetine or fluvoxamine.
How to treat autism in children - watch the video:
Autism is a rather specific disorder that does not allow a child to join social life, communicate with peers. Emotional coldness and passivity negatively affect the quality of communication with others. Treatment at the moment is an experimental psychotherapeutic technique that has just begun to be applied. An important aspect of therapy is early diagnosis, which increases the chances of successful correction and normal adaptation of these children to adulthood.
