Not so long ago autism spectrum disorder (ASA) was rare, but has become increasingly common lately. According to international data, if one out of 150 children had the disorder in 2000 and one in 110 in 2006, according to the US Centers for Disease Control, it would already be one in 68.
– Children with ASA are very peculiar: they have difficulty speaking, social relationships, they understand everything in a straightforward way, they cannot lie and think, others think like them, – says our respondent, Dean of the Faculty of Psychology and Education at Ivane Javakhishvili Tbilisi State University, Neuropsychologist Tamar G. goshidze, which speaks about the violation.
A little something from history
– Autism Spectrum Disorder (ASA) was first described in 1943 by Leo Kaner, an American child psychiatrist of Austrian descent and autism, though the term “autistic thinking” has existed before – Swiss psychiatrist Paul Blair has used it to describe a mindset that is not objective reality. But also the inner self of the individual Towards solid, own needs and dreams.
Leo Kaner studied eleven children with similar odd behaviors from 2 to 10 years old – 3 girls and 8 boys who had unevenly developed language skills, had difficulty socializing, not fully interacting with or interacting with the environment, and had extremely limited interests. Leo Kanner characterized them as extremely lonely individuals. Children with autism have also been diagnosed with schizophrenia. After the discovery of autistic spectrum disorders, child psychiatrists Michael Rutter and Lorna Wing re-evaluated former patients with a diagnosis of childhood schizophrenia in their 60s and 70s in the light of new criteria – some of them met the criteria for autistic spectrum disorder. It is noteworthy that the daughter of Laura Wing herself, Susie, Had autistic spectrum disorder. This was largely due to Wing’s interest in and contribution to the study of autistic spectrum disorders.
The disease gradually got better and better, new diagnostic criteria emerged, awareness was raised. In the 1980 US Mental Disorders Diagnosis Manual, DSM-III distinguished autism and pervasive disorders from childhood schizophrenia and formulated different diagnostic criteria for them. Today more parents and doctors are aware of these disorders, but statistics are not added for just the reasons listed – the disorder is indeed increasing. Based on my twenty-five-year practice, I can tell you that only one child with autism spectrum disorder was diagnosed in the past, and all cases – classic, now, besides the disorder itself, have increased the number of suspicious cases where it is difficult to predict: children do not have Classic symptoms, Sometimes the picture is intermediate between specific speech disorders and autistic spectrum disorder. Incidentally, English neuropsychologist Dorothy Bischoff describes such patients and notes that different types of diagnostic criteria for speech and communication disorders are generally considered.
Looking for reasons
– Why is this disorder so common , what causes it?
Autistic spectrum disorder is a multifactorial disorder, or multiple factors, including the condition of the mother’s body during pregnancy, the child’s biological, social and environmental factors.
Genetic mood and genetic vulnerability are important causes. It is estimated that the risk of developing ASA among ancestors or blood relatives is twice as high. However, according to modern studies, only 37% of autism spectrum disorders are explained by genetic factors. Mutations in genes have also been reported as a result of environmental damage (exhaust, contaminated air, food, radiation, heavy metals) and markers of genes encoding autism markers on chromosomes Ip, IIq, VIIq, XIIIq, XV and XVIIp have been identified. There are genetic disorders that are associated with autistic disorder or its symptoms, such as Williams syndrome, fragile X-syndrome.
Biological factors include hormonal and biological changes. According to some studies, the lack of hormone oxytocin in the pregnancy is associated with autistic disorder in the child. Hormonal background seems to affect a baby’s development. It has been found that the offspring of women who are taking progesterone in the first trimester or earlier of pregnancy, such as progesterone, often have a prescription speech impediment, that is, they do not understand speech. Obviously, this is just my observation and it requires serious scientific research. Such children are like children with autism spectrum disorders and their numbers have increased lately.
According to socio-psychological-cultural theory, the development of autism is primarily influenced by socio-psychological factors. American epidemiologists, for example, have found that the disorder is common among migrants. E. According to Fomboni’s 2001 epidemiological data, one or both parents’ migrant status is tied to the frequency of autism. According to some scholars, migrant women are disrupted by their environment, changing their diet, socio-psychological environment, having no relatives, friends, relatives, emotional or stressful backgrounds, causing hormonal imbalances that affect the fetus as well.
One of the theories points to the link between autism and vaccination. With the outbreak of the measles-measles vaccine in the United States, the incidence of autism seems to have increased. They suspected a vaccine-containing substance – thimerosal, which contained heavy metals and intoxication with heavy metals, was considered one of the causes of autism, but studies by the US Centers for Disease Control did not confirm the vaccine’s link to autism. No studies from 2004 to 2014 confirm the causal link between timerosal vaccines and autism.
– In my view, the increase in autism is a result of the modern lifestyle. Maternity leave in the US actually lasts three weeks, and it takes at least a year for the mother-child to become secure. Imagine a mother who left her baby with a babysitter and worried about it. I have often seen mothers who either hire an infant for work or run home for a break. They worry, they feel guilty, and eventually their son gets adrenaline milk.
By the way, during Leo Kanner’s career, the psychoanalytic model prevailed until the 1970s, until the neurodevelopmental disorder model of autism emerged. This theory was considered autism as a result of early disruption of mother-child attachment and early traumatization, which was called “cold mothers” disease. In fact, in “cold weather” the mother was not accused – when her son did not react to Alers, did not come into contact, the mother unconsciously could not contact her because she did not know how to get a wall between them. Specialist support is very important to continue dealing with such a child.
Some schools (for example, the French school and its affiliate center “The Green House”) are still psychoanalytically autistic. In their understanding, Asa is the result of early traumatization of the child. According to this theory, the autistic spectrum is a response to stressful events. The child’s cognitive but emotional development is impaired and a holistic approach to development is needed. By the way, we also have a case where a depressed mother’s son has obvious signs of autism, but as soon as the mother is depressed, the child’s condition has improved dramatically.
Another interesting point in favor of this theory: the diagnosis made by psychiatrists, the disorder of early attachment, is very similar to the autistic spectrum disorder, although it appears slightly later.
So, in fact, early traumatization – the early termination of the breast and the deficiency in the relationship with the mother – plays a key role in the development of autism. Additional factors include a nanny, a TV and a computer. The latter has a very harmful effect on the speech and language development of the child. That’s why American pediatricians advise parents not to put their two-year-old child on TV and gadgets. You might not see such a child in Georgia – they have been playing for eight months and their mothers are happy – they are doing their job, the children are learning colors and shapes … but they do not know English or Georgian. Of course, not every kid on TV has signs of autism spectrum disorder, but their brains are more vulnerable, they are addicted to television, they love unusual stimulation, especially advertising.
– How should a child ‘s normal speech and behavior develop?
– Normally a child under the age of two should already have words, be able to say two-word sentences and use language in communication, not with beats or voices, but with words, fingers, eyes, active attention, shared attention, shared emotion, shared action : Shoot or kick gibrunebs back, toy Offering – happily involved in the game, they’ve garnered the initiative of the game, when I do something, come and show your waiting for the reaction, has the ability to imitate – repeats and imitates the action, speech …
A child with speech disorders may not be able to speak at all, but speechless sharing, eye contact, and shared attention can be helpful. Most children with autism spectrum disorder neither imitate the adult in speech, nor even act and pay attention.
The main features of autism are:
- Speech disruption and developmental disruption;
- Communication Disruption– The child does not use language for communication, has difficulty imitating, the adult, his / her speech, does not pay attention, does not return to action. It may be characterized by echolalia, ie it does not answer the question, repeats the question with the same intonation. By the way, echolalia also has healthy children at an early age, but it goes unnoticed by them, it is a basis for imitation. This symptom is also present in children with speech disorders. As for children with autism spectrum disorders, even those who have speech and speech products do not use speech for communication.
- Social Interaction– The child is not able to interact with other children and adults, does not take initiative, and if the other person shows up, they may not follow. Can not imagine – “as if” the game, it is difficult to make eye contact, to exchange emotions, thoughts.
- Limited interests– obsession, stereotypical behavior. For low-functioning (ie, mentally retarded) autism these are stereotypical actions: specific hands-on, different gaze, repetition of different postures, pop-ups – and more for high-functioning (mentally retarded) autism – narrow collector-type interests. For example, a child likes only trains or only dinosaurs, knows all their names, nutrition, lifestyle features, etc. It has no other interests.
– What age can be noticed by parents of the child ‘s characteristics and how?
– The normally 6-7 month old baby is interested in talking to the boss and trying to get in the way. It is alarming when a child is not interested in human speech but is attracted to nonverbal sounds and music, has no reaction to humans but has one or more objects, pays little attention to toys but may love small objects, utensils, bottles, not only the whole subject but also In its detail, for example, not by car, but by wheel. You don’t look me in the eyes, you don’t laugh …
At the age of a year and a half, there are often serious sleep disorders that parents have difficulty regulating – waking up at midnight, waking up in the morning, then falling asleep …
For two years, stereotypical self-stimulating movements have been buzzing, jogging back and forth, jogging in a circle.
The psychological development of the child is disproportionate. For example, at 2-3 years of age, they may be reading letters, choosing letters, knowing the names of colors, but not using this knowledge in communication and demand.
In some cases, there is a regression – the parent says that the child has been deliberately saying a few words before and then forgets. However, it is a little difficult to trust a parent of a year and a half baby – who knows if the child was really deliberately using words, just pellets. The regression is not easy to find, but if found, the likelihood of autism is high. As a rule, the developmental regression is 12 to 24 months.
There is disintegrative syndrome, the same as Heller’s syndrome, where the regression is very fast. This syndrome occurs later – three years later -. According to diagnostic guidelines, Heller’s syndrome, as well as Asperger’s syndrome (ADHD), Canary syndrome and other disorders, are included in the ASA.
– What asa- ‘s a children’s intellectual development and characteristic features?
– Includes children with hundreds of different types of development. Of the ten children with such disorders, 6-7 are of varying degrees of mental retardation, and 3-4 are highly functional and have very good intelligence, well illustrated. ASA’s symptoms are specific to them: they have difficulty communicating or have a pragmatic speech disorder, which involves knowing how to engage in dialogue – defend Jerry, keep the topic, do not jump from topic to topic, say the end, know who’s vocabulary Use what words you speak to acquaintances, strangers, and more A. However, pragmatic speech disorders are also observed in other problems.
Autistic children find it difficult to watch someone else’s position, to share another’s emotion, to guess what the other person is experiencing, to foresee what the reaction might be to what he or she is saying. This is called theory of mind and was first studied with people with autism. Understanding the emotional state and intentions of others is possible even in times of mental retardation, but people with autistic disorder find it very difficult. They do not have a sense of humor, they do not understand the meaning of the word. They experience love and gratitude but cannot express it.
– How becomes asa- ‘s diagnosis?
– A pediatrician, unless specially trained, will not detect autism at an early age because it only assesses the sensory development that normally occurs with children with autism. There are no medical markers for autism, but the behavior of a small child is very variable – with different people, in different environments, so the child has to be evaluated by a number of specialists: a psychiatrist, a neurologist, a psychologist, a neuropsychologist, an occupational therapist, perhaps a speech therapist. To diagnose a child requires behavioral observation, special tests, interviewing parents – this will show signs of autistic spectrum disorder that meet diagnostic criteria and determine the presence of ASA,
Deleted, mimicry forms of autism have become more frequent recently, when all signs of the disease are not apparent, or are, and sometimes disappear in the wake of early intervention. This makes it difficult to make an accurate diagnosis. For the past ten years, there have been a growing number of children with sensory disorders, which we call sensory integration disorders. It is one of the symptoms of autistic spectrum disorder and is manifested by an unusual response to environmental stimuli. For example, a child may be exposed to hysterical music or slightly touching hysteria, with no intense high-pitched voice or clapping and grunting or, on the contrary, dislike it.
Interestingly, today such substandard responses are also observed in children with other healthy but emotional and behavioral problems. Their remedy is occupational therapy.