Autism

Autism is characterized in particular by a disorder of sensory perception. Visual , auditory or tactile stimuli from the surrounding environment cause significant problems for the disabled . They are literally “overwhelmed” by sensory perceptions, and there are also difficulties in social interaction . In recent years, medical and therapeutic approaches have shifted away from seeing autism as a disability towards its definition as a perceptual disorder/ autism spectrum disorder .

Autism : What is it?

Autism is considered a severe childhood developmental disorder. The child suffers from it from birth and it manifests itself in the first years of life. The first noticeable symptom is the fact that the relationship between the parents and the child and the communication between them are very limited. Subsequently, cognitive and motor limitations and mood disorders occur . The causes of the disorder have not yet been clarified. It is possible that this is an interplay of a number of factors, genetic and neurophysiological causes are likely. Environmental influences have an impact on the course of the disease.

Signs of autistic disorder

Autism manifests itself differently in each child and its manifestations change during development. The spectrum ranges from severe disability to barely recognizable behavior. It is possible that the child will have ordinary talents, but also that he will be highly talented or, on the contrary, mentally disabled . Manifestations are especially noticeable in the area of ​​social behavior. It is difficult for the child to express himself or herself verbally or non-verbally (for example with gestures or facial expressions). His interest is limited to only a few activities or games, often there is a repetitive stereotyped behavior.

In infants and young children, autism manifests itself as problems with sleep, lack of initiative, reduced ability to imitate or impaired food intake. In some cases, affected children react extremely sensitively to stimuli from the environment, and speech development is delayed or completely absent. Young children often start walking later. In pre-school age, the disorder can be manifested by aggressiveness , hyperactivity and repetitive, stereotyped behavior, from school age there is often a partial alleviation of symptoms.

In many cases, concurrent diseases appear , such as epilepsy , depression , anxiety, compulsive needs ( compulsions ) or eating or sleeping disorders.

Early -onset autism or atypical autism?

At the beginning of the diagnosis is an accurate history taking and a thorough interview with loved ones. Using behavioral observations and psychological examinations, striking symptoms in the areas of perception, social interaction , speech, intelligence, or motor skills are determined . A neurological/psychiatric and physical examination is also essential, and other examinations are carried out as needed. There are a number of therapy programs designed specifically for autism. In order to distinguish autism from other disorders (such as reduced intelligence, muteness, relationship disorders), the diagnosis must be made by a clinical psychologist with the appropriate specialization, a child psychiatrist or a specialist doctor specializing in child psychiatry. Psychotherapists may also be involved in the diagnosis .

According to the International Classification of Diseases ICD-10, autism belongs to severe developmental disorders. In particular, a distinction is made between the following types of autism:

• Early-onset autism: a severe developmental disorder that appears before the age of three. Social behavior and communication are impaired. Repetitive, stereotyped patterns of behavior appear that always go the same way. Other symptoms can be anxiety, increased aggression or sleep disturbances .
• Atypical autism: The difference from early-onset autism lies in the age at which autism appears, or in the fact that the diagnostic criteria are not fully met. This form of autism mainly affects children with severely delayed development and a speech development disorder.
• Asperger’s syndrome : The disorder differs from early-onset autism mainly in the absence of a general developmental delay, i.e. in the fact that they do not lag behind in the development of speech or cognitive abilities. For more information, see the article Asperger’s syndrome: what is it?

Influence on the course

A number of factors play a role in the successful treatment of a disabled child. If the affected person develops good speech skills by the age of five, the further prognosis is favorable. Possible physical difficulties (e.g. epilepsy) and the shaping of the social and school environment have an effect on the course of the disorder, or its mitigation.

Many people with autism require long-term care or nursing.

Treatment goals

Treatment is tailored individually based on the child’s symptoms and needs. The aim of the treatment is mainly the following:

• improving communication (including through symbolic or sign language ),
• support of individual areas of development,
• game behavior support,
• behavior training (mainly social behavior and targeted behavior).

Relatives, kindergarten teachers and educational staff are involved in the treatment. In most cases, children with autism can be successfully supported in inclusive kindergartens and classes.

Specific treatment for autism

There are a number of therapy programs designed specifically for autism. One of the best-known programs is the so-called TEACCH (the abbreviation comes from the English name Treatment and Education of Autistic and Communication Handicapped Children ). It is characterized in particular by:

• supporting diagnostics,
• support in school teaching / professional education,
• by training close people,
• by supporting social skills ,
• by practicing communication and
• by imparting skills for the appropriate shaping of free time.

In addition, structuring a daily routine , which is an important tool for life planning, helps the disabled a lot .

In many therapeutic programs focused on autism, methods from the field of learning theory are important pillars. Important behavioral therapy programs in the field of autism are the techniques of so-called discrete learning and modern applied behavioral analysis (ABA, English Applied Behavior Analysis ). The goal is to improve understanding of speech and expression, strengthen attention to social perceptions, build the ability to imitate, acquire preschool skills and achieve independence in performing daily activities.

Other treatment options

Other forms of autism treatment include specific communication exercises, individual or group psychotherapy (with an emphasis on strengthening social skills), group games, early care , speech therapy , physical therapy , and occupational therapy . It is also possible to use music therapy . Medicines are used in case of accompanying psychological problems or physical diseases .

Tips for parents of autistic children

In contact with autistic children, the following procedures have been proven in practice:

• try to accept the illness and avoid blaming,
• good information and contacts (e.g. with other parents, with specialized facilities),
• possibly seek professional help yourself in order to manage the situation better (e.g. psychological counseling or psychotherapy, self-help groups),
• be open to support from others (relatives, circle of friends or professionals),
• support the child but do not demand too much from him,
• remain realistic and do not expect too much success of the therapy ,
• take into account problems in the family and use counseling in this context (e.g. family counseling),
• take care of yourself: take care of basic needs, do not neglect your own interests, maintain social contacts.

Parents and other relatives of autistic children can inform other people around them about autism and thus increase public awareness of this disorder.

Related links

1. Iva Dudová, Markéta Mohaplová: Autism Spectrum Disorders – Part 1. Pediatrics for Practice 2016, 17(3): 151–153. (the link leads to a PDF file on the website pediatriepropraxi.cz, 112 kB)
2. Iva Dudová, Markéta Mohaplová: Autism Spectrum Disorders – Part 2. Pediatrics for Practice 2016, 17(4): 204–207. (the link leads to a PDF file on the website pediatriepropraxi.cz, 116 kB)