What are the symptoms of autism?
The diagnosis is made according to the criteria of the international classifiers of diseases. Qualitative impairment of social functioning expressed by at least two of the following:
- significant impairment in the use of eye contact, facial expression, gestures, body posture
- inability to develop relationships with peers at the developmental level
- insufficient spontaneous seeking to share joy, interests, or accomplishments with others
- lack of social or emotional relevance
- delay or total lack of speech development (not associated with attempts to compensate for the lack of speech with alternative attempts at communication such as gestures and facial expressions)
- individuals with normally developed speech have significant difficulty initiating or maintaining a conversation
- stereotyped or repetitive use of speech or peculiar speech
- insufficient imaginative play or developmentally appropriate social interaction simulation play
- over-engagement with stereotyped activities and limited interests
- over-engagement with specific and non-functional properties of objects
- stereotypically repetitive motor mannerisms (eg tapping or curling of fingers and hands, or complex whole-body movements)
- over-engagement with different parts of objects
What are the physical characteristics of these children?
Kanner was amazed by the intelligent and attractive appearance of autistic people. In the period from 2-7 years. age they are usually shorter than their peers. Many autistic children can use both hands equally well, when in normal children a leading hand is already formed.
Autistics are more likely to have upper respiratory tract infections, febrile seizures, constipation, and lazy bowels. They react differently to disease, which is probably due to immaturity or abnormality in the autonomic nervous system. With an infectious disease, they do not always have a fever, they have no complaints. Their behavior and compliance can improve significantly when they are sick. In some cases, this can be a sign of illness.
What are the characteristics of the behavior?
Autistic people do not show the usual attachment to their parents and other people. Many of them lacked a social smile even in infancy, and abnormal eye contact is often present. The social development of autistic children is associated with insufficient (not necessarily complete absence) attachment, as well as a lack of a specific object of attachment. They do not show anxiety when separating from loved ones and staying with strangers.
By school age, isolation may be reduced and less obvious, especially in higher-functioning children. Instead, however, they show an inability to play with peers, have friends, “social awkwardness” and incongruity. In late adolescence, progress is usually observed, and they have a desire for friendship. Their inability to show interest in others, poor emotionality, and feelings are obstacles to the development of friendly relations. At this age, autistics have sexual experiences, but their social incompetence prevents the development of such relationships. It is extremely rare for autistic people to get married
What are the characteristics of communication and language?
Gross deficits and qualitative disorders in language development are the main criteria for diagnosing an autistic disorder. Autistic children do not simply refuse to speak, and abnormal speech is not due to their lack of motivation. Deviations in speech and also delays in speech development are characteristic of the disorder. Unlike normal children and those with mental retardation, autistics make limited use of language in thought processes (inner speech). When autistic people learn to speak fluently, their dialogues are characterized by a lack of reciprocity. Their social incompetence becomes apparent.
During the first year of life, the rate of infant babbling may be reduced or abnormal. Some make noises, and sounds, and repeat meaningless syllables in a stereotypical way that lacks the meaning of communication. Unlike healthy young children who have better receptive speech skills and understand much more than they can speak, speaking autistic children say much more than they understand. Autistic people can use a word once, and then not repeat it for a long time (weeks, months). Their speech is characterized by echolaly – they repeat what the interlocutor said.
They use stereotyped phrases out of context, and a specific intonation and rhythm are often observed. About 50% of all autistic people never speak. Some of the smarter children with autism show specific interest in letters and numbers. A small number of them learn to read surprisingly well already at preschool age (hyperlexia). In almost all cases, however, these children read without understanding the meaning of what they read.
What is stereotypic behavior?
During the first year of life, exploratory play in autistic children is minimal or absent. Often they specially manipulate toys or objects – not as intended, without creativity and imagination. These children cannot imitate and use abstract pantomime. Activities and games are rigid, repetitive, and monotonous.
Ritual and repetitive behavior phenomena are common in early and middle childhood. These kids spin, hit, and line up the objects. They show an unusual attachment to inanimate objects. Stereotypes, mannerisms, and grimacing are frequently observed phenomena, especially when the child is alone. Autistic children resist changes in the home. Moving to a new home, and moving furniture can lead to panic and dread.
Some children with autism show sudden mood swings with outbursts of laughter or crying for no apparent reason. They can selectively ignore speech addressed to them and appear deaf, while at the same time showing unusual interest in the sound emanating from a wristwatch. Many have an increased threshold and altered response to pain. Most autistic people can hurt themselves badly and still not cry. These kids like music. They often hum melodies or parts of a song, as well as advertising messages, even before they can speak.
Some enjoy spinning, rocking, up and down movements, etc. Hyperactivity is a common behavioral problem in young children with autism. Aggressiveness and outbursts are observed for no apparent reason or as a result of a change in the environment. Self-injurious behavior includes head banging, biting, scratching, hair pulling. Attention is often reduced to an almost complete inability to focus on a particular task, insomnia, and problems in feeding and mastering pelvic tanks.
6. What is intellectual functioning?
About 40% of children with early childhood autism have an IQ below 50-55 (moderate, severe or profound retardation). 30% have an IQ in the range of 50-70 (slight degree of mental retardation), 30% have an IQ above 70 – normal intelligence.
IQ scores reflect the problems children have with speech and abstract concepts, indicating the significance of impairments in language-related functions. Some children with autism have abnormal cognitive or visual-motor abilities, regardless of the overall delay in functioning. For example, some may have incredible powers of memory and calculation, beyond normal human abilities.
What other diseases can autism be mistaken for?
Autism is mainly confused with early-onset schizophrenia, mental retardation with behavioral symptoms, mixed speech and language disorder, congenital deafness, malnourished children in an institution, and disintegrative psychosis.
Early childhood schizophrenia is rare in children under the age of 5. age. It is associated with hallucinations and delusions, and the frequency of epileptic seizures and mental retardation is lower.
Unlike autistics, children with mental retardation are usually able to bond with adults and communicate with children by their mental age, use speech to communicate
Children with deafness usually respond to loud noises and sounds, while autistic children may ignore these noises and show a response to quiet sounds. An audiogram or evoked potentials is very essential for the diagnosis. Unlike autistic children, deaf children show normal attachment to their parents and like to be hugged and comforted.
In severe disorders of parenting, children can appear apathetic, self-absorbed, and detached. Motor and language skills may be delayed. Such children usually improve rapidly when moved to a better psychosocial environment and given appropriate stimulation.
What is the treatment for autism?
The treatment plan aims to reduce behavioral symptoms and support the child’s development, and training in self-care skills. Parents of such children also very often need additional support and counseling.
Behavioral methods and training are currently the therapy of choice.
The structured environment combined with behavioral methods are the most effective methods for influencing autistic children. They show better influence than other behavioral approaches. Parent training and behavior modification skills can improve child functioning. These trainings require a lot of time, and the child needs a high degree of structure.
In some cases, drug therapy may also be necessary, although there is no specific drug for the treatment of autism. The drug can reduce hyperactivity, stereotypies, self-absorption, and irritability.
What are the development and prospects of the disease?
Autistic disorder has a long history. Some autistics show loss of pre-existing speech. This happens most often between 12 and 24 months. As a general rule, children with an IQ above 70 and those who use language for communication between the ages of 5 and 7 have the best prognosis. Studies of adults with autism show that 2/3 of autistic remain severely disabled and live in total or partial dependence. Only 1-2% function independently and are operational. About 5-20% have borderline normal status. The prognosis is better when the home environment is supportive and can meet the broad needs of such a child.
Although the symptoms are reduced in many cases, an exacerbation of aggressiveness and further regression in functioning is observed in one part. About 4 to 32% have epileptic seizures in late childhood and adolescence, with seizures affecting prognosis negatively.
