Kanner syndrome in children: signs, symptoms, treatment.

Causes of autism in children

Typically, in most cases of the disease presented, it is in no way associated with serious brain damage. In some cases, autism occurs due to congenital rubella, as well as against the background of phenylketonuria, cytomegalovirus infection or dangerous fragile X syndrome. Serious evidence has also been found that fully confirms the important role of genetic changes in the development of the disease.

It has been proven that parents who have a child with autistic disorder have a risk of having a subsequent child with similar developmental problems that is approximately 50-70 times higher than usual. In special monozygotic twins, the concordance of this syndrome is no less high.

Numerous studies that have been conducted among families of patients with autism suggest that several gene regions are potential targets. These include neurotransmitter receptors associated with special coding and important structural control of the nervous system. The role of external factors, such as vaccination and all kinds of diets, has not been proven by specialists to date. In many ways, the basis for the pathogenesis of autistic disorders is dysfunction and structure of the brain.

As a rule, in most children with autism, the ventricles of the brain are greatly enlarged. Some babies have dangerous hypoplasia of the cerebellar vermis, and they can also detect various anomalies of the nuclei of the important brain stem.

In addition, a parallel is drawn between autism and certain diseases:

• Rubella acquired during pregnancy.
• Cerebral palsy.
• Tuberous sclerosis.
• Obese women are more likely to have children with autism than women of normal weight.
• Chromosome mutations.

These pathologies can negatively affect the development of the child’s brain and lead to autism.

Kanner syndrome in children: signs, symptoms, treatment.

Kanner's syndrome.

Leo (Haskle-Leib) Kanner (1894-1981)

Austrian and American psychiatrist, known for the first description of childhood autism and subsequent work in this area, one of the founders of child psychiatry.

Leo Kanner was born under the name Haskl-Leib Kanner in the Galician town of Klekotov (now the Lvov region of Ukraine), in a religious Jewish family of Abram Kanner and Clara Reifeld. The war interrupted his studies at the University of Berlin, where he entered in 1913, and he received his doctorate only in 1921. In 1924 he emigrated to the United States and went to work at a hospital in South Dakota. Adolf Meyer and Edward Park suggested that he create the first children's psychiatric service at the children's hospital of Johns Hopkins Hospital in Baltimore. In 1933 he became professor of psychiatry. In 1935, his monograph “Child Psychiatry” was published in English.

In 1943 he published an article entitled Autistic Disturbance of Affective Contact

, in which he drew conclusions after five years of observation of a group of 11 children suffering from similar disorders. The name “early childhood autism” appeared a year later, and this syndrome was named after Kanner.

In 1957, Leo Kanner became the first professor of child psychiatry at Johns Hopkins University. He was also the first editor-in-chief of the Journal of Autism and Childhood Schizophrenia.

from 1971 to 1974.

From 1963 to 1969 Leo Kanner was a consultant at the Children's Guild Clinical

.

Leo Kanner died of a heart attack in 1981 at the age of 86 at his home in Sykesville, Maryland (USA).[1]

Description.

Kanner syndrome is also a type of autism, but it is very different from Rett syndrome primarily in that it occurs in both girls and boys. In this regard, Kanner's syndrome is similar to Asperger's syndrome, but it has a number of fundamental differences from the latter.

The very name of childhood early autism indicates that this syndrome manifests itself at an early age, usually at 1-2 years, while Asperger's syndrome occurs no earlier than 3 years. Another important feature of Kanner syndrome

is that children with this syndrome experience delayed mental development and various intellectual deviations.

Children with Kanner syndrome have delayed speech development, and these children are susceptible to echolalia, that is, they have the habit of meaninglessly repeating previously heard phrases. There is also a susceptibility to mutism - refusal to use speech in communication. In this case, although the child knows the words and their meaning, he does not communicate with words, but uses facial expressions and gestures for communication.

Primary disorders include increased emotional sensitivity and poor psycho-emotional stability. This in turn leads to secondary violations.

Secondary disorders are understood as a model of autistic behavior, which is seen as an attempt to avoid the influence of the outside world, by replacing reactions with stereotypical responses and replacing generally accepted interests. There is a weakening of the emotional reaction to loved ones, up to complete ignoring of them, an inhibited or insufficient reaction to auditory and visual stimuli

. In some cases, on the contrary, the reaction becomes aggressive.

Modern scientists agree on one thing regarding Kanner's autism - this syndrome is not accompanied by any, even minor, anatomical anomalies, which clearly indicates its physiological nature.

The course, in most cases, is slow but progressive, without deep disturbance of the child’s mental behavior. These children usually integrate well into social life and into the (easier) profession to which they were directed. In other cases, the course is severe, reaching schizoid manifestations or even infantile schizophrenia with a gloomy prognosis.

Causes of development of early childhood autism

The etiology of RDA, to date, has been poorly studied; there is no information about specific causative factors that stimulate the risk of the disorder. Researchers in the field of childhood autism have concluded that the syndrome may depend on a hereditary factor - in most families where a child has symptoms of RDA, similar deviations are found in ancestors of the first and second degrees. Modern genetics is conducting a comprehensive study of the inheritance of autism, in an attempt to determine the gene responsible for the emotional manifestations of a person’s personality.

This theory is supported by the facts that autism is a congenital disorder, and etiological causes only contribute to the activation of the disorder and its development.

Some research works describe the possible dependence of childhood autism on mandatory preventive vaccination against mumps, rubella and measles, based on a fairly large number of complaints from parents about the appearance of autistic signs in children after these vaccinations. However, there are currently no scientific facts to prove or refute such statements. It is quite difficult to conduct research in this case - the specified preventive measures are strictly mandatory, therefore it is not possible to create an experimental group that was not vaccinated.

Another hypothesis characterizing the possible risk of autism is the theory of the psychological climate within the family. There is such a thing as “emotional coldness of parents,” when the mother and father do not demonstrate enough emotional manifestations towards their child, treating him as something ordinary, requiring only attention in the area of ​​physiological needs. A high percentage of autistic children is observed in dysfunctional families, where financial instability, chronic alcoholism or drug addiction come to the fore. In addition, autism often manifests itself in children in families where the professional activities of parents require great intellectual expenditure and time.

Complicated childbirth, severe intoxication during pregnancy, the use of potent drugs, alcohol and drugs during this period can also stimulate the manifestation of autism in a child.

Symptoms of childhood autism

When communicating with an autistic child, a strong impression is created that he seems to live in his own world, trying to limit his mixing with the surrounding reality. A distinctive sign of childhood autism is often silence, creating the impression of deafness and unpredictability of actions. Children often exhibit a tendency to become fixated on a particular action and pronounce individual syllables or phrases out loud. As a rule, such excessive repetition occurs due to increased interest in some previous event.

Often, children with RDA syndrome tend to be alone, occupying themselves with some banal activity. Most types of the disorder are characterized by avoidance of eye contact. Intellectual activity and development are somewhat underestimated, being at average levels or below average, however, against the general background of mental development delays, a high level of intelligence is possible within one type of activity associated with specific tasks, for example, arithmetic calculations or playing chess.

It should be noted that the risk of developing autism in boys is four times higher than in girls. The reason for this difference is currently not studied. As already mentioned, the clinical signs of early childhood autism are very individual, especially with regard to the quality of the symptoms shown. However, there are a number of general characteristics that are the same for each case of the disorder, which can be roughly divided by age category.

It is common for children aged two years and older not to look their interlocutor in the eyes; this sign can be classified as a symptom that defines the disorder. Often a child strives to take the same body position when doing something, the same applies to facial expressions. It is very difficult for children to communicate with peers, so autistic people always tend to be alone, preferring to do their own thing rather than find contact with others. They are always little interested in hobbies characteristic of this age; as a rule, the range of their activities is very limited.

Outwardly, the child often looks detached from the surrounding reality, due to emotional cold-bloodedness, a state that does not allow them to show empathy for other people's problems and share other people's joy.

Speech delay in autism is a characteristic symptom that occurs in 95% of children with autistic disorders. 40% of this number never begin to speak fully, limiting their verbal communication to rare, short phrases. In addition, conducting a dialogue with a child is quite complex; the thread of the conversation is often lost in the response silence of the little patient. Speech is usually cyclical and stereotypical. Autists are the first category of people who do not understand humor, whether directed at themselves or others.

Children with autistic symptoms are characterized by a concentration of attention on individual details of objects, which is logically very difficult to explain. For example, of a toy car, a child will only be interested in its wheels, which he can play with for hours. At an older age, hobbies are localized and move into the stage of mania for a certain type of activity - playing chess, video games, drawing, and so on.

The majority of children with autism have serious problems with night sleep. A child can often be caught doing what he loves in the middle of the night. Sensory perceptions of tactile and auditory directions are often distorted. A conversation in a whisper can excite a child, leading him to a state of hysteria, and loud exclamations can, on the contrary, calm him down.

Children under the age of two are also characterized by certain features of the manifestation of RDA syndrome, which begin to appear within a few months of birth. The primary signs may be an almost complete lack of attachment to the mother and manifestations of emotions towards her. The baby rarely smiles, does not gurgle, and his tears can only cause serious pain, usually associated with digestion. For such children, it can be extremely difficult to determine the moment when it is necessary to change a diaper or diaper.

As a rule, spoken language does not appear by the age of two years. There are incoherent individual vocal gestures or sounds reminiscent of the hum of a car engine.

Signs of mild autism

Modern medicine distinguishes four degrees of childhood autism syndrome, which can be conditionally distinguished by the severity of symptoms. The degree of severity within the groups is graded from the fourth group to the first, which is the most severe and is characterized by clear classic symptoms of RDA syndrome. The second and third groups contain symptoms due to which a child suffering from autism can be distinguished from healthy peers. The fourth group includes clinical signs that allow the course of the disorder to be characterized as a mild form of autism.

Signs of a mild form of autism draw a very fine line between a healthy state and an autistic one, so diagnosing the disorder in this form is quite difficult.

In children, increased vulnerability and tearfulness are noted against the backdrop of difficulties in making contact with the child and trying to maintain a dialogue with him. Children with mild forms of communication have practically no forms of communication. Often, a small patient reacts correctly and logically emotionally to the events occurring around him, but his facial expressions reveal the course of the pathology. Mimic emotional manifestations seem to be of a demonstrative nature, which is typical for inexperienced actors in the theater, when the emotional manifestation looks overtly feigned.

The main sign of a mild form of autism in children is the child’s ability to look into the eyes of an interlocutor, which is not observed in the other three forms. The conversation is slow, it seems that the child is searching for words for a long time before formulating a phrase. Social contacts are possible only in the presence of adults whom the patient trusts. After each action, parents will meet their child’s questioning glance about the correctness of his actions.

Parting with a loved one is very difficult for a child to bear. This situation will significantly increase the clinical manifestations of the syndrome. For this reason, psychologists strictly do not recommend leaving children alone or with strangers during treatment.

The development of intelligence and learning ability in children with a mild form of autism is close to that of healthy peers. With some help and support from specialists and parents, the child will have access to all the social opportunities of healthy people in adulthood.

The mild form of childhood autism greatly differs in symptoms depending on the gender of the patients. In girls, it sometimes becomes impossible to recognize the clinical symptoms of the disorder. For example, they have virtually no signs of fixation on stereotypical actions and mental retardation. Autistic girls very often become attached to individuals or personal relationships.

Examination of a child with autism

In addition to autism, manifestations of other mental illnesses, such as schizophrenia and neuroses, are also possible in childhood. Certain symptoms characteristic of autism can occur both in mentally healthy children and in children with brain damage as a result of birth and other injuries, or severe infections. Only a specialist in child psychiatry can correctly assess a child’s condition, often not alone, but in collaboration with psychologists, teachers, neurologists and pediatricians. Therefore, parents should not engage in self-diagnosis, and even more so, self-medication, because there is a serious danger of further disrupting the functioning of the child’s nervous system through the unreasonable use of any drugs.

To confirm the diagnosis of autism and exclude other diseases, the doctor may prescribe an electroencephalogram and a consultation with a psychologist. Sometimes it is important for a psychiatrist to know the general condition of the child’s body - in this case, he will need to familiarize himself with the conclusion of a pediatrician, neurologist, ENT doctor, and evaluate the data of blood and urine tests. 4

Treatment of childhood autism

The question of how to cure autism in a child is asked not only by parents, but also by specialists. Given the unrecognized causes of the development of RDA syndrome and its pathogenesis, no drug therapy has been developed. All known treatment methods are symptomatic. Also widely used are various measures of mental re-education, medical and pedagogical treatment, which involves a pediatrician, neuropsychiatrist, psychologist and speech therapist. This contributes to the partial recovery and socialization of children who have “Kanner autism.”[2]

In addition, there are special classes for parents where classes are held on how to better communicate with an autistic child, educate him and stimulate his development of potential. [3]

Bibliography.

1. 2003-2016. TsPMSSDiP GBOU VPO MGPPU. https://www.autismhelp.ru/ob-autizme/sindrom-kannera/
2. Autism Magazine

https://autism.invamama.ru/posts/12-kratkaja-harakteristika-sindroma-kannera.html

1. https://onevroze.ru/prichiny-i-simptomy-razvitiya-detskogo-autizma-metody-terapii.html
2. Articles by doctors for patients, psychiatrist Bochkareva O.S. https://www.medicalj.ru/diseases/psychiatrics/852-autizm

Signs of autism in a child

Scientists have identified 4 main signs that characterize autism as a disease:

1. Social behavior disorder.
2. Violation of the communication sphere.
3. Stereotypical behavior.
4. Early symptoms of the disease that occur in children under 3 years of age.

Social behavior disorder

Violation of social interaction is manifested by the following symptoms:

• The child avoids eye-to-eye contact. His gaze is directed as if through a person.
• The child’s facial expressions are not expressive and do not correspond to the situation. The child does not laugh when they try to make him laugh, but may burst into laughter for no reason. The child's face resembles a mask; from time to time it is distorted by grimaces.
• The child rarely uses gestures. He uses gestures only to indicate his own needs. Healthy children try to attract their parents' attention to interesting objects by pointing at them. Autistic people don't do this.
• The child cannot understand the emotions of other people. Healthy children are able to determine a person’s emotions by his gaze, facial expression, and eyes. Children with autism do not have this ability.
• The child does not show interest in peers. He does not take part in their games; he strives to remain alone, as he is immersed in his own world. Autistic children do not perceive other children, equating them to inanimate objects.
• Difficulties with imagination and distribution of social roles. Healthy children can put a doll to sleep and take a toy car into the garage. Children with autism do not perceive a toy as a solid object. They can simply spin a car wheel for several hours.
• The child does not respond to emotional manifestations of close relatives. For a long time, it was believed that autistic people do not experience emotional attachment to their mother and father. However, recent studies have found that their mother's departure still causes them some anxiety. However, when she is around, the child will not show any emotion towards her. He will not cry or call his mother after she leaves, but his anxiety increases at such moments. However, he will not take any action to return her. It will not be possible to determine that he is feeling something.

Violation of communication sphere

A communication disorder is manifested by the following symptoms:

• The child’s speech development is difficult, sometimes speech is absent for a long time. If the disease is severe, then children never master speech. They use a few words that are designed to indicate their needs. The child may ask to sleep or indicate that he is hungry. Other children have speech skills, but it is difficult to call such phrases meaningful. For a long time, children can repeat the same set of words that are meaningless. Children speak to themselves in the third person, for example, “Masha wants to sleep.”
• Speech is abnormal. It is characterized by echolalia and repetitions. For example, an adult asks him: “Are you going to sleep?” To which the child replies: “Are you going to sleep?” Speech may be too loud or too soft. He doesn't respond to his name. In the life of every healthy child there comes a so-called “period of questions.” Autistic people either do not go through this period at all, or it comes late for them. They are not interested in their parents about the structure of the world around them. Children can ask adults questions, but they are devoid of practical meaning and are often repeated.

Stereotypical behavior

Signs characterizing stereotypical behavior:

• A child can perform the same action for a long time, for example, arranging construction set pieces by color, or building a tower. It is problematic to convert it to another type of activity.
• Strict adherence to routine requirements. A child with autism will only feel comfortable in a familiar environment. Changing the daily routine, leaving the usual route, rearranging furniture or things in the room - all this can cause increased isolation or aggression.
• Repeating movements that don't make sense. If a child is afraid of something or finds himself in a situation that is unusual for him, he will begin to stimulate himself on his own. This can be expressed in finger snapping, palm clapping, and other similar movements.

Children are often haunted by fears and obsessive movements. If a child is scared, he becomes aggressive. Moreover, this feeling manifests itself both in relation to other people and to oneself.

Early symptoms of the disease that occur in children under 3 years of age

Autism appears at an early age. Even before the first birthday, parents may notice that their child does not smile, does not respond to his name, or behaves strangely. Children are not as active as their peers and give inadequate reactions in various situations.

Kanner syndrome

Kanner syndrome is a non-processual variant of childhood autism, the nuclear form. Clinical manifestations:

1) The inability to establish meaningful relationships with people from the beginning of life. In infancy, there is no “revival complex” when in contact with the mother (the child does not react to her leaving or coming, is passive or negative towards her). Sometimes symbiosis is observed - the child does not part with the mother, but does not show affection to her.

2) Autism – “withdrawal into oneself”, manifests itself in the form of self-isolation with an inability to establish contact with others (i.e. contacts with others are reduced or absent):

• - the child is immersed in his inner world;
• - looks “past” the children, plays “around”;
• - does not answer questions addressed to him;
• - speech is often directed into space, responses are in the nature of immediate and delayed echolalia (“gramophone or parrot speech” according to Kanner);
• - often refers to himself in the 2nd or 3rd person (there is a delay in the development of the personal pronoun “I”).

3) There is no adequate emotional response (they are cold, alienated from loved ones).

4) Outwardly, these are usually beautiful children with a “thoughtful, sleepy, detached” face (“the face of a prince” according to Kanner) - wary, tense and dissatisfied in the presence of people and satisfied when they leave.

5) Noteworthy is the extreme isolation from the outside world, ignoring environmental stimuli until they become painful. There is also a weakness of emotional resonance with hyperesthesia to light, auditory, tactile, and temperature stimuli. Those. For them, the environment is a source of emotional discomfort; its perception is accompanied by a negative mood background.

6) Painful hyperesthesia and emotional discomfort lead to increased timidity and ease of fear in autistic children. They often have fears of noise from household appliances, water, and wind, which can persist for years. (Autistic fears are associated with a distorted perception of the surrounding world, which is perceived on the basis of individual affectively significant signs, and not holistically).

7) For autistic children, the “phenomenon of identity” is typical - the desire to maintain and preserve the immutability of the environment. Seemingly unaware of anything around, a child may react with violent and incomprehensible excitement for parents in response to minor changes in the environment. This is the ultimate expression of the fear of novelty in general, expressed in the extremely difficult acceptance of any changes (in food, clothing, furnishings, walking routes, etc.). Related to this is the intolerance of looking into the eyes - the human face turns out to be painfully excessively changeable for an autistic child.

Therefore, autistic children are characterized by the absence or insufficiency of eye contact (which is perceived as an excessive irritant). The lack of face to face creates a difficult experience for both parents and the doctor of detachment and alienation, leading to attempts to actively stimulate eye contact. But the result most often is a complete cessation of contact.

9) In autism, there is no behavioral orientation toward people, and there is an inability to distinguish them from inanimate objects. An autistic child treats people as things, “walks past people,” “looks through people,” does not respond to treatment, and usually behaves with people as inanimate carriers of properties that interest him, which can mislead parents who attribute his attention to themselves.

10) Physical contact, if it happens, is clumsy and very manipulative, often giving a formal impression of aggression: a child may step on the head of another child or hug another child by the head so that he cannot breathe.

11) An autistic child not only does not participate in children’s games, but also in his solitary play does not display communicative tendencies (characteristic of healthy children). Gaming activities are stereotypical and monotonous. Most often, these are mechanical manipulations with non-play (ropes, nails, pieces of paper) (less often play) objects (for example, a child stereotypically rearranges pots, turns on and off the light). There is a pervasive predilection for playing with unstructured material (sand, water).

12) Recently, data have been obtained according to which 70-80% of children with Kanner syndrome suffer from mental retardation. But in any case, there is unevenness in intellectual development and a “recession” of nonverbal indicators compared to verbal ones when studied using Wechsler’s method. Normal intellectual activity is always characterized by an autistic orientation (games, interests, fantasies are divorced from the real situation).

13) Speech, regardless of whether it develops in normal terms, with a delay or, conversely, with advance, is not used or is used extremely limitedly for communicative purposes. Speech production is usually spontaneous, limited to immediate and (or) delayed echolalia (non-situational and stereotypical reproduction of what was once heard). In milder cases, attention is drawn to the discrepancy between correct (grammatically and syntactically), complex speech and an inability to engage in dialogue. The voice modulations are pretentious and unnatural, the intonation is poor. With good speech development, the child often uses metaphorical statements and unusual language strategies.

14) Features of communication are interconnected with the formation of the “I”, which in many children with autism occurs only by the age of 6-8 years. The pronoun “I” appears in speech no earlier than the child begins to use the pronouns “he, she, they” and “you” quite freely and correctly. Even by 5-6 years old, most children call themselves by name or in the 2nd or 3rd person, without using the word “I”, which, however, is pronounced in echolalic speech.

15) For children suffering from autism, motor skills are typical - movements are angular, awkward, and simple self-care skills are often difficult to master. Against the background of motor awkwardness, motor stereotypies, pretentiousness and mannerisms of movements are noted.

16) The clinical manifestation of symptoms in Kanner syndrome occurs in the 1st year of life. However, a child usually comes to the attention of specialists no earlier than 2-3 years, when the disorders become quite obvious. But even then, parents often find it difficult to determine violations, resorting to value judgments: “Strange, not like everyone else.” Often the true problem is masked by imaginary or real disorders that are more understandable to parents - for example, delayed speech development or hearing impairment.

When collecting an anamnesis, it is often possible to find out that already in the first year the child reacted poorly to people, did not take a ready pose when picked up, and when picked up was unusually passive (“like a bag of sand”), afraid of household noises (vacuum cleaner, coffee grinder, etc.). etc.), not getting used to them over time, showed extraordinary selectivity in food, refusing food of a certain type or color. (Some researchers believe that rigidity, rigidity, and aggressiveness when picked up are more characteristic of those children who later develop schizophrenia, while passivity is more characteristic of non-processual Kanner syndrome.)

17) Autism, as Kanner understood it, differs from schizophrenia in the absence of procedural progression and tends towards (varying degrees) positive dynamics. The dynamics of communication difficulties that are core to autism reveal a number of patterns that are revealed as the condition spontaneously or therapeutically improves. Initially absent or grossly insufficient contact with the mother is replaced by a symbiotic one, which occurs in different children at different ages, depending on the individual characteristics of the dynamics of maturation - in some children at 2-3 years, in others at 5-7 years. At this stage, separation from the mother leads to anxiety, protests, and in extreme cases, psychotic-type reactions. As the symbiotic contact with the mother smoothes out, contacts with other people gradually develop: first with close and well-known adults, then with a wider circle of adults and older children, then with children younger than oneself, and only lastly with peers.

18) The prognosis for childhood autism depends on:

• - on the severity of autistic manifestations themselves,
• — the presence or absence of pronounced organic lesions,
• - rate of development of intelligence and speech,
• - and the time of initiation of treatment (the pathogenetic effect of medications is maximum up to the age of 7-8 years, after which the medications have a symptomatic, “cosmetic” effect; and medical, pedagogical and psychological assistance is most productive at the basic stages (up to 5-7 years) of formation personality).
• Pismennaya N.V.

The following literature was used: Bashina V.M. Autism in childhood. - Moscow. - "Medicine". - 1999; Kovalev V.V. Childhood psychiatry. - Moscow. - "Medicine". - 1995; Nikolskaya O.S., Baenskaya E.R., Liebling M.M. Autistic child. Ways to help. - Moscow. - “Terevinf.” – 1997

Note to parents

Having noticed that someone else's baby is throwing a tantrum, there is no need to show pronounced bewilderment. It is likely that the child suffers from autism. You need to behave tactfully in such situations.

Tips for parents:

• You need to offer your help and try to encourage the parents of a special child.
• All objects that surround children with autism must be safe.
• You need to remain as calm as possible.
• Parents of sick children should not face the bewilderment of people around them; they need to show compassion and attention towards them.
• Neither parents nor children should be criticized.
• You should not look closely at a hysterical child.
• You should not make noise or attract the attention of strangers to the baby.
• Parents of a sick child should not be rude.

Mental development of children with autism

The vast majority of children with autism have poorly developed intelligence. Mental retardation ranges from mild to moderate. This is due to defects in brain development. In addition, autistic people have difficulty learning. Profound mental retardation is observed when autism is combined with other pathologies: epilepsy, microcephaly, chromosomal mutations. If autism is mild, the child’s intelligence remains normal or may be above average.

A child can count, draw, and play music well, but in other areas he often lags behind his peers. This is a feature of his intellectual development, which is distinguished by selectivity.

The giftedness of an autistic person in a certain area of ​​activity is called savantism. Such children can repeat a complex melody on the violin after hearing it once, or draw a picture, conveying all the halftones, although they have seen it only once. Often such children add or multiply multi-digit numbers in their minds.

Asperger's syndrome

Asperger's syndrome is a type of autism that is characterized by a mild course of the disease. It appears at older ages.

Features of Asperger's syndrome:

• The first manifestations of the disease will be noticed at the age of 7-10 years.
• The child's intelligence is developed normally.
• The child's speech is developed, but its intonation and volume may be impaired.
• Often a person is fixated on some action or activity. He may tell his interlocutor a story that is not interesting to him. At the same time, he does not care about the listener’s reaction.
• The patient's movements seem awkward and postures seem strange.
• A person cannot come to a compromise, he does not know how to negotiate. Such people are self-centered.

People with Asperger syndrome study well and successfully graduate not only from secondary but also from higher educational institutions. They start families, but for this they need the support of loved ones and the participation of parents in upbringing.

Rett syndrome

This disease develops only in girls. It has a genetic basis, since it causes a violation in the X chromosome. If such mutations occur in a male fetus, he dies in the womb. The disease occurs in one in 10,000 children.

Autism is deep, the girl will be completely immersed in herself. Other symptoms of the disorder:

• At the age of up to 1.5 years (sometimes up to six months), the child’s development is slightly impaired.
• After six months - 1.5 years, a slowdown in head growth is observed.
• The child loses previously formed reflex skills and cannot purposefully move his hands.
• The child performs monotonous movements with the upper limbs, which may resemble washing or shaking hands.
• The child's motor activity is reduced and coordination is impaired.
• Speech skills disappear.

Such children are often diagnosed with brain underdevelopment and epilepsy. The prognosis is unfavorable, and movement disorders are difficult to cope with.

Diagnosis of autism

Most often, parents are the first to notice abnormal behavior in a child. This happens most quickly in those families that already have children and have the possibility of comparison. The sooner violations are noticed, the better. This will allow you to begin treatment with the involvement of professionals. In the future, a child with autism will be able to enter society more easily and will have a greater chance of becoming a full-fledged member of society.

There are specialized tests that can identify children with autism. Parents must go through them. The doctor also studies the child’s behavior in his usual environment.

Testing is carried out using the following methods:

• ADI-R – Autism Diagnostic Questionnaire.
• ADOS – Autism Diagnostic Observation Scale.
• CARS – Childhood Autism Rating Scale.
• ABC is a behavioral questionnaire for diagnosing autism.
• ATEC – Autism Evaluation Checklist.
• CHAT – Questionnaire for Autism in Young Children.

In addition, there are instrumental examination techniques that allow you to clarify the diagnosis:

• Ultrasound examination of the brain.
• Electroencephalography, which allows to exclude foci of epileptic activity.
• Hearing test by an audiologist. This study will eliminate hearing loss as a cause of speech impairment.

To learn to correctly perceive the behavior of a child with autism, parents must understand what is happening to him. The information presented in the table will help with this.

Modern ideas about autism

Autism was long considered a psychiatric disease until the work of Bernard Rimland (1964) and Carl Delacato (Delacato, 1974) appeared in the early second half of the twentieth century.

Bernard Rimland, professor of psychology, founder of the Autism Society of America, and father of a child with autism, believed that the problem with a child with autism is that he is unable to correctly interpret incoming sensory signals.

Carl Delacato also believed that many manifestations of autism are caused by disturbances in the functioning of sensory functions and that, therefore, autism is not a psychological or mental disorder, but a neurological disorder that must be addressed by neurological rehabilitation methods. He showed that severe behavioral problems in children with autism can be caused by sensory processing disorders and proposed methods for addressing these problems, many of which were developed during his many years of work at IAHP, the Institutes for Achieving Human Potential, founded by Glenn Doman. The book by Carl Delacato (Delacato, 1974) undeservedly remains little known, despite the fact that it contains information that anyone dealing with autism, especially specialists, needs to know.

Treatment of autism

Autism is an incurable disease. There is no such drug created that, if consumed, a child would recover. In order for the patient to socialize, it is necessary to work with him every day and create special conditions around the child. This is the only way to achieve certain success. The family should closely interact with teachers and psychologists.

The main directions that are implemented in the treatment of autism:

• Autism is a special feature of a child. He will not be able to perceive information in the same way as most people.
• It is necessary to create conditions for the child in which he can comfortably develop, live and study. The situation should not frighten him or force him to withdraw into himself.
• A psychologist, teacher, speech therapist and other specialized specialists should work with the child.

Steps to be taken sequentially:

• It is necessary to direct efforts to develop those skills that the child lacks. If he cannot establish contacts, then it is necessary to teach him how to do this; if his speech suffers, then it should be corrected.
• Efforts should be directed toward combating such manifestations as: aggression, fixation, fears, self-aggression, and withdrawal.
• The child must be taught to observe and imitate other people.
• The child needs to be taught to play and take on social roles.
• Efforts should be made to teach the child to make contact with other people.

Correction of a child's behavior is based on behaviorism. This is a separate branch of psychology. ABA therapy is applicable in the treatment of children with autism. In this case, you need to observe the baby’s behavior and reactions. After which certain incentives are selected. It all depends on the preferences of the individual child. This could be music, food, sounds, etc. All positive reactions that the child gives should be encouraged. This allows you to establish contact, as well as prevent unwanted reactions in the form of hysterical attacks and aggression.

Classes with a speech therapist are a must when working with autistic people. Every sick child has certain problems with speech, so it will not be possible to do without the help of a specialist. He teaches him to watch his intonation, pronounce sounds correctly, and prepares him for school.

It is imperative to teach your child self-care and socialization skills. Children with autism have no motivation to communicate with other people, do not want to contact children or play with them. They are not keen on certain types of activities; they find it difficult to perform hygienic skills. To instill them, teachers recommend using cards. They contain detailed instructions for action and their sequence: getting out of bed, brushing your teeth, combing your hair, etc.

Medicines are not used to treat autism. They are used only in cases where a child’s destructive behavior becomes an obstacle to his full development. We must remember that hysterics and even stereotypical actions are all an attempt to communicate with the world. It’s bad if the child doesn’t express himself in any way: he sits in one place all day and turns the wheel of the car. Psychotropic and sedatives should be given to autistic people only after consultation with the doctor.

There is an opinion that a gluten-free diet can help cope with autism, but this theory has not received scientific confirmation.

Parents who are concerned about the health of their baby often have to deal with charlatans. They offer treatment with stem cells, micropolarization, and nootropic drugs. However, such therapy can be dangerous for a child with autism and harm his health.

Is autism a psychological disorder?

Leo Kanner believed that the cause of autism was organic brain damage, but in the 1950s his assumption about psychological causes was further developed. In his famous 1943 article, Kanner noted that the parents of his patients were engaged in intellectual work (among them were psychologists and psychiatrists), were too busy with themselves and did not pay enough attention to their children, which he saw as a possible cause of the disorders. It is now known that autism manifests itself regardless of social status.

Although Leo Kanner later abandoned the idea of ​​psychological guilt of "too intelligent" parents, this idea was further developed in the 1950s by the work of Bruno Bettelheim, who was recognized as one of the leading experts on autism, although he was not a psychiatrist or psychologist. Bettelheim put forward the “refrigerator mother” theory and argued that autism is a psychological disorder caused by the cold attitude of parents towards the child. Even in 1981, he wrote that all his life he worked with children whose lives were ruined because their mothers hated them.

Bettelheim's approach was unanimously accepted and dominated until the early 1960s; accordingly, the then fashionable psychoanalysis became the main method of treatment. Some experts still share this point of view; For example, in France, psychoanalysis as the main treatment for autism began to come under criticism only in 2012.

In many countries, the application of this theory has brought a lot of grief to children with autism and their families. This did not escape us either. When Petya was still very young, two of the specialists who looked at him - psychologists and psychiatrists, in Russia and France - insisted that even during pregnancy I treated my boy poorly, and in early childhood I did not notice him and did not talk to him.

Disorders that resemble autism

• Attention deficit hyperactivity disorder (ADHD).

  This syndrome is often confused with autism. It is believed that it manifests itself to one degree or another in every 3 children. Children with ADHD are restless, have difficulty learning, have difficulty concentrating, and are very active. Some adults also suffer from this syndrome. It manifests itself in difficulties with remembering dates and events. It is difficult for such people to make informed decisions. Such a disorder must be diagnosed as early as possible. Such patients are prescribed psychostimulants and sedatives. Classes with a psychologist have a good effect.

• Hearing loss. If a child has poor hearing, this will certainly affect his speech development. Children may not respond to their name, they do not fulfill the requests of adults, and they may seem spoiled and disobedient. Such symptoms resemble autism, which is why it is so important to test the hearing of children with similar disorders. Hearing loss can be managed through the use of hearing aids. Their use allows you to correct all existing developmental deviations.
• Schizophrenia. In years past, autism was considered a manifestation of schizophrenia. Modern science has good reason to claim that these are two different diseases that have nothing to do with each other. Schizophrenia manifests itself at an older age. In children under 5-7 years of age, this disease is never diagnosed. The disease develops smoothly. Adults note unmotivated fears in the child; he becomes obsessive, can withdraw into himself, and talk to himself. Then signs of the disease appear, such as delusional thoughts and hallucinations. Schizophrenia is accompanied by short-term remissions with further deterioration of the disease. Treatment boils down to taking medications. These patients are managed by psychiatrists.

Autism should not be taken as a death sentence. The reasons for the development of the disease are unknown. There is no way to accurately describe how exactly a sick child perceives the world. However, it has been reliably established that the early start of treatment and its competent organization allows such children to lead a normal lifestyle, study, work and start families. The most important thing for a child with autism is parental support.

Author of the article:

Sokov Andrey Vladimirovich |
Neurologist Education: In 2005, she completed an internship at the First Moscow State Medical University named after I.M. Sechenov and received a diploma in the specialty “Neurology”. In 2009, she completed her postgraduate studies in the specialty “Nervous Diseases”. Our authors