Reference materials~~

Children’s autism, also known as childhood autism, is a type of autism characterized by severe loneliness, lack of emotional response, language development impairment, stereotyped repetitive movements and A mental illness characterized by strange reactions to the environment. Originally called infantile autism, it is now also known as autistic disorder. It is a pervasive developmental disorder. It is very different from autism in adults in terms of causes, development methods and treatment methods. It is a serious developmental disorder in infants and young children. It is characterized by abnormalities in social interaction, language movements and behavioral interactions, and onset before the age of three.

It usually occurs before the age of 3 and usually manifests itself before the age of 3. It begins in infancy and lasts throughout life. It is a serious emotional disorder.

Autism has no racial, social, or religious distinctions, and has nothing to do with family income, lifestyle, or education level. According to statistics from European and American countries, there are approximately 2-13 cases per 10,000 children. At present, it is estimated that there are about 500,000 children with autism in our country. This disease is more common in boys, with a male to female ratio of 2.6-5.7:1. Among the 60 cases counted by the Institute of Mental Health of Peking Medical University from 1989 to 1992, the male:female ratio was 7.5:1. Among the 19 cases reported in the child psychology outpatient clinic of our hospital from 1995 to 1997, the male:female ratio was 6.3:1. June 1984 As of May 1986, the Nanjing Children's Mental Health Research Center had admitted 170 children with mental illness from many regions across the country. Among them, 15 cases were diagnosed with autism, accounting for 8.82%. This number only represents the cases among children with mental disorders. Rate.

[Cause]

A lot of research has been done from the aspects of genetic factors, neurobiological factors, and social psychological factors. However, so far, the causes and symptoms of autism in children have not been elucidated. Pathogenesis, but at least treat it as an abnormal behavioral syndrome caused by pervasive developmental disorders caused by multiple biological reasons.

[History]

First described by Kanner in 1943. And called it "emotional contact loneliness disorder." The 11 cases he reported at that time all began to develop after the baby was born, so it was called early infantile autism. Later, after he and other scholars observed more cases, they found that some children developed normally for the first one or two years and only became ill later. Nowadays, most people set the age of onset as within 30 months.

Because autism has such an early onset, strange symptoms, and serious prognosis, it has aroused widespread interest among scholars and concern from society. The United States, the United Kingdom, Canada and other countries have specialized societies and magazines on autism. They have conducted in-depth discussions on social, psychological, neurophysiological, biochemical, genetic and other aspects, and written many monographs and articles.

Clinical manifestations and diagnosis

Manifestations (symptoms) of autism in children

The main symptom is the inability to interact with others and establish normal social relationships. Children with the disease are silent in their own world, unable to communicate with others or even their own parents using language, expressions, and movements. Some children will be mistaken for being mentally retarded or introverted at the beginning, while others may seem normal when they are one or two years old, but only notice unusual behavior when they are about 3 years old. Autistic patients will have difficulty learning the language of normal people, and it will also be difficult for them to communicate with others and the outside world. They may repeat several movements (clapping, swaying). When changes occur in their daily lives, they resist them vehemently. The impact of autism on behavior, in addition to language and social difficulties, can also cause extreme excitement or depression in front of parents and family members.

Specifics:

1. Early manifestations include extreme loneliness and inability to smile at relatives. When feeding, the child does not close his body to the adult. When reaching out to hug, the child has no greeting posture, will not reach out to prepare to be hugged, will not close his body to the mother, and will not look at the person holding him.

2. Difficulty in social interaction, especially lonely, lack of social contact with others, lack of emotional connection, no attachment even to parents, like a stranger. But don't feel intimidated when getting along with strangers.

Normal children often express their feelings and demands by staring at each other, but children with this disease lack eye-to-eye gaze and cannot express their feelings and demands in this way. Don't like to play, don't like to play games. When children are around 5 years old, they often have no friends, rarely play with children, lack emotional responses, and often say or do some unsocial things.

3. Language development delay or disorder. Children with the disease are usually silent or speak in imitative language, imitating other people's language like a parrot. His ability to understand and express language is low, he cannot understand slightly more complex sentences, and he cannot express "goodbye" with gestures. Unable to understand and use facial expressions, movements, postures and tones to interact with others. Lack of imagination and social simulation, unable to use toys to "cook", "drive trains", and "build houses" like normal children. Some children have stereotyped language and use pronouns incorrectly, such as saying "I want" instead of "you want", or calling themselves he. Difficulty communicating with the outside world, unable to associate new words with their meanings, and communicating with others using gestures rather than words.

4. Ritual and compulsive behavior. Due to a lack of variety and imagination, children often insist on repeating stereotyped play patterns, repeating some physical tasks, and repeating the same life, such as lining up toys repeatedly, always playing with their toes, dressing in the same order, insisting on certain items. The placement form cannot be changed. Once something changes, they will be extremely frustrated. If others change, the affected children will make a fuss. They will also express opposition and uneasiness to any changes in their room, including the shifting of furniture and changes in decorations, etc.

5. Most of the brain intelligence is lower than that of normal people. Only those with an IQ of 20 are higher than or equivalent to normal people.

6. Expressing special interest in certain objects, such as a cup or a brick, and even becoming attached to them, but not to relatives.

In addition, some children may also have sensory impairments, and may be slow or allergic to vision, hearing, touch, etc. Some have cognitive impairment, low intelligence, and poor abstract thinking ability. A few children may have epileptic seizures. Children with autism are sometimes deaf and unresponsive to sounds. Normal children will be frightened by sounds such as barking dogs, while autistic children will be indifferent. They are also less sensitive to pain, cold and heat, do not like to make friends, prefer to be alone, and rarely touch other people's eyes or smile.

For children with autism, only early detection, early intervention, and behavioral modification can help them shorten the gap with normal society and allow them to integrate into society as soon as possible. How can we detect autism tendencies in children at an early stage?

The following 18 behaviors are early manifestations of autism. If a child is found to have the following 7 behaviors at the same time, he should be suspected of having autism tendencies.

1. No response to sounds

2. Difficulty intervening with peers

3. Refuse to accept change

4. Indifference to the environment

5. Parroting

6. Like to rotate items

7. Laughing for no apparent reason

8. Resistance to normal learning methods

9. Weird way of playing

10. Unbalanced movement development

11. Insensitive to pain

12. Lack of eye contact

13. Particularly dependent on a certain item

14. Unexplained crying

15. Particularly restless or immobile

16. Refuse to hug

17. Not afraid of real danger

18. Use actions to express needs

[Differential diagnosis]

1. Brain retardation: Most people with brain retardation will not develop skills, while autistic patients will not develop well in their skills. Under guidance, the brain will develop and some skills can be mastered.

Causes of autism in children

The causes of autism in children are not yet clear, and the cause has not yet been determined.

Recent surveys believe that autism is related to the physiological structure of the brain or neurology, and is the result of several "causes". It is related to genetic factors, organic factors and environmental factors.

(1) Genetic factors: The sibs of the affected children have a higher incidence of the disease than others. The incidence of monozygotic twins is higher. 41 children have long Y chromosomes. Their father and brother Bei were also found to have long Y chromosomes, suggesting a genetic factor.

(2) Organic factors: such as brain damage, maternal rubella infection during pregnancy, meningitis, encephalitis, etc. after giving birth. In recent years, studies have found that enlargement of the left temporal horn of the ventricle is more common in children with this disease, suggesting that lesions of the medial temporal lobe may be caused by an allergic reaction of brain tissue. Recent research has shown that the immune system of children with autism may mistake a basic brain protein for a foreign body and eat it. This results in brain damage that may be characteristic of the disease. This disease also causes emotional, intellectual and communication deficits, and is also related to brain lesions.

(3) Environmental factors: In the past, some people believed that cold and over-intellectual parenting methods in the early life environment, lack of rich and appropriate stimulation, and failure to teach social behavior were important factors in the disease. Children who have been in a monotonous environment for a long time will use repetitive actions to stimulate themselves and become less interested in the external environment. Most of the parents of children with this disease are professional and technical personnel, highly educated and relatively smart, but they are rigid and have obsessive-compulsive tendencies, are cold and stubborn towards their children, and lack warmth in their families. Now, this view is rejected. Research has confirmed that it is due to some kind of brain disease. The cause is a virus or a metabolic disorder. There is currently no conclusion.

Treatment of Autism in Children

There are many types of autism, ranging from mild to severe. Since the cause of the disease is unclear, it is still unclear how autism affects people and how to effectively communicate with autistic patients. It is especially difficult to cooperate with treatment. An effective treatment method has not yet been found. It is a lifelong, chronic disease that affects normal brain function and the inability to correctly understand what they see, hear, and feel. It is difficult to cure, but it is impossible to be cured for life.

Treatment of autism has come a long way since the symptom was first described in 1943. Some patients experience less symptoms as they age. Researchers are also currently actively seeking methods. They believe that autism symptoms can be improved with the right knowledge. With specially trained teachers and special education methods, autistic patients can gradually adapt to normal life.

The prognosis of this disease is mostly poor, and behavioral disorders often remain, making it difficult to adapt and unable to live independently. Only a few people can adapt to social life when they grow older. The prognosis is related to the level of intelligence, and patients with severe intellectual disability have a poor prognosis.

Comprehensive treatment methods should be adopted for children with autism.

The most important thing in treatment is education and behavioral therapy. The purpose is to promote the education of children's normal behavior, especially the correction of social behavior, correct abnormal behavior, such as stereotyped work, etc., and eliminate sleep disorders. , tantrums, hyperactivity and other secondary symptoms. Family members of children with the disease should also pay attention to overcoming anxiety, self-blame, and impatience in order to produce good results in the treatment of the children.

Parents should change their parenting style, be closer to the child, care more about the child, and provide warmth to the child. The prognosis of this disease is usually poor, and behavioral disorders often remain, making it difficult to adapt and unable to live independently. A small number of patients can adapt to social life when they grow older. Children with good intelligence have a better prognosis than children with poor intelligence.

Drug treatment may only be effective for individual symptoms. For example, for short-term severe insomnia, diazepam can be used. For aggressive behavior, perphenazine can be used. Drugs that promote brain function can be Naofuxin, Naofukang, or γ -Tyrosine, in addition, Ritalin is effective in treating loneliness and speech disorders. In recent years, some people have reported that fenfluramine is effective in treating autism. This drug is a derivative of amphetamine. After taking it, it can reduce serotonin levels in the central nervous system, reduce hyperactivity and stereotyped movements, and improve attention. , it can still improve IQ in some cases.

Haloperidol can improve children's withdrawal, withdrawal, and certain stereotyped behaviors. The choice of drug depends on the age of the child, the severity of the disease, and the length of the disease. The dose should also be based on the specific situation of each child, starting from the smallest dose. Start by slowly increasing the dosage until appropriate effects or side effects appear.

Although many parents swear by secretin, researchers reported Tuesday that secretin is not an effective drug for treating autism in children. Secretin attracted widespread attention because of NBC's report last year about a child named Parker. Parker underwent an endoscopy, which found nothing. He took some secretin, and the child began sleeping and talking again. Parents then believed that this once-taken indigestion diagnostic drug was related to the improvement of the child's silent autism. Several major newspapers published Parker's news, and as a result, three to four thousand autistic children took secretin at least once. The Autism Research Society collected responses from more than a thousand children and found that a considerable number of children showed significant improvement. But when scientists carefully analyzed the effects of secretin again, they found that a dose of secretin was ineffective in treating autism.

Children with autism generally have a longer course of disease, so the medication treatment time is also relatively longer. Parents should pay attention to the side effects of drugs during treatment, such as extrapyramidal reactions, liver function, cardiovascular and blood abnormalities. Therefore, regular review of children is necessary.

The above-mentioned drugs are confirmed to have an important therapeutic effect on children with autism. They can alleviate some symptoms and facilitate behavioral and psychological treatment, but they have not yet achieved a radical cure. Drugs themselves cannot improve children's learning and understanding abilities, nor can they establish normal behavior, but effective drugs can make children more adaptable to the environment and management. Through comprehensive measures such as medication, special training, and behavioral modification, children's symptoms can be improved ideally.

Researchers are actively seeking various treatment methods to help patients with autism, including speech therapy, sensory integration, visual therapy, music therapy, auditory therapy, etc.

Experiments have proved that with good methods, the patient's condition will be controlled and improved. A good approach would include some communication therapy, social skills development, sensory impairment treatment, etc. Experts believe that the more severe the condition, the better the effect, and advocate one teacher's specialized treatment for one patient. Autistic patients need support and help from the entire society, not just family members and teachers.

Social rehabilitation

Children with autism can generally do repetitive tasks. Like artists, tuners, painters, office workers, dishwashers, assembly line workers, etc.

Usually like music, swimming, hunting, guessing, etc.

Vocational training, employment opportunities, supervisory authorities, etc. are needed after adulthood.

Reference materials:

Clinical characteristics

The basic clinical characteristics of autism are the "Kanner" triad.

(1) Social communication impairment Social defects are the core of autism. Some children can show symptoms in infancy, refuse hugs from others, and have no sense of attachment to their parents. When their parents come back, There was no sign of pleasure either. When they feel unhappy or hurt, they will not seek comfort from their mother and are easy to separate from their parents. Sometimes they follow strangers like their parents, and sometimes their relatives call their names. They often ignore and do not respond, showing that they turn a blind eye or not hear. The lack of eye-to-eye contact is often seen as a special manifestation of autism.

(2) Speech development disorder The speech disorder of autism is a qualitative and comprehensive damage, and most people seek medical treatment based on this symptom. 1. Being silent or using less language. 2． Impairment in the ability to use language is manifested in the inability to take the initiative to talk to others, and the inability to raise or maintain topic topics. They often talk to themselves, but others cannot understand what they say; they often have their own little world, Take pleasure in this. without paying any attention to the surrounding environment. Some children cannot use pronouns or use pronouns reversely, so that their speech becomes meaningless or incomprehensible.

3. Stereotyped repetitive speech or imitated speech. 4. Speech pitch and rhythm disorders. 5. Use of words for self-stimulation: sometimes screaming or uttering "words" that others cannot hear or understand, often called "egocentric language". 6． Damage to non-verbal communication

(3) Narrow scope of interests and harsh and rigid behavior. 1. Tend to require fixed or abnormal responses to the environment. 2. Unusual interests and unusual ways of playing: showing a special fascination with certain objects or activities. 3. Stereotyped, repetitive behaviors and special movement postures. 4. Interest in non-main characteristics of objects and special ways of contacting them.

(4) Perceive common abnormalities.

(5) Intellectual and cognitive deficiencies.

Zhang Qingsong

Zhang Qingsong Cerebral Palsy Epilepsy Network

Little common sense about childhood autism. Childhood autism, also known as childhood autism, is related to children’s perception, language and thinking, It is related to psychological activities in multiple fields such as emotion, movement and social interaction, and is a developmental disorder. Many countries have conducted surveys on the prevalence of autism in children. Canada is 10 per 10,000 people, the United States is 4 per 10,000 people, and Japan is 7 per 10,000 people. Our country has not yet conducted an epidemiological survey. From the statistics of clinical cases, we found that the incidence rate in men is higher than that in women, with a ratio of about 5.1. Survey research has found some interesting phenomena: parents of children with autism have a higher socioeconomic status; among twins, if one of the monozygotic twins has autism, the prevalence rate of the other twin is as high as about 36% , but this phenomenon does not occur in dizygotic twins. This shows that the occurrence of autism has a certain relationship with heredity.

The latest medical research has found that children with excessive levels of opiates in their brains often suffer from symptoms of loneliness, numbness, and barriers to emotional communication. So far, there are many theories of etiology, but what exactly causes autism in children is not yet clear.

The following behavioral characteristics are common in children with autism:

(1) Emotional communication with people around them is limited. Children with autism cannot distinguish between relatives or strangers to varying degrees. When interacting with others, do not look at the other person's face and avoid eye contact. Likes to be alone, feels comfortable playing alone, and lacks sympathy.

(2) Maintain a fixed lifestyle: Rigid living environment requirements, the movement of furniture, and even changes in diet and daily life will cause emotional changes in them, such as anger or panic. Some children are so serious that they can’t even eat. You cannot change where you sit, where you put your bowl and chopsticks, or even which toilet you use when going to the toilet.

(3) Speech disorder. Children with autism talk a lot, but their comprehension ability is low and their common words are inappropriate. The pronunciation is incorrect and a strange tone comes out.

(4) Children with autism often cannot sit still, move excessively, and walk on their toes. Their attention is distracted and they are used to looking around, or making weird postures such as stretching their necks or pretending to be erect.

Generally speaking, children with autism can be diagnosed with the following three basic characteristics:

(1) A general lack of emotional response to people, which seriously affects social interaction;

(2) Verbal and non-verbal communication and imaginative activities are severely reduced;

(3) Rigid, repetitive or ritualistic behaviors seriously restrict life activities. Through treatment, behavioral symptoms can be reduced and development promoted. Common treatment methods include: games, hugs, family, drug therapy, etc.

For further information, please read "Medical Psychology" and "Mental Health Care".

What kind of disease is childhood autism? January 11, 2001 16:54:4 Peking University Institute of Mental Health Yang Xiaoling

Childhood autism is a disease that occurs in early childhood. Comprehensive mental development disorder mainly has the following symptoms:

(1) Loneliness and isolation, unable to establish normal contact with others. That is the lack of interaction with people.

The tendency to communicate. Some children with this disease have shown this characteristic since infancy. For example, they have not been close to their parents since childhood, and they do not like to be hugged by others. When someone wants to pick them up, they do not stretch out their hands to show the gesture of expecting them to be picked up. , does not take the initiative to play with children, avoids others when they come to play with him, does not respond to calls, and always likes to act alone and play by himself. Although some children do not refuse others, they do not interact with children, that is, they lack social communication skills. For example, when looking for a child, they either suddenly pat the person, grab the person, or suddenly go over to hug the person, and then leave by themselves. , it seems that photographing and grabbing people is not just an action to find someone to contact, or that there is only a form of contact without the content and purpose of contacting people. Their loneliness is also reflected in their indifference to the things around them. They seem to be indifferent to hearing and turning a blind eye. They do whatever they want to do without any scruples and act as if no one else is around. What happens around them seems to have nothing to do with them, and it is difficult to arouse their interest and interest. Pay attention, their eyes often change, and it is not easy to stay on the things that others ask them to pay attention to. They seem to live in their own little world. In addition, their eyes do not look at each other or even avoid each other's eyes. Their eyes wander during daily activities. They often squint, squint or peripheral vision when looking at people. They rarely look directly, rarely smile, and never say hello to people.

(2) Speech disorder is very prominent. Most children with the disease have very little speech. In severe cases, they are almost speechless for life. They can speak and use limited vocabulary. Even if some children can speak, they are often reluctant to speak and would rather use gestures instead. Some can speak, but their voices are very low, or they repeat monotonous words to themselves. Some children can only imitate what others have said, but cannot talk in their own language. Many children cannot ask or answer questions, but just repeat what others ask. Language communication is often manifested in the confusion and inversion of pronouns, such as "you" and "him" being often used instead of himself. There are also many autistic children who often scream, which can sometimes last until they are 5 to 6 years old or longer.

(3) Narrow interests, stereotyped and repetitive behaviors, and strong demand for the environment to remain unchanged. Children with autism often focus on one or several games or activities for a long time, such as being obsessed with rotating pot lids. , placing building blocks monotonously, keen on watching TV commercials and weather forecasts, but have no interest in cartoons, children's TV, and movies that children usually like. Some children have to eat the same meals every day and take the same steps when going out. The route and toilet require the same defecation. If there is any change, they will cry and fuss, showing obvious anxiety reactions. They are unwilling to change their original habits and behaviors, and have difficulty adapting to the new environment. Most children also show aimless activities. Excessive activity, monotonous and repetitive jumping, clapping, waving, running and spinning, and some even self-injury, such as repeatedly picking their noses, picking their mouths, biting their lips, sucking and other actions.

(4) Most of them have backward and uneven intellectual development. Most children's intellectual development is slower than that of children of the same age, and a few children have normal or close to normal intelligence. However, some of them are surprisingly good at certain aspects of intellectual activities, which is incredible. Many children with this disorder have very strong mechanical memory abilities, especially the ability to remember text and symbols. For example, there is a 3 or 4-year-old child who particularly likes to read words. When he sees a word, he takes the initiative to ask what he is reading and remembers it after only asking once. For this reason, he can read children's storybooks effortlessly and fluently, which shows that he has mastered a lot. Vocabulary, but when he wants to use words to express his meaning, he has obvious difficulties, indicating that they have impairment in understanding language and using language ability.

Main symptoms of childhood autism

(2001-09-2612:59:03)

Childhood autism, also known as autism, is a relatively Severe developmental disorders. There is a significant difference in the incidence of this disease between men and women. The male-to-female prevalence ratio in my country is 6-9:1. The main symptoms are:

1. Social communication disorder generally manifests as lack of communication or communication skills with others, lack of secure attachment relationship with parents, etc.

2. Language communication disorder: language development lags behind, or language regression occurs after normal language development, or language lacks communicative nature.

3. Repeat stereotyped behaviors.

4. About 70% of autistic children with abnormal intelligence are mentally retarded, but these children may have strong abilities in some aspects, 20% have intelligence within the normal range, and about 10% have supernormal intelligence. Most children with autism have Good memory, especially mechanical memory.

5. Abnormal sensation manifests as dull pain perception, special fear or preference for certain sounds or images, etc.

6. Other common behaviors include hyperactivity, distraction, temper tantrums, aggression, self-injury, etc. This type of behavior may be related to the greater use of spanking or punishment in parental education.

Will infantile autism affect the intellectual development of children?

Infantile autism is a mental disorder that begins at a young age, is related to congenital rubella, and is often accompanied by epilepsy. Most children with autism are mentally retarded, but may have special talents in music and remembering numbers.

Opinions on the cause of autism in infants are not yet unified. Most researchers believe that such behavioral abnormalities are due to organic lesions. Children often have more physical abnormalities and EEG changes.

Common manifestations of this disease include difficulty in speech and social interaction. 2 months after birth, he still doesn’t smile. 4 months after birth, he doesn’t feel happy when his mother hugs him, and he can’t look at others eye-to-eye. Unable to maintain good social interactions with the people around them, unable to adapt well to changes in the environment, often with stereotyped movements, and more than 75% of the children are mentally retarded. Only 1/3 of the sick children can barely be independent, and some are accompanied by epilepsy or other significant abnormalities of the nervous system. .

The treatment of this disease is still in the exploratory stage. Language training, behavior modification and psychological guidance are the more important treatment methods. The more commonly used drugs include haloperidol, sulpiride, fluamphetamine, etc.

Therefore, when parents find that their children cannot laugh or react poorly to things around them 2 months after birth, they should closely observe the growth of their children. For example, if they are unwilling to play with children or participate in group games, they should not Likes to imitate adults' movements, speaks monotonously, often speaks repetitive language, stereotyped language or self-made words and phrases, and uses inappropriate facial expressions, body postures or gestures in social activities. This disease should be highly suspected and sent to the hospital for treatment. At the same time, strengthen language training and correct abnormal behaviors.

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