Autism in children: signs of the disease and causes. Autism

There are more and more children diagnosed with autism every day. This prevalence of the disease is primarily due to improved diagnosis. Talented and gifted children in Russia often miss the diagnosis of autism. Such children require special attention and must be socialized in society.

What it is?

In simple words, “autism” is a mental disorder or disease characterized by mental changes, loss of social adaptation in society and altered behavior. Typically, the child experiences a persistent disruption of interaction within society.

Often autism is not diagnosed for a long time, since parents attribute changes in behavior to the child’s character traits.

The disease can indeed be mild. In this case, identifying the first characteristic signs and recognizing the disease is a very difficult task not only for parents, but also for doctors.

In Europe and the USA, the diagnosis of autism is much more common. This is due to the presence of excellent diagnostic criteria, which allow a committee of doctors to accurately make a diagnosis even in mild cases of illness or in complex clinical cases.

In autistic children, various changes occur in the cerebral cortex. They appear immediately after birth. However, they can appear much later, after many years. The disease occurs without periods of stable remission. With a long course of the disease and the use of various psychotherapeutic techniques that can improve the behavior of an autistic child, parents may see some improvements.

To date, no specific treatment has been developed. This means that a complete cure for the disease is, unfortunately, impossible.

Prevalence

Statistics on the incidence of autism in the USA and Europe differ markedly from Russian data. This is primarily due to the high detection rate of sick children abroad. Foreign doctors and psychologists use numerous questionnaires and diagnostic behavioral tests, which allow them to accurately diagnose children of any age.

In Russia, the statistics are completely different. Often, not all children show the first symptoms of the disease on time and at an early age. Russian children who suffer from autism often remain just withdrawn kids.

Symptoms of the disease are “attributed” to the child’s character and temperament, which leads to serious consequences. Such children subsequently integrate poorly into society, cannot find themselves in a profession, or they fail to create a good and happy family.

The prevalence of the disease is no more than 3%. Boys are most often affected by autism. Typically this ratio is 4:1. Girls from families where there are many cases of autism in relatives may also suffer from this mental illness.

Most often, the first clear symptoms of the disease are revealed only by the age of three. The disease, as a rule, manifests itself at an even earlier age, but remains unrecognized in most cases until 3-5 years of age.

Why are children born with autism spectrum disorder?

To date, scientists have not yet reached a consensus on this issue. In the development of autism, many experts believe that several genes are to blame, which cause disruption in the functioning of certain parts of the cerebral cortex. Often when analyzing cases of the disease it becomes obvious strongly expressed heredity.

Another theory of the disease is mutation. Scientists believe that the cause of the disease can be various mutations and breakdowns in the genetic apparatus of a particular individual.

Various factors can lead to this:

• exposure to ionizing radiation on the fetus during the mother's pregnancy;
• infection with bacterial or viral infections of the fetus during intrauterine development;
• exposure to hazardous chemicals that have a teratogenic effect on the unborn child;
• chronic diseases of the nervous system in the mother, for which she took various symptomatic psychotropic drugs for a long time.

According to American experts, such mutagenic effects quite often led to various disorders characteristic of autism.

This effect on the fetus is especially dangerous during the first 8-10 weeks from the moment of conception. At this time, the formation of all vital organs occurs, including the formation of the areas of the cerebral cortex responsible for behavior.

Genetic or mutational disorders that underlie the disease ultimately lead to specific damage to individual areas of the central nervous system. As a result, the coordinated work between the various neurons responsible for social integration is disrupted.

There is also a change in the functions of the mirror cells of the brain, which leads to the appearance of specific symptoms of autism, when the baby can repeatedly perform the same type of action and pronounce individual phrases several times.

Kinds

Currently, many different classifications of the disease are used. All of them are divided according to the variants of the course of the disease, the severity of manifestations, and also taking into account the stage of the disease.

There is no single working classification that would be used in Russia. In our country, specific criteria for the disease are currently being developed and streamlined, which will form the basis for diagnosing the disease.

Autism can usually occur in several forms or variations:

1. Typical. With this option, the signs of the disease appear quite clearly in childhood. Children are characterized by more withdrawn behavior, lack of involvement in games with other children, and have poor contacts even with close relatives and parents. To improve social integration, it is imperative to carry out a whole range of various psychotherapeutic procedures and the help of a child psychologist who is well versed in this problem.
2. Atypical. This atypical variant of the disease occurs at a much later age. As a rule, after 3-4 years. This form of the disease is characterized by the manifestation of not all specific signs of autism, but only some. Atypical autism is diagnosed quite late. Often, failure to diagnose in time and delay in making a diagnosis leads to the development of more persistent symptoms in the child, which are much more difficult to treat.
3. Hidden. There are no exact statistics on the number of children with this diagnosis. With this form of the disease, the manifestation of the main clinical symptoms is extremely rare. Very often, children are considered simply overly withdrawn or introverted. Such children practically do not allow strangers into their own inner world. Establishing communication with a child diagnosed with autism is very difficult.

How does the mild form differ from the severe form?

Autism can occur in several forms depending on severity. The mildest form occurs in most cases. It is characterized by violations of social adaptation, when the baby does not want to establish contacts or communicate with other people.

It is important to understand that he does this not because of modesty or excessive isolation, but simply due to the manifestations of the disease. Such children, as a rule, start speaking late.

Violations of one's personality in mild forms of the disease practically do not occur. Kids can make contact with the people closest to them. Usually the child chooses several family members who, in his opinion, treat him with more care and attention. Autistic children do not perceive physical contact well. Usually the child tries to shy away from hugs or does not like kisses.

Babies with more severe illness They try in every possible way to avoid contact with other people. Even touching or hugging from close relatives can cause them severe mental trauma. Only the closest people, according to the child, can touch him. This is a very important clinical sign of the disease. A child with autism is very sensitive to any interference in his personal space from a very young age.

Some severe variants of the disease are characterized by mental tendencies to cause harm to themselves. Such babies may even bite themselves or attempt to inflict various injuries at an older age.

This manifestation is rare, but requires urgent consultation with a psychiatrist and the prescription of special medications that reduce manifestations of aggression towards one’s own personality.

The mild form of the disease often goes undiagnosed, especially in Russia. Manifestations of the disease are simply attributed to the developmental characteristics of the child or the uniqueness of his character. Such children can grow up and carry the disease into adulthood. The course of the disease may change at different ages. However, the classic violation of social integration is observed almost constantly, without remission.

Severe forms of the disease, which often manifest as complete forced isolation of the baby from the outside world, are much easier to identify.

The behavior of a child with severe autism is manifested by a pronounced reluctance to communicate with any people. Such kids are more willing to be alone. This brings them peace of mind and does not disrupt their usual way of life.

Failure to provide therapeutic psychotherapy can lead to deterioration of the child’s condition and complete social maladjustment.

Symptoms and first signs

Manifestations of the disease can be checked already in the first years of a child’s life. With a thorough and attentive analysis of the baby’s behavior, even at a very young age, the first characteristic signs of autism syndrome can be identified. There are special psychological traits and characteristics for this disease.

The main characteristics of the disease can be divided into several main categories:

• Reluctance to create new social contacts.
• Disturbed interests or use of special games.
• Repeating typical actions many times.
• Speech behavior disorder.
• Changes in intelligence and different levels of mental development.
• Changing your own sense of personality.
• Psychomotor dysfunction.

The reluctance to create new social contacts is evident in children from birth. At first, children are reluctant to respond to any touch from those closest to them. Even hugs or kisses from parents do not evoke positive emotions in children with autism. From the outside, such children seem overly calm and even “cold.”

Babies practically do not respond to smiles and do not notice the “grimas” that their parents or close relatives make to them. They often fix their gaze on some object that is of great interest to them.

Newborn babies with autism syndrome They can stare at a toy for hours or stare at one point.

Children practically do not experience any expressed joy from new gifts. Children of the first year of life can be absolutely neutral towards any new toys. Most often, it is difficult to even get a smile from such kids in response to a gift. In the best case, an autistic child will simply twirl the toy in his hands for a few minutes, and then put it aside indefinitely.

Children older than one year are very selective in choosing people close to them. They usually choose no more than two people. This is due to the reluctance to create close contacts, as this leads to severe discomfort for the baby.

They usually choose one of their parents as their “friend.” This could be either dad or mom. In some cases - grandmother or grandfather.

Autistic children have virtually no contact with their peers or children of a different age. Any attempt to disturb their own comfortable world can bring such children significant discomfort.

They try in every possible way to avoid any situation that is traumatic for their psyche. Autistic children have practically no friends. They experience difficulties making new friends throughout their lives.

The first serious problems in such children appear at the age of 2-3 years. Usually at this time children are sent to kindergarten. As a rule, this is where the disease is detected, since it becomes simply impossible not to notice the characteristic manifestations of the disease.

When visiting kindergarten, the behavior of autistic children stands out sharply. They seem more withdrawn than other children, they can stay aloof, and play with the same toy for hours, performing some stereotypical repetitive movements.

Children with autism exhibit more withdrawn behavior. Most kids ask for almost nothing. If they need something, they prefer to take it themselves without outside help.

Children under three years of age may have difficulty potty training.

If you ask a child to give you a toy or some object, most often he will not give it to you, but will simply throw it on the floor. This is a manifestation of impaired perception of any communication.

Autistic children are not always completely passive in a new, unfamiliar group. Often, when trying to introduce a sick child into a new society, he may experience vivid negative outbursts of anger or aggression towards others. This is a manifestation of a violation or invasion of the boundaries of one’s own and such a cozy, and most importantly, safe inner world for children with autism. Expansion of any contacts can lead to severe outbursts of aggression and deterioration of mental well-being.

Disturbed interests or use of special games

Very often, children with autism remain indifferent to any active recreational activities. They seem to be in their own inner world. Entry into this personal space is usually closed to other people. Any attempts to teach a child to play very often lead to the complete failure of this idea.

Children with autism choose 1-2 favorite toys, with whom they spend a huge amount of time. Even with a large selection of different toys, they remain completely indifferent to them.

If you carefully observe the play of a child with autism, you will notice a strict repetition of the sequence of actions that he performs. If a boy plays with boats, then very often he lines up all the ships he has in one line. A child can sort them by size, color, or some characteristics that are special to him. He performs this action every time before the game.

Strict orderliness often manifests itself in everything in children with autism. This is a manifestation of a world that is comfortable for them, in which all objects are in their place and there is no chaos.

All new objects that appear in the life of an autistic child cause him severe mental trauma. Even rearranging furniture or toys can cause a strong attack of aggression in a child or, conversely, put the child into a state of complete apathy. It is better that all items remain in their places at all times. In this case, the baby will feel more comfortable and calm.

Girls with autism also experience changes in the form of play. Notice how the little girl plays with her doll. During such a lesson, every day she will perform all movements and actions according to the established algorithm. For example, she will first comb her hair, then wash the doll, then change her clothes. And never vice versa! Everything is in a strictly established sequence.

Such systematic actions in children with autism are due to the peculiarity of disturbed mental behavior, and not to character. If you try to ask your child why he does the same actions every time, you will not get an answer. The child simply does not notice what actions he performs. For the perception of his own psyche, this is absolutely normal.

Repeating typical actions multiple times

The behavior of a child with autism is not always very different from the communication style of a healthy child. From the outside, such children look absolutely normal, since the appearance of the children practically does not change.

Children with autism often do not lag behind in physical development and are not at all different in appearance from their peers. However, with more careful observation of the child's behavior, it is possible to identify actions that differ slightly from usual behavior.

Often, children with autism may repeat various words or combinations of several letters or syllables. Such disorders can occur in both boys and girls.

This symptom can manifest itself in different ways:

• Repetition of counting or sequential naming of numbers. Autistic children often count repeatedly throughout the day. This activity brings comfort and even positive emotions to the child.
• Repeating words previously spoken by someone. For example, after the question “how old are you?”, a child can repeat “I’m 5 years old, 5 years old, 5 years old” several dozen times. Very often, such kids repeat one phrase or word at least 10-20 times.

In other cases, children with autism may perform the same activity for a long time. For example, they turn lights off and on repeatedly. Some kids often open or close water taps.

Another feature may be constant wringing of fingers or the same type of movements with legs and arms. Such typical actions, repeated many times, bring peace and tranquility to children.

In more rare cases, babies may perform other similar actions, for example, sniffing various objects. Many scientists attribute this to the fact that disturbances occur in those areas of the cerebral cortex that are active in the perception of odors. Smell, touch, vision and taste - these areas of sensory perception in a child with autism are also often damaged, and various manifestations appear.

Speech behavior disorders

Speech disorders occur quite often in children with autism. The severity of manifestations varies. In milder forms of the disease, as a rule, speech disturbances are mild. In more severe cases, there may be a complete delay in speech development and the acquisition of persistent defects.

The disease can manifest itself in different ways. Children with autism often start talking late. As a rule, after the child says the first few words, he may remain silent for a long time. A baby's vocabulary consists of only a few words. He often repeats them many times throughout the day.

Children with autism have difficulty expanding their vocabulary. Even when memorizing words, they try not to use a large number of different combinations in their speech.

A peculiarity of speech behavior in a child over two years old is the mention of objects in the third person. Most often, the child will call himself by name or say, for example, “girl Olya.” The pronoun “I” is almost never heard from a child with autism.

If you ask a baby if he wants to swim, the child may answer “he wants to swim” or call himself by name “Kostya wants to swim.”

Very often, children with autism do not answer direct questions that are addressed to them. They may remain silent or avoid answering, move the conversation to other topics, or simply ignore. This behavior is associated with a painful perception of new contacts and an attempt to invade personal space.

If a child is pestered with questions or asked too many questions in a short time, the child may even react quite violently, showing aggression.

The speech of older children often includes many interesting combinations and phrases. They perfectly remember various fairy tales and proverbs.

A child suffering from autism can easily recite an excerpt from Pushkin’s poem by heart at the age of five or recite a complex poem.

Such children often have a tendency to rhyme. At a younger age, children get great pleasure from repeating various rhymes over and over again.

The combination of words may seem completely meaningless, and in some cases even crazy. However, for children with autism, repeating such rhymes brings joy and positive emotions.

Changes in intelligence and different levels of mental development

It has long been believed that children with autism are mentally retarded. But this is a huge misconception! A large number of autistic children have the highest IQ levels.

With proper communication with a child, you can notice that he has a high level of intelligence. However, he will not show it to everyone.

The peculiarity of the mental development of an autistic person is that it is very difficult for him to concentrate and be purposeful in achieving specific goals.

The memory of such children has the property of selectivity. The child will not remember all events with equal ease, but only those that, according to his personal perception, will be closer to his inner world.

Some children have defects in logical perception. They perform poorly on tasks to construct an associative series.

The baby perceives ordinary abstract events well, can easily repeat a sequence or chain of events even after a long time. Long-term memory impairments are not observed in children with autism.

Children with a higher level of intelligence integrate very poorly at school. Often such a child becomes an “outcast” or a “black sheep.”

The impaired ability to socialize contributes to the fact that autistic children become even more distant from the outside world. As a rule, such kids have a penchant for various sciences. They can become real geniuses if the right approach is applied to the child.

Different variants of the disease may progress differently. In some cases, children experience a decrease in intellectual abilities. They perform unsatisfactorily in school, do not answer teachers' questions, and do not solve difficult geometric tasks that require good spatial and logical abilities.

Very often, such children require special training using special pedagogical programs that are designed specifically for children with autism.

It is important to note that any deterioration in the child’s condition can occur suddenly when exposed to any provoking cause. Often these can be severe stress or attacks from peers.

Children with autism have a very difficult time with such triggering events. This can even lead to severe apathy or, conversely, cause violent aggression.

Watch the following video about teaching children with autism spectrum disorder.

Changing your sense of self

When any contact with other people is disrupted, autistic people often project any negative events onto themselves. This is called self-aggression. This manifestation of the disease in varying degrees of severity occurs quite often. Almost every third child with autism suffers from this unfavorable manifestation of the disease.

Psychotherapists believe that this negative symptom arises as a result of a disrupted perception of the boundaries of one’s own inner world. Any threat to personal safety is perceived excessively by a sick child. Children can cause various injuries to themselves: biting themselves or even cutting themselves on purpose.

Even in childhood, the child’s sense of limited space is disturbed. Such babies often fall out of the playpen after swaying violently. Some children may unfasten from the stroller and fall to the ground.

Usually such a negative and painful experience will force a healthy baby not to do such actions in the future. A child with autism, even despite the resulting pain syndrome, will still repeat this action over and over again.

It is quite rare for a child to show aggression towards others. In 99% of cases, the manifestation of such a reaction is self-defense. As a rule, kids are very sensitive to any attempts to invade their personal world.

Inept actions towards a child with autism or even a simple desire to make contact can cause an attack of aggression in the child, which provokes internal fear.

Psychomotor dysfunction

Quite often, children with autism experience an altered gait. They try to walk on tiptoes. Some children may bounce when walking. This symptom occurs every day.

All attempts to make comments to the baby that he is walking incorrectly and needs to walk differently do not evoke a response from him. The child remains faithful to his gait for quite a long time.

Children with autism do not notice the changes that appear in their everyday life. Older children try to choose routes that are familiar to him. A child with autism will almost always choose the same path to school, without changing his own habits.

Kids often remain true to their taste preferences. Such children should not be taught a certain diet. All the same, a child with autism will have his own idea and even a whole system in his head about what and when it is best for him to eat.

It will be almost impossible to force your baby to eat an unfamiliar product. They remain true to their taste preferences throughout their lives.

Basic characteristics by age

Up to a year

Children with symptoms of autism react poorly to any attempts to address them, especially by name. Children do not babble or utter their first words for a long time.

The child's emotions are quite impoverished. Gesticulation is also significantly reduced. A baby with autism gives the impression of a very calm child who cries little and practically does not ask to be held. Any contacts with parents and even mother do not give the child strong positive emotions.

Newborn babies and infants practically do not express various emotions on their faces. Such children even seem somewhat renounced. Often, when trying to make a child smile, he does not change his face or perceives this attempt rather coldly. Such children love to look at various objects. Their gaze stops on some object for a very long time.

Kids often try to choose one or a couple of toys with which they can spend almost the entire day. They absolutely do not need any outsiders to play. They feel great alone with themselves. Sometimes attempts to intrude on their play can cause an attack of panic or aggression.

Children in their first year of life with autism practically do not call adults for help. If they need something, they try to take the item themselves.

As a rule, there are no intellectual impairments at this age. Most children do not lag behind their peers in terms of physical or mental development.

Up to 3 years

Before the age of 3 years, symptoms of limited personal space begin to manifest themselves to a greater extent.

When playing outside, children categorically refuse to play in the same sandbox with other children. All objects and toys that belong to a child with autism belong only to him.

From the outside, such children seem very closed and “on their own.” Most often, by the age of one and a half years, they can only utter a few words. However, this does not happen to all babies. They often repeat various verbal combinations that do not carry much meaning.

After the child utters the first word, he may suddenly become silent and practically not speak for quite a long time.

Children with autism almost never answer questions asked of them. Only with the people closest to them can they utter a few words or answer in the third person a question addressed to them.

Very often such children try to avert their eyes and do not look at the interlocutor. Even if the child answers the question, he will never use the word “I”. Children with autism identify themselves as “he” or “she.” Many children simply call themselves by name.

Some children are characterized by manifestations of stereotypical actions. They may sway violently in their chair. Parents' comments that doing this is wrong or ugly do not evoke any response from the child. This is not due to the desire to demonstrate one’s character, but simply to a violation of the perception of one’s own behavior. The baby really does not notice and does not see anything wrong in his action.

Some babies may have problems with fine motor skills. When trying to take any small objects from the table or floor, the child does it very clumsily.

Often babies cannot clench their hands well. Such a violation of fine motor skills necessarily requires special classes that are aimed at improving this skill.

If correction is not carried out in a timely manner, the child may develop writing impairments, as well as the appearance of gestures that are unusual for an ordinary baby.

Autistic children love to play with water taps or switches. They also really enjoy opening and closing doors. Any similar movements evoke excellent emotions in the child. He can perform such actions for as long as he likes until his parents intervene. When performing these movements, the baby absolutely does not notice that he is performing them repeatedly.

Autistic children eat only those foods that they like, play independently and practically do not get to know other children. Many people around them mistakenly consider such kids to be too spoiled. This is a huge misconception!

A child with autism, under the age of three, sees absolutely no differences in his behavior relative to the behavior of others. He simply tries to limit the boundaries of his inner world from any outside interference.

It used to be that children with autism had certain facial features. Often such features were called aristocratic forms. Autistic people were believed to have thinner and longer noses. However, this is not at all true.

To date, the connection between facial structural features and the presence of autism in a child has not been reliably established. Such judgments are just speculation and lack scientific evidence.

From 3 to 6 years

The incidence of autism peaks at this age. Children begin to be sent to kindergarten, where disturbances in social adaptation become noticeable.

Children with autism perceive morning trips to preschool educational institutions without expressed delight. They would rather stay at home than leave their familiar safe home.

A child with autism practically does not meet new friends. At best, he makes one new acquaintance who becomes his best friend.

A sick child will never accept a large number of people into his inner world. Very often, such children try to close themselves off even more, to escape from the traumatic situation.

The child tries to come up with some kind of magical story or fairy tale that explains why he should go to this kindergarten. Then he becomes the main character of this action. However, visiting kindergarten does not give the child any pleasure. He doesn't get along well with his peers and practically doesn't listen to his teachers.

All things in the baby’s personal locker are usually folded strictly in order. This becomes clearly visible from the outside. Such children cannot stand any chaos or scattered things. Any violation of the ordering of the structure can cause them to have an attack of apathy, and in some cases, aggressive behavior.

Trying to force a child to meet new kids in a group can cause him extreme stress.

Children with autism should not be scolded for doing the same type of behavior over a long period of time. You just need to find the “key” to such a child.

Often, kindergarten teachers simply cannot cope with a “special” child. Many features of disrupted behavior are perceived by teaching staff as excessive spoilage and character traits. In these cases, the mandatory work of a medical psychologist is required, who will work daily with the child in a preschool institution.

Over 6 years old

Children with autism in Russia attend regular schools. In our country there are no specialized educational programs for such children. Typically, children with autism do well in school. They have a penchant for various disciplines. Many guys even show the highest level of mastery of the subject.

Such children often focus on one subject. In other disciplines that do not resonate in the child’s inner world, they may have very mediocre performance.

Children with autism have difficulty concentrating and are also characterized by insufficient concentration on several objects at the same time.

Often in such children, if the disease was detected at an early stage and there were no severe defects in fine motor skills, brilliant abilities for music or creativity are discovered.

Kids can play various musical instruments for hours. Some children even compose various works on their own.

Children, as a rule, try to lead a rather secluded lifestyle. They have few friends. They practically do not attend various entertainment events, which can be attended by a huge number of people. Being at home is more comfortable for them.

Very often, children have a commitment to certain foods. In most cases, it occurs in early childhood. Children with autism eat at specific times according to their own schedule. All meals are accompanied by the performance of a specific ritual.

They often eat only from plates that are familiar to them and try to avoid dishes of new colors. All cutlery is usually laid out by the child on the table in a strictly defined sequence.

Children with autism can graduate from school very successfully, showing excellent knowledge in one discipline.

In only 30% of cases, children suffering from this disease fall behind the school curriculum and have poor academic performance. As a rule, in such children the diagnosis of autism was made quite late or a good rehabilitation program was not carried out to reduce the unfavorable symptoms of the disease and improve social adaptation.

Problems

Very often, children with autism experience not only behavioral disorders, but also various pathological manifestations of internal organs.

Gastrointestinal disorders

They manifest themselves in the form of possible diarrhea or constipation, which are practically independent of the food that the child receives. Children with autism have special taste preferences. To normalize adverse manifestations and stool disorders, a gluten-free diet is effectively used. Such a diet, which contains a limited amount of gluten, promotes the smooth functioning of the gastrointestinal tract and reduces the negative symptoms of indigestion.

You can learn more about the diet for autism by watching the following video.

Sleep disorders

Babies are almost equally active during the day and at night. It is very difficult to put such children to sleep. Even if they fall asleep, they may only sleep for a few hours. Very often babies wake up very early in the morning. During the daytime, they may refuse to sleep. In some cases, when exposed to strong psychologically traumatic situations, insomnia may worsen or nightmares may appear, which further contribute to the disruption of the child’s general well-being.

When is a consultation with a psychiatrist necessary?

You should seek the help of a doctor immediately if parents suspect the first signs of illness in their baby. Only a psychiatrist can accurately establish a diagnosis and recommend the necessary therapeutic treatment.

As a rule, all children diagnosed with autism should be seen periodically by a doctor. Don't be afraid of this doctor! This does not mean that the child has severe mental disorders. Such observation is important primarily for preventing the development of unwanted long-term symptoms of the disease.

In our country, children diagnosed with autism practically do not undergo any specialized rehabilitation programs. European specialists and doctors from the United States use a whole range of different psychotherapeutic techniques that can greatly improve the quality of life of a child suffering from autism.

Medical psychologists, professional physical therapy instructors, defectologists and speech therapists work with children from a very early age. Throughout his life, such a patient must be observed by a psychiatrist.

At what age is the disease most often diagnosed?

According to statistics, The largest number of cases of newly registered disease occurs at the age of 3-4 years. It is at this time that the symptoms of the child’s social maladjustment begin to clearly manifest themselves.

There is scientific evidence that suggests that with the development of better diagnostic criteria, it will be much easier to identify cases of autism in children at an earlier age.

Determining the first manifestations of the disease in newborns is a very difficult task even for an experienced pediatrician. To conduct a full examination and establish a diagnosis, it is necessary to organize a full-fledged medical examination, which usually involves at least 5-6 different specialists with skills and knowledge in the treatment of autism in children.

Diagnostics

Diagnosing the disease is quite difficult. In Russia, the diagnosis of “autism” will most often be given upon detection of the following psychological disorders:

• social maladjustment of the child in the environment;
• pronounced difficulties in establishing new communications and contacts with other people;
• repeated repetition of typical actions or words over a long period of time.

If the course of the disease occurs in a typical or classic form, then the above symptoms occur in 100% of cases. Such children require mandatory consultation with a psychiatrist, and, if necessary, an extensive consultation with the involvement of specialists in related specialties who work with autistic children.

During a more detailed examination, doctors try to determine the presence or absence of not only the main signs, but also additional ones. To do this, they use several classifications of diseases.

For autism use:

• ICD-X is the main working document for Russian specialists.
• The DSM-5 rubricator or Diagnostic Statistical Manual of Mental Disorders is used by psychiatrists around the world, including in Europe and the United States.

According to these medical reference books, a child with autism must exhibit at least six of the symptoms listed. To determine them, doctors resort to various questionnaires, using which they assess the baby’s condition in a playful way. Such research is carried out in the most gentle way possible, so as not to traumatize the disturbed child’s psyche.

An interview with parents is also required. This study allows us to clarify the presence and nature of violations in the child’s behavior that cause them concern.

Parents are interviewed by several psychiatrists, as well as a medical psychologist. Such diagnostic methods are mainly used only in Europe and the USA. In Russia, unfortunately, the diagnosis of autism is in an extremely deplorable state.

Children with this disease remain unexamined for a long time.

Over time, their negative manifestations of social maladaptation intensify; apathy and inability to establish contacts with people around them may increase. In our country, working diagnostic criteria have not yet been developed that would easily establish such a diagnosis. In this regard, there are quite a few cases of establishing a correct and timely diagnosis.

Is testing at home possible?

It is almost impossible to conduct a full inspection of the house. During such testing, you can only get an approximate answer. The diagnosis of autism can only be made by a psychiatrist. To do this, he uses several different tests that are used to diagnose the disease, as well as various other techniques to clarify the extent and level of damage.

When testing at home, parents can often get a false result. Very often, the information system automatically analyzes the answers without applying differentiated treatment to a specific child.

To make a diagnosis, a multi-stage medical examination is required to determine whether the child has autism.

How to treat?

Currently, no specific treatment for autism has been developed. Unfortunately, there is no special pill or magic vaccine that would reliably protect the baby from the possible development of the disease. A single cause of the disease has not been established.

Lack of understanding about the original source of the disease does not allow scientists to create a unique medicine that would completely cure children with autism.

Treatment of this mental illness is carried out comprehensively, taking into account the symptoms that arise. Such psychotropic drugs are prescribed only by a psychiatrist. They are written out on special prescription forms and issued according to strict records in pharmacies. Such medications are prescribed in courses or for the entire period of deterioration.

All treatment methods can be divided into several groups:

• Drug treatment. In this case, various medications are prescribed to eliminate the adverse symptoms that occur in various stages of the disease. Such drugs are prescribed by a doctor only after examining the baby and possibly conducting additional examinations.
• Psychological consultations. A child medical psychologist must work with a child suffering from autism. Using various psychological techniques, the specialist will help the child cope with emerging outbursts of anger and auto-aggression, as well as improve the internal feeling when integrating into a new team.
• General restorative health procedures. Playing sports is not at all contraindicated for children with autism. However, they must study in special groups with professional instructors or trainers who are trained in the elements of working with “special” children. Such children can show excellent results and achieve good sporting achievements. Success is only possible by applying the right pedagogical approach.
• Speech therapy classes. A speech therapist must conduct classes with a child under 3 years of age. At such lessons, children learn to speak correctly and refuse to use repeated repetitions of words. Speech therapy classes allow you to improve your child’s vocabulary and add even more words to his vocabulary. Such educational games help children adapt better to new groups and improve their social adaptation.

Drug treatment

Prescription of various medications on an ongoing basis is not required for children with autism. Such drugs are used only to eliminate the negative manifestations of the disease. In this case, untimely treatment can lead to the development of various adverse consequences and even worsen the baby’s condition.

The following medications are most often prescribed to children with autism.

Psychotropic drugs and neuroleptics

Used to treat attacks of aggressive behavior. They can be prescribed as a course of treatment or once to eliminate a violent outbreak of auto-aggression. Psychiatrists choose various medications that can eliminate the negative symptoms of the disease. For example, the antipsychotic drugs Rispolept and Seroquel can cope with acute attacks of severe aggression and calm the baby.

It is important to note that the prescription of antipsychotic drugs on an ongoing basis is carried out only in severe cases of the disease. In this case, the severity of symptoms is excessively high.

Long-term use of any antipsychotic drugs can cause addiction and various side effects. In order to prevent this, doctors resort to prescribing a course of treatment.

To eliminate panic attacks or improve mood, the doctor may prescribe special medications that affect the level of endorphins. These drugs also have a number of contraindications. They are used only in cases where various psychological methods for correcting behavior were carried out, but they were not successful and did not lead to an improvement in the child’s well-being.

Probiotics for the treatment of dysbiosis

In children with autism, in 90% of cases, doctors register persistent irritable bowel syndrome or dysbiosis. In this case, the microflora in the gastrointestinal tract is disrupted. It contains practically no beneficial lactobacilli and bifidobacteria, but microorganisms of pathogenic flora reproduce well. Very often, such children also exhibit increased yeast growth.

To eliminate these unfavorable symptoms, doctors resort to prescribing various medications enriched with lacto- and bifidobacteria. Children are prescribed: “Bifidobacterin”, “Acipol”, “Linex”, “Enterol” and many others. The prescription of these funds is carried out after additional research - stool culture and a test for dysbacteriosis. The drugs are prescribed as a course of treatment. It is usually designed for 1-3 months of daily use.

In addition to medications, the diet of a child with dysbacteriosis must include fresh fermented milk products with a high content of microorganisms beneficial to the intestines.

You can also make them at home. In this case, the beneficial properties of the product are not lost, and you can safely give it to your baby.

The effect of using fermented milk products usually occurs by the end of the first week.

Vitamin therapy

Children with autism have a pronounced and almost constant deficiency of a number of vitamins: B1, B6, B12, PP. To eliminate this condition, the prescription of a complex of biologically active substances is required. Such vitamin and mineral preparations can eliminate the deficiency of any vitamins, as well as normalize the microelement composition within the body.

Since children with autism are very committed to some type of food, their diet is often very monotonous. This leads to insufficient supply of vitamins and microelements from the outside.

In order to improve this condition, daily addition of various vegetables and fruits to the diet is required, especially in the summer. These products contain a high content of various vitamins and microelements, which are vital for the baby.

Sedatives

Used to eliminate anxiety. Very often, when exposed to a strong traumatic situation, a sick child may experience a severe state of panic. In this case, psychiatrists prescribe psychotropic drugs that can effectively eliminate this manifestation. A course of such medications is not required. Only a single dose is enough.

Children with autism often have trouble sleeping. They have difficulty falling asleep. The duration of sleep can be no more than 6-7 hours a day.

For a small child this is not enough. To improve night sleep, as well as normalize the circadian rhythm, doctors recommend using mild medications that calm the nervous system and promote rapid sleep.

It is safe for children to use various herbs that have a sedative effect. Such natural medicines practically do not cause side effects and do not have numerous contraindications. To normalize sleep, decoctions of lemon balm or mint are used. You can give these herbs to your baby in the form of tea. It is better to drink such a sedative medicine no later than 2-3 hours before bedtime.

The prescription of sedative medications is allowed only for severe sleep disturbances. Typically, such drugs are prescribed for quite a long time. It is not advisable to use these drugs in milder forms of the disease, since they can have a pronounced tranquilizing effect or be addictive. The prescription of medications is made by a psychotherapist after a preliminary examination.

Help from a psychologist

The use of various psychological techniques is an important element of therapy for children suffering from autism. American experts who conduct classes with sick children every day recommend conducting such classes at least 2-3 times a week.

It is better for the psychologist to also have a medical education. In this case, it can quickly help him or her when the condition worsens and send the child for consultation with a psychiatrist.

The psychologist does not prescribe medications. He treats only with words. Usually, for children with autism, the first meeting with a specialist is very important. It is at this time that you can understand whether such classes will be successful and whether the child will find a common language with the psychologist.

In order to penetrate into the inner world of a child suffering from autism, the psychologist must very delicately make friends with him. Only in this case will the baby make contact.

Often, treatment may not bring a pronounced positive effect in the absence of primary contact between the autistic child and the psychologist.

All classes are conducted in a specially equipped room. Often, to work with children with autism, all lessons are held in only one room. This helps create a calmer and more comfortable atmosphere for the child.

Psychologists try not to move or rearrange toys without reason, as this can bring severe mental discomfort to the baby.

Usually, game forms of conducting classes are chosen. During such games, children are as “open” as possible and can demonstrate real emotions. Each lesson usually lasts no more than an hour.

With longer communication, the baby may become very tired and reluctant to make contact with a specialist.

Working with children who suffer from autism usually continues throughout the child's life. At the same time, only the types and forms of psychological techniques change.

Very often, psychologists become real family members or very close friends. In America, several cases of families turning to psychologists have been recorded. In this case, not only the child, but also one of the parents suffered from autism.

It is important to note that family activities also have a good therapeutic effect.

Classes with a psychologist for children under 3-5 years old are often carried out together with one of the parents. Usually the parent with whom the baby has a closer relationship is chosen. The psychologist, in a playful way, creates various everyday situations that can occur in everyday life. During such a game, he teaches the baby how to react correctly to new people. Children learn to communicate better with other kids, and also acquire new useful skills that can be useful to them every day.

Classes

To improve the integration into society of a child suffering from autism, additional activities are required to help him with this. Typically, such a complex of various activities is compiled together with a child psychologist or on the recommendation of a psychiatrist.

Usually, before choosing any hobby that will be interesting to the child, a good analysis of his abilities and a qualitative assessment of the level of health and physical development are required. Not all children with autism will perform the same tasks with the same interest. The correct choice of activities greatly improves the prognosis of treatment and has a beneficial effect on the mental and psychological development of the baby.

Typically, children with autism are recommended various correctional activities that can improve the child’s social integration in society. Sports are recommended for children. However, not all sports training can be selected. For autistic children, calm sports are more suitable: learning to swim, playing chess or checkers, golf. It is worth choosing those sports that require concentration on one subject.

Sports that require high speed or a high risk of injury are best left aside. Children with autism should not engage in running, jumping, boxing and various types of strength wrestling.

Team games are also not suitable. It is better to give preference to calmer sports that will help improve the baby’s health and have a positive effect on his nervous system.

Children with autism are very warm towards various animals. In such children, doctors often even note a certain “cult” of animals. An autistic child may have a whole collection of cats or dogs. Direct contact and touching of pets can evoke strong positive emotions in the baby and even improve the prognosis of treatment.

Children with autism benefit from spending time interacting with a variety of animals. Doctors recommend hippotherapy or dolphin therapy sessions. Such contacts with animals will bring great joy to the baby and will have a positive impact on his development.

When a baby touches any living creature, special endorphin molecules begin to be produced in the cerebral cortex, which evoke a sea of ​​positive emotions in him.

If possible, such exercises with animals should be carried out as often as possible. It is better that the child has the opportunity to constantly observe living beings and communicate with them. While communicating with a dog or cat, the baby learns to contact the environment. This has a positive effect on his ability to make new contacts and improves social adaptation in society.

What toys should I buy?

Parents often rack their brains over what gift to give to their baby, who has been diagnosed with autism by doctors. It seems that every new toy brings virtually no joy to the child. However, this is not quite true. Every child with autism has their own personal preference for a particular type of toy.

Often boys choose different planes or ships, and girls choose different animals or dolls. It is important to note that autistic children can be delighted with donated animals. The main thing is to determine which specific animal your child likes. Usually this does not pose any difficulty: an autistic child will never let go of the animal toy he likes.

If a plush dog once presented is the child’s favorite, then any other dogs will also cause great delight.

Children diagnosed with autism are not at all prone to hoarding. They only need 2-3 different toys to feel comfortable and happy. A huge number of different gifts can even scare them!

Children under three years old should choose toys that improve fine motor skills of their fingers. Typically, children with autism are quite poor at performing any tasks related to drawing or modeling.

You can try to interest your baby in putting together various puzzles consisting of large and bright parts. Construction sets are perfect, from the elements of which you can build numerous combinations of figures.

For children aged 1.5-2 years, rugs that consist of several large parts are perfect. The upper surface of such products has small elevations or irregularities. This is necessary so that your legs are massaged while walking. This effect has a beneficial effect on the entire musculoskeletal system of the child. You should choose a rug in more neutral colors, avoiding overly bright colors.

For older children and those especially prone to aggression, you can choose a spinner. This fashionable toy normalizes the functioning of the nervous system and even helps fight the effects of stress. Kids often like to spin the spinner, as any repeated action brings them calm and even positive emotions.

In adolescence, it is better not to buy computer games for your child. Most of these toys can cause a spontaneous attack of aggression in a child or, on the contrary, increase an apathetic state.

Very often, children with autism love to play computer games, since it does not require any real contact with the outside world. However, the consequences can be very negative.

Can autistic people have healthy children in the future?

Scientists note a pronounced genetic pattern in the possibility of inheriting the disease. There are also theories about the presence of special genes that are responsible for the development of the disease in children in whose families cases of autism have previously been established.

Autistic people can have healthy children. Inheritance of genes occurs at the stage of intrauterine development. If a baby was born into a family where only one of the parents has autism, then he may well turn out to be healthy.

If both parents have autism, the chance of having an affected child is 25%, and the chance of having a child who is a carrier of this gene is 50%. This disease is inherited in an autosomal recessive manner.

If more than one baby is born in such families, then the risk of having sick babies may increase. It also increases when exposed to various provoking factors on the unborn child during intrauterine development in the body of a pregnant mother.

To determine hidden autism in newborns, the “heel” method is used. It suggests the presence of this mental illness in the baby. It is usually carried out in autistic parents or in cases where there is a suspicion that the child may develop the disease.

Is the child given a disability?

In Russia, the diagnosis of autism requires the establishment of a disability group. However, it is not shown to all children. In our country, special medical and social criteria are used that take into account various factors.

The decision to establish a group is made strictly collectively. This involves specialists from several specialties: psychiatrist, psychologist, rehabilitation specialist.

In order for a child to have a disability group established, all necessary medical documentation must be provided to the medical and social examination authorities. The child’s child’s record must contain the conclusions of the psychiatrist and child psychologist who observed him. In this case, expert doctors can have a more informative picture about the duration of the disease.

Before undergoing a medical and social examination, the baby is often prescribed additional tests and examinations. This can be either various laboratory tests or specialized brain studies that make it possible to clarify the nature and extent of disorders. Usually in our country an EEG or electroencephalography of the brain is prescribed.

Using this method, it is possible to establish various disorders of the conduction of nerve impulses in the cerebral cortex. The method is quite informative and is quite often used in child psychiatric and neurological practice.

The test results allow doctors to determine the nature and extent of impairments resulting from the disease.

Not all forms of autism can be assigned a disability group. As a rule, it is determined in the presence of persistent disorders of nervous activity, which lead to pronounced maladaptation of the baby.

The level of mental development and intelligence also significantly influence the prognosis of the course of the disease and the establishment of a group.

Often, disability is established after three years. Cases of establishing a group at an earlier age in Russia practically do not occur and are episodic in nature.

Autism is a disease that in most cases occurs without persistent periods of remission. This leads to the fact that the disability group is usually set for life.

Children with mental disabilities must undergo a whole range of rehabilitation measures. Speech therapists, psychologists, and rehabilitation doctors work with such children. The rehabilitation course is usually designed for a fairly long period, since the treatment of the disease is carried out throughout the life of a person suffering from autism.

Parents who are faced with establishing a disability group for their child often note some difficulties when conducting a medical and social examination. They most often note: a huge amount of pre-prepared medical documentation and long queues for examination. The disability group was not always determined upon initial treatment. Often, only on the second or third attempt did expert doctors make a positive decision about the presence of disabling signs in the child.

Establishing a group is a highly complex and often controversial task. However, for children with autism, this step is often forced, but truly necessary. To conduct full-fledged classes with a child, quite large financial costs are required: training with a psychologist, consultations with a speech therapist, hippotherapy courses, the use of special psychotropic medications. All this without a disability group becomes very difficult and financially burdensome for many families.

For parents raising autistic children, the main thing is to understand that this disease will remain with the child for life. Unfortunately, there is currently no cure for autism.

With the right approach, autistic children develop well and, from the outside, do not even differ at all from their peers. Only a few strangers may notice that the baby is a little different from the others. However, they often believe that such a child is simply overly spoiled or has a bad character.

In order to improve your baby’s quality of life and help him with social adaptation, use the following tips:

• Try to communicate correctly with your child. Autistic children categorically do not accept raised voices or swearing. It is better to communicate with such children in the same calm tone, without using curse words. If your child does something wrong, try not to react too violently and aggressively, but simply explain to your child how to do this action correctly. You can also show this as a kind of game.
• Both parents should be involved in raising a child. Even though, as a rule, the baby chooses to communicate with dad or mom, they both must participate in his life. In this case, the child feels more comfortable and gets a correct idea of ​​the family organization. In the future, when creating his own life, he will largely be guided by the principles laid down in childhood.
• Potty training children with autism can be quite difficult. Child psychologists usually help with this. In a playful way, they create a similar everyday situation and work through the correct sequence of actions with the baby. For independent training at home, remember that you should potty train your child gradually and consistently. Never raise your voice or punish your child if he has done something wrong. In the case of an autistic child, this measure will not lead to a positive result.
• You can teach a child with autism to read only with daily lessons. Try to choose educational books without overly bright pictures. A huge number of different colors can alarm and even frighten a child. Choose publications without colorful pictures. Training is best done in a playful way. So the baby will perceive this process as a normal game.
• During a severe hysteria, the baby needs to be carefully calmed. It would be better to do this by the family member with whom the child has closer contact. If your child is overly aggressive, try to quickly take him to the nursery. A familiar environment will help your baby calm down more easily. Never raise your voice at a child, trying to shout to him! This won't lead to anything good. Explain to your baby that he has nothing to be afraid of and that you are nearby. Try to switch your attention to another event or object.
• Try to establish contact with your autistic child. The child communicates calmly only with the people closest to him. To do this, never ask your baby a million questions. Frequent hugs will also not lead to establishing contact. Try to spend more time with your baby, just watching his games. After some time, the child will perceive you as part of his game and will make contact more easily.
• Teach your child to the correct daily routine. Typically, autistic children respond well to a clearly organized routine. This gives them a feeling of complete comfort and security. Try to have your child fall asleep and wake up at the same time. Be sure to follow the feeding schedule. Even on weekends, maintain your baby's usual daily routine.
• Be sure to undergo regular examination and observation by a child psychotherapist and psychologist. Such consultations are very important for assessing the prognosis of the disease and establishing the dynamics of the child’s condition. Typically, young patients with autism should see a therapist at least twice a year. If your health worsens, more often.
• Provide proper nutrition for your baby. Considering the characteristics of the disturbed microflora, all children with autism need to eat fermented milk products. They must be as fresh as possible. It is in this case that the concentration of beneficial lactobacilli and bifidobacteria will be sufficient. Only such products will be beneficial for the child and improve his digestion.
• From the very first days of your child’s birth, try to show him care and affection more often. Autistic children react very poorly to various physical manifestations of love and tenderness. However, this does not mean at all that this should not be done. Doctors advise hugging and kissing your child more often. This must be done without causing him mental pressure. If the baby is not in the mood, it is better to postpone hugs for a while.
• Give your baby a new friend. Most autistic children love pets. Communication with furry animals not only brings positive emotions to the baby and has a beneficial effect on the course of his illness, but also has a real therapeutic effect on tactile sensitivity. A cat or dog will become real friends for your baby and will help him more easily establish contacts not only with animals, but also with new people.
• Don't scold your child! A child suffering from autism perceives any raising of his voice very painfully. The reaction can be the most unpredictable. Some kids fall into severe apathy and become more indifferent to everything that happens in everyday life. Other children may experience excessive aggression that may even require medication.
• Try to choose an interesting hobby for your child. Very often, children with autism are excellent at drawing or playing musical instruments. Studying in a specialized art school will help your child achieve high professional success. Often such children become real geniuses. Be sure to monitor the load that falls on the baby. Excessive enthusiasm can lead to severe fatigue and impaired attention.
• Do not move furniture in the children's room or throughout the apartment. Try to keep all toys and objects that belong to the child in their place. Strong changes can cause real panic attacks and excessive aggression in a child suffering from autism. Purchase new items carefully, without attracting much attention to it.
• Don't limit your child to just being at home! Children with autism should not be confined to four walls all the time. This will only exacerbate your inability to make new friends and connections. Gradually expand the conditions where the baby spends a lot of time. Try to motivate him to go for a walk, visit close relatives. However, this should be done gradually, without psychological pressure. The baby should be very comfortable in new conditions.

Autism is not a death sentence. This is just a disease that requires increased and special attention to a child who is sick with this mental illness.

The right approach to organizing life and establishing personal contact helps such children feel more protected and improves the prognosis of the course and development of the disease.

Moms and dads should remember that a child diagnosed with autism requires your attention and care every day throughout his life. Such children are often called “special” because you need to build a unique approach with them.

Children with autism, with good rehabilitation, integrate quite well into society and are quite successful in later life.

Useful videos

Yana Summ (ex-wife of Konstantin Meladze) in the next video from my own experience talks about what you should pay attention to in order to suspect a child has autism.

You will learn a lot of nuances about autism by watching the programs of Dr. Komarovsky and “Live Healthy.”

When preparing the article, materials from the website “autism-test.rf” were used.

Specialty: Practicing psychiatrist of the 2nd category.

AUTISM is a mental disorder characterized by a deficit in social interaction. Autistic children exhibit lifelong developmental disabilities that affect their perception and understanding of the world around them.

At what age does autism appear?

Childhood autism today occurs in 2–4 cases per 100,000 children. In combination with mental retardation ( atypical autism) the figure increases to 20 cases per 100,000. The ratio of boys to girls with this pathology is 4 to 1.

Autism can occur at any age. Depending on age, the clinical picture of the disease also changes. Conventionally, early childhood autism is distinguished ( up to 3 years), childhood autism ( from 3 years to 10 – 11 years) and adolescent autism ( in children over 11 years old).

Controversy over the standard classifications of autism continues to this day. According to the international statistical classification of diseases, including mental ones, there are childhood autism, atypical autism, Rett syndrome and Asperger syndrome. According to the latest version of the American classification of mental illnesses, only autism spectrum disorders are distinguished. These disorders include both early childhood and atypical autism.

As a rule, the diagnosis of childhood autism is made at the age of 2.5 – 3 years. It is during this period that speech disorders, limited social communication and isolation are most clearly manifested. However, the first signs of autistic behavior appear in the first year of life. If the child is the first in the family, then parents, as a rule, later notice his “difference” from his peers. Most often this becomes obvious when the child goes to kindergarten, that is, when trying to integrate into society. However, if there is already a child in the family, then, as a rule, the mother notices the first symptoms of an autistic child in the first months of life. Compared to an older brother or sister, the child behaves differently, which immediately catches the eye of his parents.

Autism may also appear later. The debut of autism can be observed after 5 years. The IQ in this case is higher than that of children whose autism debuted before the age of 3 years. In these cases, basic communication skills are preserved, but isolation from the world still dominates. These children have cognitive impairment ( deterioration of memory, mental activity, etc.) are not so pronounced. Very often they have a high IQ.

Elements of autism may be present in Rett syndrome. It is diagnosed between the ages of one and two years. Cognitive-sparing autism, called Asperger's syndrome ( or mild autism), occurs between 4 and 11 years.

It is worth noting that there is a certain period between the first manifestations of autism and the moment of diagnosis. There are certain characteristic features of the child that parents do not attach importance to. However, if you focus the mother’s attention on this, then she really recognizes “something like that” with her child.

Thus, the parents of a child who was always obedient and did not create problems recall that in childhood the child practically did not cry, could spend hours looking at a spot on the wall, and so on. That is, certain character traits exist in a child initially. It cannot be said that the disease appears like a bolt from the blue. However, with age, when the need for socialization increases ( kindergarten, school) these symptoms are accompanied by others. It is during this period that parents seek advice from a specialist for the first time.

What is special about the behavior of a child with autism?

Despite the fact that the symptoms of this disease are very diverse and depend on age, there are nevertheless certain behavioral traits that are common to all autistic children.

Characteristics of the behavior of a child with autism are:

• disruption of social contacts and interactions;
• limited interests and characteristics of the game;
• tendency to engage in repetitive behavior stereotypies);
• verbal communication disorders;
• intellectual disorders;
• impaired sense of self-preservation;
• features of gait and movements.

Violation of social contacts and interactions

It is the main characteristic of the behavior of children with autism and occurs in 100 percent. Autistic children live in their own world, and the predominance of this inner life is accompanied by a withdrawal from the outside world. They are uncommunicative and actively avoid their peers.

The first thing that may seem strange to a mother is that the child practically does not ask to be held. Infants ( children under one year old) are characterized by inertia and inactivity. They do not react as animatedly as other children to a new toy. They have a weak reaction to light and sound, and they may also rarely smile. The animation complex, which is inherent in all young children, is absent or poorly developed in autistic people. Babies do not respond to their name, do not respond to sounds and other stimuli, which often imitates deafness. As a rule, at this age parents first turn to an audiologist ( hearing specialist).

The child reacts differently to an attempt to make contact. Attacks of aggression may occur and fears may develop. One of the most well-known symptoms of autism is lack of eye contact. However, it does not manifest itself in all children, but occurs in more severe forms, so the child ignores this aspect of social life. Sometimes a child can look as if through a person.
It is generally accepted that all autistic children are unable to show emotions. However, it is not. Indeed, many of them have a very poor emotional sphere - they rarely smile, and their facial expressions are the same. But there are also children with very rich, varied, and sometimes not entirely adequate facial expressions.

As the child grows, he can go deeper into his own world. The first thing that attracts attention is the inability to contact family members. The child rarely asks for help and begins to look after himself early. An autistic child practically does not use the words “give” and “take.” He does not make physical contact - when asked to give up this or that object, he does not give it in his hands, but throws it away. Thus, he limits his interaction with people around him. Most children also cannot tolerate hugs or other physical contact.

Problems most clearly make themselves felt when the child is taken to kindergarten. Here, when trying to introduce the baby to other children ( for example, seat them at the same common table or involve them in the same game) it can give various affective reactions. Ignoring the environment can be passive or active. In the first case, children simply do not show interest in the children around them or in their games. In the second case, they run away, hide, or act aggressively towards other children.

Limited interests and game features

One fifth of autistic children ignore toys and all types of play activities. If a child shows interest, it is, as a rule, in one toy or one television program. The child does not play at all or plays monotonously.

Infants can fix their gaze on a toy for a long time, but do not reach for it. Older children can spend hours watching the sun on the wall, the movement of cars outside the window, or watching the same film dozens of times. At the same time, children’s absorption in this activity can be alarming. They do not lose interest in their occupation, sometimes giving the impression of detachment. When trying to tear them away from classes, they express dissatisfaction.

Games that require fantasy and imagination rarely attract such children. If a girl has a doll, she will not change her clothes, seat her at the table and introduce her to others. Her play will be limited to monotonous actions, for example, combing this doll's hair. She can perform this action dozens of times a day. Even if a child does several actions with his toy, it is always in the same sequence. For example, an autistic girl can brush, bathe and change her doll, but always in the same order, and not in any other way. However, as a rule, children do not play with their toys, but rather sort them. A child can arrange and sort his toys according to various criteria - color, shape, size.

Autistic children also differ from normal children in the specifics of play. So, they are not occupied by ordinary toys. The attention of an autistic person is more attracted to household items, for example, keys, a piece of material. Typically, these objects make their favorite sound or have their favorite color. Typically, such children are attached to the selected object and do not change it. Any attempt to separate a child from his “toy” ( because sometimes they can be dangerous, for example, when it comes to a fork) is accompanied by protest reactions. They can be expressed in pronounced psychomotor agitation or, conversely, withdrawal.

A child’s interest may come down to folding and arranging toys in a certain sequence, or counting cars in a parking lot. Sometimes autistic children may even have different hobbies. For example, collecting stamps, robots, a passion for statistics. What makes all of these interests different is the lack of social content. Children are not interested in the people depicted on the stamps or the countries from which they are sent. They are not interested in the game, but they may be attracted to various statistics.

Children do not let anyone into their hobbies, even those who are autistic like them. Sometimes children's attention is attracted not even by games, but by certain actions. For example, they can turn the faucet on and off at regular intervals to watch the water flow, or turn on the gas to watch the flames.

Much less often in the games of autistic children, pathological fantasizing with transformation into animals and inanimate objects is observed.

Tendency to engage in repetitive actions ( stereotypies)

Repetitive behavior or stereotypy occurs in 80 percent of children with autism. In this case, stereotypies are observed both in behavior and in speech. Most often, these are motor stereotypies, which boil down to monotonous turns of the head, twitching of the shoulders, and bending of the fingers. In Rett syndrome, stereotypical finger wringing and hand washing are observed.

Common stereotypic behaviors in autism:

• turning lights on and off;
• pouring sand, mosaics, cereals;
• door swinging;
• stereotypical account;
• kneading or tearing paper;
• tension and relaxation of the limbs.

Stereotypes observed in speech are called echolalia. This can be manipulations with sounds, words, phrases. In this case, children repeat words heard from their parents, on TV or from other sources without realizing their meaning. For example, when asked “will you have juice?”, the child repeats “will you have juice, will you have juice, will you have juice.”

Or the child may ask the same question, for example:
Child- "Where we are going?"
Mother- “To the store.”
Child- "Where we are going?"
Mother- “To the store for milk.”
Child- "Where we are going?"

These repetitions are unconscious and sometimes stop only after interrupting the child with a similar phrase. For example, to the question “Where are we going?”, Mom answers “Where are we going?” and then the child stops.

Stereotypes in food, clothing, and walking routes are often observed. They take on the character of rituals. For example, a child always follows the same path, prefers the same food and clothes. Autistic children constantly tap out the same rhythm, spin a wheel in their hands, sway in a chair to a certain beat, and quickly turn the pages of books.

Stereotypes also affect other senses. For example, taste stereotypies are characterized by periodic licking of objects; olfactory - constant sniffing of objects.

There are many theories about the possible reasons for this behavior. Proponents of one of them consider stereotypies as a type of self-stimulating behavior. According to this theory, the body of an autistic child is hyposensitive and therefore it exhibits self-stimulation in order to excite the nervous system.
Proponents of another, opposite concept, believe that the environment is hyperexcitable for the child. In order to calm the body and eliminate the influence of the surrounding world, the child uses stereotypical behavior.

Verbal communication disorders

Speech impairment, to one degree or another, occurs in all forms of autism. Speech may develop delayed or not develop at all.

Speech disorders are most pronounced in early childhood autism. In this case, even the phenomenon of mutism may be observed ( complete lack of speech). Many parents note that after the child begins to speak normally, he becomes silent for a certain time ( a year or more). Sometimes, even at the initial stages, a child is ahead of his peers in his speech development. Then, from 15 to 18 months, regression is observed - the child stops talking to others, but at the same time fully speaks to himself or in his sleep. In Asperger's syndrome, speech and cognitive functions are partially preserved.

In early childhood, there may be no humming or babbling, which, of course, will immediately alert the mother. There is also a rare use of gestures in children. As the child develops, expressive language impairments are common. Children use pronouns and addresses incorrectly. Most often they refer to themselves in the second or third person. For example, instead of “I want to eat,” the child says “he wants to eat” or “do you want to eat.” He also refers to himself in the third person, for example, “Anton needs a pen.” Often children can use excerpts from conversations they have heard from adults or on TV. In society, a child may not use speech at all and not answer questions. However, alone with himself, he can comment on his actions and declare poetry.

Sometimes a child’s speech becomes pretentious. It is replete with quotes, neologisms, unusual words, and commands. Their speech is dominated by autodialogue and a tendency to rhyme. Their speech is often monotonous, without intonation, and is dominated by commentary phrases.

Also, the speech of autistic people is often characterized by a peculiar intonation with a predominance of high tones at the end of the sentence. Vocal tics and phonetic disorders are often observed.

Delayed speech development is often the reason why the child’s parents turn to speech therapists and speech pathologists. In order to understand the cause of speech disorders, it is necessary to determine whether speech is used in this case for communication. The cause of speech disorders in autism is a reluctance to interact with the outside world, including through conversation. Anomalies of speech development in this case reflect a violation of the social contact of children.

Intellectual disorders

In 75 percent of cases, various intellectual disorders are observed. This may be mental retardation or uneven mental development. Most often, these are various degrees of mental retardation. An autistic child has difficulty concentrating and being goal-oriented. He also has a rapid loss of interest and attention disorder. Commonly accepted associations and generalizations are rarely available. An autistic child usually performs well on tests of manipulation and visual skills. However, tests that require symbolic and abstract thinking, as well as logic, perform poorly.

Sometimes children show interest in certain disciplines and the formation of certain aspects of intelligence. For example, they have unique spatial memory, hearing or perception. In 10 percent of cases, initially accelerated intellectual development is complicated by the decay of intelligence. With Asperger's syndrome, intelligence remains within the age norm or even higher.

According to various data, a decrease in intelligence within the range of mild and moderate mental retardation is observed in more than half of children. Thus, half of them have an IQ below 50. A third of children have borderline intelligence ( IQ 70). However, the decline in intelligence is not total and rarely reaches the level of severe mental retardation. The lower a child’s IQ, the more difficult his social adaptation. Other children with a high IQ have non-standard thinking, which also very often limits their social behavior.

Despite the decline in intellectual functions, many children learn basic school skills on their own. Some of them independently learn to read and acquire mathematical skills. Many people can retain musical, mechanical and mathematical abilities for a long time.

Intellectual disorders are characterized by irregularity, namely, periodic improvements and deteriorations. Thus, against the background of situational stress and illness, episodes of regression may occur.

Impaired sense of self-preservation

A violation of the sense of self-preservation, which manifests itself as auto-aggression, occurs in one third of autistic children. Aggression is one of the forms of response to various not entirely favorable life relationships. But since there is no social contact in autism, negative energy is projected onto oneself. Autistic children are characterized by hitting themselves and biting themselves. Very often they lack a “sense of edge”. This is observed even in early childhood, when the baby hangs over the side of the stroller and climbs over the playpen. Older children may jump onto the road or jump from a height. Many of them do not consolidate negative experiences after falls, burns, or cuts. So, an ordinary child, having fallen or cut himself once, will avoid this in the future. An autistic child can do the same action dozens of times, hurting himself, but not stopping.

The nature of this behavior has been little studied. Many experts suggest that this behavior is due to a decrease in the threshold of pain sensitivity. This is confirmed by the absence of crying when the baby hits or falls.

In addition to self-aggression, aggressive behavior directed at someone can be observed. The reason for this behavior may be a defensive reaction. Very often it is observed if an adult tries to disrupt the child’s usual way of life. However, an attempt to resist change can also manifest itself in self-aggression. A child, especially if he suffers from a severe form of autism, may bite himself, hit himself, or deliberately hit himself. These actions stop as soon as the interference in his world stops. Thus, in this case, such behavior is a form of communication with the outside world.

Features of gait and movements

Autistic children often have a specific gait. Most often, they imitate a butterfly, walking on tiptoes and balancing with their hands. Some people skip and jump. A peculiarity of the movements of an autistic child is a certain awkwardness and angularity. The running of such children may seem ridiculous, because during it they swing their arms and spread their legs wide.

Also, children with autism may walk with a side step, sway while walking, or walk along a strictly defined special route.

What do children with autism look like?

Children under one year old

The appearance of the baby is distinguished by the absence of a smile, facial expressions and other bright emotions.
Compared to other children, he is not as active and does not attract attention. His gaze is often fixed on some ( always the same) subject.

The baby does not reach out into his arms, he does not have a revival complex. He does not copy emotions - if you smile at him, he does not respond with a smile, which is completely uncharacteristic for small children. He does not gesticulate or point to objects that he needs. The baby does not babble like other one-year-old children, does not gurgle, and does not respond to his name. An autistic infant does not create problems and gives the impression of being a “very calm child.” For many hours he plays by himself without crying, without showing interest in others.

It is extremely rare for children to experience delays in growth and development. At the same time, with atypical autism ( autism with mental retardation) concomitant diseases are very often observed. Most often, this is a convulsive syndrome or even epilepsy. In this case, there is a delay in neuropsychic development - the child begins to sit late, takes his first steps late, and lags behind in weight and height.

Children from one to 3 years old

Children continue to be closed off and unemotional. They speak poorly, but most often they don’t speak at all. At 15–18 months, children may stop speaking altogether. A distant gaze is noticed; the child does not look the interlocutor in the eyes. Very early, such children begin to take care of themselves, thereby providing themselves with increasing independence from the world around them. When they do start speaking, those around them notice that they refer to themselves in the second or third person. For example, “Oleg is thirsty” or “Are you thirsty?” To the question: “Are you thirsty?” they answer: “He is thirsty.” A speech disorder seen in young children is echolalia. They repeat passages of phrases or phrases heard from the mouths of other people. Vocal tics are often observed, which manifest themselves in the involuntary pronunciation of sounds and words.

Children begin to walk, and their parents' attention is attracted by their gait. Walking on tiptoes, with arms flailing, is often observed ( as if imitating a butterfly). Psychomotor-wise, children with autism may be hyperactive or hypoactive. The first option is more common. Children are in constant motion, but their movements are stereotypical. They sway on a chair and make rhythmic movements with their torsos. Their movements are monotonous and mechanical. When studying a new object ( for example, if mom bought a new toy) they carefully sniff it, feel it, shake it, trying to extract some sounds. Gestures observed in autistic children can be very eccentric, unusual and forced.

The child develops unusual activities and hobbies. He often plays with water, turning the faucet on and off, or with the light switch. The attention of relatives is attracted by the fact that the baby very rarely cries, even when hit very hard. Rarely asks for anything or whines. An autistic child actively avoids the company of other children. At children's birthdays and matinees, he sits alone or runs away. Sometimes autistic children can become aggressive in the company of other children. Their aggression is usually directed at themselves, but can also be projected onto others.

Often such children give the impression of being spoiled. They are selective in food, do not get along with other children, and develop many fears. Most often, this is a fear of darkness, noise ( vacuum cleaner, doorbell), a certain type of transport. In severe cases, children are afraid of everything - leaving the house, leaving their room, being alone. Even in the absence of certain formed fears, autistic children are always fearful. Their fearfulness is projected onto the world around them, since it is unknown to them. Fear of this unknown world is the main emotion of a child. To counter the change in situation and limit their fears, they often throw tantrums.

Outwardly, autistic children look very diverse. It is generally accepted that children with autism have fine, defined facial features that rarely show emotion ( prince's face). However, this is not always the case. Children at an early age may exhibit very active facial expressions and an awkward, sweeping gait. Some researchers say that the facial geometry of autistic children and other children is still different - their eyes are wider apart, the lower part of the face is relatively short.

Preschool children ( from 3 to 6 years)

In children of this age group, difficulties with social adaptation come to the fore. These difficulties are most pronounced when the child goes to kindergarten or preparatory group. The child does not show interest in his peers, he does not like the new environment. He reacts to such changes in his life with violent psychomotor agitation. The child’s main efforts are aimed at creating a kind of “shell” in which he hides, avoiding the outside world.

Your toys ( if there are any) the baby begins to arrange them in a certain order, most often by color or size. People around them notice that, compared to other children, there is always a certain structure and order in the room of an autistic child. Things are laid out in their places and grouped according to a certain principle ( color, material type). The habit of always finding everything in its place gives the child a feeling of comfort and security.

If a child of this age group has not been consulted by a specialist, then he withdraws even more into himself. Speech disorders progress. It becomes increasingly difficult to disrupt an autistic person’s usual way of life. An attempt to take a child outside is accompanied by violent aggression. Fearfulness and fears can crystallize into obsessive behavior and rituals. This could be periodic hand washing, certain sequences in food, or in play.

More often than other children, autistic children exhibit hyperactive behavior. Psychomotorally, they are disinhibited and disorganized. Such children are in constant motion and can hardly stay in one place. They have difficulty controlling their movements ( dyspraxia). Autistic people also often exhibit compulsive behavior—they deliberately perform their actions according to certain rules, even if these rules go against social norms.

Much less often, children may exhibit hypoactive movement. At the same time, their fine motor skills may suffer, which will cause difficulties in some movements. For example, a child may have difficulty tying shoelaces or holding a pencil in his hand.

Children over 6 years old

Autistic students can attend both specialized educational institutions and general schools. If a child does not have disorders in the intellectual sphere and copes with learning, then selectivity of his favorite subjects is observed. As a rule, this is a hobby for drawing, music, and mathematics. However, even with borderline or average intelligence, children have attention deficits. They have difficulty concentrating on tasks, but at the same time they are extremely focused on their studies. Autistic people are more likely to have reading difficulties than others ( dyslexia).

At the same time, in one tenth of cases, children with autism demonstrate unusual intellectual abilities. These could be talents in music, art, or a unique memory. In one percent of autistic cases, savant syndrome is observed, in which outstanding abilities are noted in several areas of knowledge.

Children who show a decrease in intelligence or significant withdrawal into themselves are engaged in specialized programs. In the first place at this age are speech disorders and social maladjustment. A child can resort to speech only in case of urgent need in order to communicate his needs. However, he tries to avoid this too, starting to serve himself very early. The less developed the language of communication is in children, the more often they show aggression.

Deviations in eating behavior can become serious disorders, including refusal to eat. In mild cases, meals are accompanied by rituals - eating food in a certain order, at certain hours. The selectivity of individual dishes is not based on taste, but on the color or shape of the dish. For autistic children, what food looks like matters a lot.

If the diagnosis is made early and treatment measures taken, many children can adapt well. Some of them graduate from general education institutions and master professions. Children with minimal speech and intellectual disorders adapt best.

What tests can help identify autism in a child at home?

The purpose of using tests is to identify a child's risk of autism. Test results are not the basis for making a diagnosis, but are a reason to contact specialists. When assessing the characteristics of child development, one should take into account the child’s age and use tests recommended for his age.

Tests for diagnosing autism in children are:

• assessment of child behavior based on general development indicators - from birth to 16 months;
• M-CHAT test ( modified autism screening test) – recommended for children from 16 to 30 months;
• CARS Autism Scale ( Autism Rating Scale for Children) – from 2 to 4 years;
• ASSQ screening test – intended for children from 6 to 16 years old.

Testing a child for autism from birth

Child health institutes advise parents to monitor their baby’s behavior from the moment of birth and, if any discrepancies are identified, to contact pediatric specialists.

Deviations in child development from birth to one and a half years of age are the absence of the following behavioral factors:

• smiling or trying to express happy emotions;
• response to smiles, facial expressions, sounds of adults;
• attempts to establish eye contact with the mother during feeding, or with people around the child;
• reaction to one's own name or to a familiar voice;
• gesturing, waving arms;
• using fingers to point to objects of interest to the child;
• attempts to start talking ( walk, coo);
• please take him in your arms;
• the joy of being held in your arms.

If even one of the above abnormalities is detected, parents should consult a doctor. One of the signs of this disease is an extremely strong attachment to one of the family members, most often the mother. Outwardly, the child does not demonstrate his adoration. But if there is a threat of interruption of communication, children may refuse to eat, vomit, or develop a fever.

M-CHAT test for examining children from 16 to 30 months

The results of this test, as well as other childhood screening tools ( examinations), are not 100% reliable, but are a basis for undergoing a diagnostic examination by specialists. You must answer “Yes” or “No” to the M-CHAT test items. If the phenomenon indicated in the question occurred no more than twice during observations of the child, this fact is not counted.

The M-CHAT test questions are:

• №1 – Does the child enjoy being rocked ( on hands, knees)?
• №2 – Does the child become interested in other children?
• № 3 – Does the child like to use objects as steps and climb up them?
• № 4 – Does the child enjoy a game like hide and seek?
• № 5 – Does the child imitate any actions during the game ( talking on an imaginary phone, rocking a non-existent doll)?
• № 6 – Does the child use his index finger when he feels the need for something?
• № 7 – Does the child use his index finger to emphasize his interest in some object, person or action?
• № 8 – Does the child use his toys for their intended purpose ( builds forts from blocks, dresses dolls, rolls cars on the floor)?
• № 9 – Has the child ever focused his attention on objects that interested him, bringing them and showing them to his parents?
• № 10 – Can a child maintain eye contact with adults for more than 1–2 seconds?
• № 11 – Has the child ever shown signs of hypersensitivity to acoustic stimuli ( did he cover his ears during loud music, did he ask to turn off the vacuum cleaner?)?
• № 12 – Does the child have a response to a smile?
• № 13 – Does the child repeat after adults their movements, facial expressions, intonation;
• № 14 – Does the child respond to his name?
• № 15 – Point your finger at a toy or other object in the room. Will the child look at him?
• № 16 – Is the child walking?
• № 17 - Look at some object. Will your child repeat your actions?
• № 18 – Has the child been observed making unusual finger gestures near his face?
• № 19 – Does the child make attempts to attract attention to himself and to what he is doing?
• № 20 – Does the child give reason to think that he has hearing problems?
• № 21 – Does the child understand what the people around him say?
• № 22 – Has it ever happened that a child wandered around or did something without a goal, giving the impression of complete absence?
• № 23 – When meeting unfamiliar people or phenomena, does the child look his parents in the face in order to check his reaction?

Decoding M-CHAT test answers
To determine whether the child passed this test or not, you should compare the answers received with those given in the interpretation of the test. If three normal or two critical points coincide, the child must be examined by a doctor.

The M-CHAT test interpretation points are:

• № 1 - No;
• № 2 - No ( critical point);
• № 3, № 4, № 5, № 6 - No;
• № 7 - No ( critical point);
• № 8 - No;
• № 9 - No ( critical point);
• № 10 - No;
• № 11 - Yes;
• № 12 - No;
• № 13, № 14, № 15 - No ( critical points);
• № 16, № 17 - No;
• № 18 - Yes;
• № 19 - No;
• № 20 - Yes;
• № 21 - No;
• № 22 - Yes;
• № 23 - No.

CARS scale for determining autism in children from 2 to 6 years old

The CARS is one of the most used tests for identifying autism symptoms. The study can be conducted by parents on the basis of observations of the child during his stay at home, among relatives and peers. Information received from educators and educators should also be included. The scale includes 15 categories that describe all areas that are relevant for diagnosis.
When identifying correspondence with the proposed options, you should use the score indicated opposite the answer. When calculating test values, you can also take into account intermediate values ​​( 1.5, 2.5, 3.5 ) in cases where the child’s behavior is assessed as average between the descriptions of the answers.

The CARS rating scale items are:

1. Relationships with people:

• no difficulties- the child’s behavior meets all the necessary criteria for his age. Shyness or fussiness may be observed in cases where the situation is unfamiliar - 1 point;
• mild difficulties- the child shows anxiety, tries to avoid direct gaze or suppress conversations in cases where attention or communication is intrusive and does not come on his initiative. Problems can also manifest themselves in the form of embarrassment or excessive dependence on adults in comparison with children of the same age - 2 points;
• moderate difficulties— deviations of this type are expressed in a demonstration of detachment and ignoring adults. In some cases, perseverance is required to gain children's attention. The child very rarely makes contact of his own accord - 3 points;
• serious relationship problems- the child rarely answers and never shows interest in what those around him are doing - 4 points.

2. Imitation and imitation skills:

• abilities correspond to age- the child can easily reproduce sounds, body movements, words - 1 point;
• imitation skills are slightly impaired- the child repeats simple sounds and movements without difficulty. More complex imitations are carried out with the help of adults - 2 points;
• average level of violations- to reproduce sounds and movements, the child needs outside support and significant effort - 3 points;
• serious problems with imitation- the child does not make attempts to imitate acoustic phenomena or physical actions, even with the help of adults - 4 points.

3. Emotional background:

• emotional response is normal— the child’s emotional reaction corresponds to the situation. Facial expression, posture and behavior change depending on the events taking place - 1 point;
• there are minor violations- sometimes the manifestation of children's emotions is not connected with reality - 2 points;
• emotional background is subject to moderate disturbances- a child’s reaction to a situation may be delayed in time, expressed too brightly or, conversely, restrained. In some cases, the child may laugh for no reason or not express any emotions corresponding to the events taking place - 3 points;
• the child is experiencing serious emotional difficulties- children's answers in most cases do not correspond to the situation. The child’s mood remains unchanged for a long time. The opposite situations may occur - the child begins to laugh, cry or express other emotions for no apparent reason - 4 points.

4. Body control:

• skills are age appropriate- the child moves well and freely, movements are precise and well-coordinated - 1 point;
• disorders in a mild stage- the child may experience some awkwardness, some of his movements are unusual - 2 points;
• average deviation level- the child's behavior may include such things as tiptoeing, pinching the body, unusual finger movements, pretentious poses - 3 points;
• the child experiences significant difficulties with control of his body- in children's behavior, strange movements are often observed, unusual for their age and situation, which do not stop even when trying to impose a ban on them - 4 points.

5. Toys and other household items:

• norm- the child plays with toys and uses other objects in accordance with their purpose - 1 point;
• slight deviations- strangeness may occur when playing or interacting with other things ( for example, a child can taste toys) – 2 points;
• moderate problems- the child may have difficulty determining the purpose of toys or objects. He may also pay increased attention to individual parts of a doll or car, become very interested in details and use toys in an unusual way - 3 points;
• serious violations- it is difficult to distract a child from playing or, conversely, to encourage him to do this activity. Toys are increasingly used in strange, inappropriate ways - 4 points.

6. Adaptability to change:

• the child's reaction is appropriate to the age and situation- when changing conditions, the child does not experience much excitement - 1 point;
• there are minor difficulties— the child has some difficulties with adaptation. So, when the conditions of the problem being solved change, the child can continue searching for a solution using the original criteria - 2 points;
• average level deviations- when the situation changes, the child begins to actively resist it and experiences negative emotions - 3 points;
• the response to changes does not fully correspond to the norm- the child perceives any changes negatively, hysterics may occur - 4 points.

7. Visual assessment of the situation:

• normal indicators- the child makes full use of vision to meet and analyze new people and objects - 1 point;
• mild disorders- such moments as “looking into nowhere”, avoidance of eye contact, increased interest in mirrors, light sources can be identified – 2 points;
• moderate problems- the child may experience discomfort and avoid direct gaze, use an unusual viewing angle, or bring objects too close to the eyes. In order for a child to look at an object, you need to remind him about it several times - 3 points;
• significant problems using vision- the child makes every effort to avoid eye contact. In most cases, vision is used in an unusual way - 4 points.

8. Sound reaction to reality:

• compliance with the norm- the child’s reaction to sound stimuli and speech corresponds to age and situation - 1 point;
• there are minor disorders- the child may not answer some questions, or respond to them with a delay. In some cases, increased sound sensitivity may be detected - 2 points;
• average level deviations- a child’s reaction may be different to the same sound phenomena. Sometimes there is no response even after several repetitions. The child may react excitedly to some ordinary sounds ( cover your ears, show displeasure) – 3 points;
• the sound response does not fully meet the norm- in most cases, the child’s reaction to sounds is impaired ( insufficient or excessive) – 4 points.

9. Using the senses of smell, touch and taste:

• norm- in exploring new objects and phenomena, the child uses all senses in accordance with age. When experiencing pain, it exhibits a reaction that corresponds to the level of pain - 1 point;
• small deviations- sometimes a child may have difficulty knowing which senses to use ( for example, tasting inedible objects). When experiencing pain, a child may express or exaggerate its meaning - 2 points;
• moderate problems- the child can be seen smelling, touching, tasting people and animals. The reaction to pain is not true - 3 points;
• serious violations— getting to know and studying subjects mostly occurs in unusual ways. The child tastes toys, smells clothes, touches people. When painful sensations arise, he ignores them. In some cases, an exaggerated reaction to minor discomfort may be detected - 4 points.

10. Fears and reactions to stress:

• natural response to stress and fears- the child’s behavioral model corresponds to his age and current events - 1 point;
• unexpressed disorders- sometimes a child may become scared or nervous more than usual compared to the behavior of other children in similar situations - 2 points;
• moderate impairment- children's reaction in most cases does not correspond to reality - 3 points;
• strong deviations— the level of fear does not decrease, even after the child experiences similar situations several times, and it is quite difficult to calm the baby down. You may also notice a complete lack of worry under circumstances that cause other children to worry - 4 points.

11. Communication skills:

• norm- the child communicates with the environment in accordance with the capabilities characteristic of his age - 1 point;
• slight deviation- A slight speech delay may be detected. Sometimes pronouns are changed, unusual words are used - 2 points;
• mid-level disorders- the child asks a large number of questions and may express concern about certain topics. Sometimes speech may be absent or contain meaningless expressions - 3 points;
• severe impairment of verbal communication— speech with meaning is almost absent. Often in communication the child uses strange sounds, imitates animals, imitates transport - 4 points.

12. Nonverbal communication skills:

• norm- the child makes full use of all the possibilities of nonverbal communication - 1 point;
• minor violations- in some cases, the child may have difficulty indicating his desires or needs with gestures - 2 points;
• moderate deviations- basically, it is difficult to explain to a child without words what he wants - 3 points;
• serious disorders- It is difficult for a child to understand the gestures and facial expressions of other people. In his gestures, he uses only unusual movements that have no obvious meaning - 4 points.

13. Physical activity:

• norm- the child behaves in the same way as his peers - 1 point;
• slight deviations from the norm- children's activity may be slightly higher or lower than normal, which causes some difficulties in the child's activities - 2 points;
• average degree of violation- the child’s behavior does not correspond to the situation. For example, when going to bed, he is characterized by increased activity, and during the day he remains in a sleepy state - 3 points;
• abnormal activity- the child is rarely in a normal state, in most cases showing excessive passivity or activity - 4 points.

14. Intelligence:

• child development is normal- child development is balanced and does not differ in unusual skills - 1 point;
• mild impairment- the child has standard skills, in some situations his intelligence is lower than that of his peers - 2 points;
• deviations of average type- in most cases the child is not so smart, but in some areas his skills are normal - 3 points;
• serious problems in intellectual development- children's intelligence is below generally accepted values, but there are areas in which the child understands much better than his peers - 4 points.

15. General impression:

• norm- outwardly the child does not show signs of illness - 1 point;
• mild manifestation of autism- under some circumstances the child shows symptoms of the disease - 2 points;
• average level- the child exhibits a number of signs of autism - 3 points;
• severe autism- the child shows an extensive list of manifestations of this pathology - 4 points.

Calculation of results
By placing a rating in front of each subsection that corresponds to the child’s behavior, the points should be summed up.

The criteria for determining the child’s condition are:

• number of points from 15 to 30– no autism;
• number of points from 30 to 36– the manifestation of the disease is likely to be mild to moderate ( Asperger's syndrome);
• number of points from 36 to 60– there is a risk that the child has severe autism.

ASSQ test for diagnosing children from 6 to 16 years old

This testing method is intended to determine a tendency towards autism and can be used by parents at home.
Each question in the test has three answer options - “no”, “somewhat” and “yes”. The first answer option is marked with a zero value, the answer “somewhat” implies 1 point, the answer “yes” - 2 points.

The ASSQ test questions are:

• Is it okay to use expressions such as “old-fashioned” or “smart beyond his years” to describe a child?
• Do your child's peers call you a "nutty or eccentric professor"?
• Can we say about a child that he is in his own world with unusual rules and interests?
• Collects ( or remembers) Does the child have data and facts on certain topics without understanding them enough or not at all?
• Has there been a literal perception of phrases spoken in a figurative sense?
• Does the child use an unusual communication style ( old-fashioned, pretentious, ornate)?
• Has the child been observed making up his own expressions and words?
• Can a child's voice be called unusual?
• Does the child use such techniques as squealing, grunting, sniffling, or screaming in verbal communication?
• Was the child markedly successful in some areas and significantly underperforming in other areas?
• Is it possible to say about a child that he uses speech well, but at the same time does not take into account the interests of other people and the rules of being in society?
• Is it true that the child has difficulty understanding other people's emotions?
• Is it common for a child to make naive statements and remarks that confuse other people?
• Is the type of eye contact abnormal?
• Does your child feel the desire, but cannot build relationships with peers?
• Is being with other children possible only on his terms?
• Child doesn't have a best friend?
• Can we say that the child’s actions lack common sense?
• Are there any difficulties when playing in a team?
• Were awkward movements and clumsy gestures noted?
• Has the child experienced involuntary movements of the body or face?
• Do you experience any difficulties in performing daily duties due to obsessive thoughts that visit your child?
• Does the child have a commitment to order according to special rules?
• Does the child have a special attachment to objects?
• Is a child exposed to weed from peers?
• Does the child use unusual facial movements?
• Has your child noticed any strange movements with his hands or other parts of his body?

Interpretation of the data obtained
If the total score does not exceed 19, the test result is considered normal. With a value that varies from 19 to 22, the likelihood of autism is increased; above 22, it is high.

When is it necessary to see a child psychiatrist?

You should consult a doctor at the first suspicion of elements of autism in a child. Before testing the child, the specialist observes his behavior. Often the diagnosis of autism is not difficult ( stereotypies are present, there is no contact with the environment). At the same time, making a diagnosis requires careful collection of the child’s medical history. The doctor is attracted to details about how the child grew and developed in the first months of life, when the mother’s first concerns appeared and what they are connected with.

Most often, before coming to a child psychiatrist or psychologist, parents had already visited doctors, suspecting the child to be deaf or dumb. The doctor clarifies when the child stopped speaking and what caused it. The difference between mutism ( lack of speech) in autism from another pathology is that in autism the child initially begins to speak. Some children begin to speak even earlier than their peers. Next, the doctor asks about the child’s behavior at home and in kindergarten, and about his contacts with other children.

At the same time, the patient is monitored - how the child behaves at the doctor’s appointment, how he orients himself in a conversation, whether he makes eye contact. A lack of contact may be indicated by the fact that the child does not give objects into his hands, but throws them on the floor. Hyperactive, stereotypical behavior speaks in favor of autism. If a child speaks, then attention is paid to his speech - is there any repetition of words in it ( echolalia), whether monotony or, conversely, pretentiousness predominates.

Ways to identify symptoms consistent with autism include:

• observation of a child in society;
• analysis of nonverbal and verbal communication skills;
• studying the interests of the child, the characteristics of his behavior;
• carrying out tests and analyzing the results obtained.

Deviations in behavior change with age, so the age factor should be taken into account when analyzing child behavior and the characteristics of its development.

The child's relationship with the outside world

Social impairments in children with autism may appear from the first months of life. From the outside, autistic people look calmer, undemanding and withdrawn compared to their peers. Being in the company of strangers or unfamiliar people, they experience severe discomfort, which, as they grow older, ceases to be anxiety. If a person from the outside tries to impose his communication or attention, the child may run away and cry.

Signs that can be used to determine the presence of this disease in a child from birth to three years are:

• lack of desire to make contact with the mother and other close people;
• strong ( primitive) attachment to one of the family members ( the child does not show adoration, but when separated, he may become hysterical and have a fever);
• reluctance to be held by the mother;
• lack of an anticipatory posture when the mother approaches;
• expression of discomfort when trying to establish eye contact with the child;
• lack of interest in events happening around;
• demonstration of resistance when trying to caress the child.

Problems with building relationships with the outside world remain even at a later age. The inability to understand the motives and actions of other people makes autistic people poor communicators. In order to reduce the level of their worries about this, such children prefer solitude.

Symptoms that indicate autism in children aged 3 to 15 years include:

• inability to form friendships;
• demonstration of detachment from others ( which can sometimes be replaced by the emergence of a strong attachment to one person or a narrow circle of people);
• lack of desire to make contact on one’s own initiative;
• difficulty understanding the emotions and actions of other people;
• difficult relationships with peers ( bullying by other children, using offensive nicknames towards the child);
• inability to take part in team games.

Verbal and nonverbal communication skills in autism

Children with this disease begin to speak much later than their peers. Subsequently, the speech of such patients is characterized by a reduced number of consonants and is replete with mechanical repetition of the same phrases that are not related to the conversation.

Deviations of speech and non-speech communication in children aged 1 month to 3 years with these diseases are:

• lack of attempts to interact with the outside world using gestures and facial expressions;
• absence of babbling before the age of one year;
• non-use of single words in conversation for up to one and a half years;
• inability to construct full-fledged meaningful sentences under the age of 2 years;
• lack of a pointing gesture;
• weak gestures;
• inability to express one’s desires without words.

Communication disorders that may indicate autism in a child over 3 years of age include:

• speech pathology ( inappropriate use of metaphors, reversal of pronouns);
• use of squealing, screaming in conversation;
• the use of words and phrases that are inappropriate in meaning;
• strange facial expressions or its complete absence;
• absent, directed to “nowhere” look;
• poor understanding of metaphors and speech expressions spoken in a figurative sense;
• inventing your own words;
• unusual gestures that have no obvious meaning.

Interests, habits, behavioral characteristics of a child with autism

Children with autism have difficulty understanding the rules of playing with toys that are understandable to their peers, such as a car or a doll. So, an autistic person may not roll a toy car, but spin its wheel. It is difficult for a sick child to replace some objects with others or use fictitious images in play, since poorly developed abstract thinking and imagination are one of the symptoms of this disease. A distinctive feature of this disease is disturbances in the use of the organs of vision, hearing, and taste.

Deviations in the behavior of a child under 3 years of age that indicate the disease are:

• concentration when playing not on the toy, but on its individual parts;
• difficulties in determining the purpose of objects;
• poor coordination of movements;
• increased sensitivity to sound stimuli ( severe crying due to the sound of the TV playing);
• lack of response to calling by name, requests from parents ( sometimes it seems that the child has hearing problems);
• studying objects in an unusual way - using the senses for purposes other than their intended purpose ( the child can smell or taste the toys);
• using an unusual viewing angle ( the child brings objects close to his eyes or looks at them with his head tilted to the side);
• stereotypical movements ( swinging your arms, swaying your body, turning your head);
• non-standard ( insufficient or excessive) response to stress, pain;
• sleep problems.

Children with autism at an older age retain the symptoms characteristic of this disease, and also show other signs as they develop and mature. One of the characteristics of autistic children is the need for a certain structure. For example, a child may insist on walking along the route he has drawn up and not change it for several years. When trying to make changes to the rules he has established, an autistic person may actively express dissatisfaction and show aggression.

Symptoms of autism in patients whose age ranges from 3 to 15 years are:

• resistance to change, tendency to monotony;
• inability to switch from one type of activity to another;
• aggression towards oneself ( According to one study, about 30 percent of children with autism bite, pinch, or cause other types of pain.);
• poor concentration;
• increased selectivity in choosing dishes ( which causes digestive problems in two thirds of cases);
• narrowly defined skills ( memorization of irrelevant facts, passion for topics and activities that are unusual for age);
• poorly developed imagination.

Tests to determine autism and analysis of their results

Depending on the age, parents can use special tests that will help determine whether the child has this pathology.

Tests to determine autism are:

• M-CHAT test for children aged 16 to 30 months;
• CARS Autism Rating Scale for children 2 to 4 years of age;
• ASSQ test for children from 6 to 16 years old.

The results of any of the above tests are not the basis for making a final diagnosis, but are a valid reason to consult a specialist.

Decoding M-CHAT results
To pass this test, parents are asked to answer 23 questions. Answers obtained from observations of the child should be compared with options that support autism. If three matches are identified, it is necessary to show the baby to the doctor. Particular attention should be paid to critical points. If the child’s behavior meets two of them, consultation with a specialist in this disease is required.

Interpretation of the CARS Autism Scale
The CARS autism scale is a voluminous study that consists of 15 sections affecting all areas of a child’s life and development. Each item requires 4 answers with corresponding points. If parents cannot choose the proposed options with firm confidence, they can choose an intermediate value. To complete the picture, observations provided by those people who surround the child outside the home are necessary ( educators, teachers, neighbors). Having summed up the points for each item, you should compare the total amount with the data given in the test.

Rules for determining the final diagnostic result on a scale CARS are:

• if the total score varies from 15 to 30 points, the child does not suffer from autism;
• the number of points ranges from 30 to 36 – there is a possibility that the child is sick ( mild to moderate autism);
• If the score exceeds 36, there is a high risk that the child has severe autism.

ASSQ Test Results
The ASSQ screening test consists of 27 questions, each of which has 3 answer types ( “no”, “sometimes”, “yes”) with a corresponding award of 0, 1 and 2 points. If the test results do not exceed 19, there is no cause for concern. With a score of 19 to 22, parents should consult a doctor, as there is an average likelihood of illness. When the test result exceeds 22 points, the risk of the disease is considered high.

Professional help from a doctor does not only include drug correction of behavioral disorders. First of all, these are special educational programs for autistic children. The most popular programs in the world are the ABA program and Floor Time ( game time). ABA includes many other programs that are aimed at gradually mastering the world. It is believed that learning results are felt if the learning time is at least 40 hours per week. The second program uses the child's interests to establish contact with him. In this case, even “pathological” hobbies are taken into account, for example, pouring sand or mosaics. The advantage of this program is that any parent can master it.

Treatment of autism also comes down to visits to a speech therapist, speech pathologist and psychologist. Behavioral disorders, stereotypies, and fears are corrected by a psychiatrist and psychotherapist. In general, treatment for autism is multifaceted and targets areas of development that are affected. The sooner you consult a doctor, the more effective the treatment will be. It is believed that treatment is most effective before 3 years of age.

childhood autism social rehabilitation

The early development of an autistic child generally falls within the approximate normal time frame; At the same time, there are two options for the general peculiar background against which development occurs. In the first case, from the very beginning such a child may show signs of weak mental tone, lethargy, low activity in contacts with the environment, unexpressed manifestations of even vital needs (the child may not ask for food, tolerate wet diapers). At the same time, he can eat with pleasure, love comfort, but not so much as to actively demand it, defend a form of contact that is convenient for himself; He leaves the initiative in everything to his mother.

And later such a child does not seek to actively explore the environment. Parents often describe such children as very calm, “ideal,” and comfortable. They can be left alone without requiring constant attention.

In other cases, children, on the contrary, already at a very early age are characterized by special excitability, motor restlessness, difficulty falling asleep, and special selectivity in food. It is difficult to adapt to them; they may develop special habits of going to bed, feeding, and grooming procedures. They can express their dissatisfaction so sharply that they become dictators in developing the first affective stereotypes of contact with the world, single-handedly determining what and how to do.

It is difficult to hold such a child in your arms or in a stroller. Excitement usually increases as the child ages. When such a child begins to move independently, he becomes completely uncontrollable: he runs without looking back, behaves with absolutely no “sense of edge.” The activity of such a child, however, is of a field nature and is in no way connected with a directed examination of the environment.

At the same time, both parents of passive, submissive children and parents of excited, difficult-to-organize children often noted anxiety, fearfulness, and a slight onset of sensory discomfort in children. Many parents report that their children were especially sensitive to loud sounds, could not tolerate household noise of normal intensity, had a dislike for tactile contact, and characteristic disgust when feeding; in a number of cases, aversion to brightly colored toys was noted. In many cases, unpleasant impressions were recorded for a long time in the child’s affective memory.

The unusual reaction to sensory impressions manifested itself in other ways. In an attempt to limit sensory contact with the world, with insufficient focus on examining the environment, the child was noted to be captivated and fascinated by certain stereotypical impressions - visual, auditory, vestibular, proprioceptive. Having received these impressions once, the child again and again sought to reproduce them. Only after a long period of fascination with one impression was it replaced by an addiction to another.

The difficulty of distracting a child from such impressions is typical, for example, a nine-month-old child stretches an expander to the point of complete exhaustion, another child falls asleep over a construction set.

Being captivated by rhythmic, repeating impressions is generally characteristic of early childhood. Until one year of age, it is natural for the behavior of “circulating reactions” to dominate, when the child repeats the same actions in order to reproduce the effect - knocking with a toy, jumping, closing and opening the door. A child with normal development gladly includes an adult in his activities.

In the case of early childhood autism, it is practically impossible for a loved one to join in the activities that absorb the child. Special sensory hobbies begin to isolate him from interaction with loved ones, and therefore from the development and complication of interaction with the outside world.

The origins of the problems in forming a bond between an autistic child and his mother:

A normal child tends to develop socially almost from birth. The baby very early shows a selective interest in social stimuli: a human voice, a face. Already in the first month of life, the child can spend a significant part of his waking hours in eye contact with his mother. It is contact through gaze that has the function of launching and regulating the communication process.

Many mothers of autistic children report that their child did not fixate his gaze on the adult’s face, but looked past, “through.”

Clinical observations and studies of older autistic children have shown that a person, his face, is the most attractive object for an autistic child, but he cannot focus his attention on it for a long time, his gaze seems to hesitate, there is a desire to come closer, and a desire to leave.

Adult contact is attractive to an autistic child, but social stimulation is not within his comfort range.

The first smile, according to the parents, appeared in such a child in time, but it was not addressed to an adult and arose as a reaction both to the approach of an adult and to a number of pleasant impressions for the child (braking, the sound of a rattle, the mother’s colorful clothes, etc.) . Obvious “smile contagion” was observed only in some children (according to F. Volkmar - in a third of the observed cases).

Along with the disruption of the development of the first stereotypes of everyday interaction, the formation of stereotypes of emotional contact is disrupted.

If normal by 3 months. a stable “revitalization complex” appears - the child anticipates the situation of contact, in which he becomes its active initiator, demanding attention, emotional activity of the adult, the baby takes an anticipatory pose, stretches out his arms towards the adult, then such manifestations are not typical for small autistic children. In the mother's arms, many of them feel uncomfortable: they do not take a position of readiness, the child's indifference, or his tension, or even resistance is felt.

The ability to differentiate facial expressions and intonations usually occurs during normal development between 5 and 6 months. Autistic children are less able to recognize the facial expressions of loved ones and may even react inappropriately to a smile or a sad expression on their mother’s face.

Thus, in the first half of life, an autistic child experiences disturbances in the development of the initial phase of communication skills, the main content of which is the establishment of the ability to exchange emotions and the development of common emotional meanings of everyday situations.

By the end of the first - beginning of the second half of life, a child developing normally has a clear differentiation of “us” and “strangers,” and among “friends,” the greatest attachment arises to the mother as the main caregiver or person replacing her, which indicates sufficient development of individual stereotypes of emotional communication.

According to developmental histories, many autistic children still identify someone close to them in the second half of life. Based on the results of the experiment, M. Sigman and her colleagues conclude that attachment is formed because an autistic infant reacts to separation from the mother in the same way as other children.

The attachment of an autistic child, however, most often manifests itself only as a negative experience of separation from the mother. As a rule, affection is not expressed in positive emotions. A child, however, can rejoice when loved ones bother him and entertain him, but this joy is not addressed to his loved one, the child does not strive to share it with him.

Such attachment has the character of a rather primitive symbiotic relationship between a child and his mother, when the mother is perceived only as the main condition for survival.

The insufficiency of the development of emotional connections and the development of individual stereotypes of communication with loved ones is also manifested in the absence of “fear of strangers”, which is characteristic of many autistic children, which is normally observed at the end of the first year of life. Such children can, with the same indifference, go into the arms of both loved ones and strangers.

By the end of the first year, a normal child usually develops differentiated stereotypes of relationships with different family members, with his own people and with strangers. In autistic children, symbiotic attachment to one person usually increases and is accompanied by difficulties in contact with other loved ones.

After six months of normal development, thanks to the development of stereotypes, communication rituals, games, in the interactions of a child with an adult, it becomes possible to mutually focus attention not only on each other, but also on external objects. After some time, the child himself begins to use the pointing gesture and vocalization not only as a response, but also as an active attraction of the mother’s attention to an event or object that interests him. P. Mundy and M. Sigman consider the inability to unite attention, to generally concentrate on an object, as one of the earliest obvious manifestations of childhood autism.

Activity disturbances, sensory vulnerability, insufficient development of affective interaction stereotypes, emotional contact - all this pushes the child to search for additional autostimulation, leading to the development of hypercompensatory mechanisms that allow the child to drown out and reduce the feeling of affective discomfort. At a level accessible to him, he develops sophisticated methods of autostimulation of sthenic affective states. The obsessive desire of autistic children to constantly reproduce the same stereotypical actions that cause pleasant sensations makes a great contribution to the development of their monotonous behavior. These hypercompensatory actions, while providing temporary relief, only increase the child’s overall maladjustment.

Normally, by the age of one and a half years, signs of true imitation and imitation appear, which are expressed in the child’s delayed reproduction of intonations, gestures, and behavior patterns characteristic of those close to him. In an autistic child, the development of these forms is delayed for a long time

Such severe damage to affective development also causes the formation of a special distortion in the child’s intellectual and speech development.

Underdevelopment of the affective mechanisms of selective and voluntary concentration becomes an insurmountable obstacle to the development of higher mental functions. Under these conditions, even with the highest prerequisites for intellectual development, an autistic child cannot cognitively master the environment. Its development here seems to change its direction and goes mainly in line with the affective assimilation of impressions for the needs of hypercompensatory autostimulation. Such a child masters ways of obtaining certain stereotypical motor, sensory, speech and even intellectual impressions. The intellectual development of these children is extremely diverse. Among them there may be children with normal, accelerated, sharply delayed and uneven mental development. Both partial or general giftedness and mental retardation are also noted.

In stories about such children, the same circumstance is constantly noted: they never look into the eyes of another person. Such children avoid communication with people in any way. They seem to not understand or not hear at all what is being said to them. As a rule, these children do not speak at all, and if this happens, then most often such children do not use words to communicate with other people. Another feature of their speech is noted in their manner of speaking: they do not use personal pronouns; an autistic child speaks about himself in the second or third person.

There is also such a noticeable feature as a great interest in all kinds of mechanical objects and extraordinary dexterity in handling them. On the contrary, they show obvious indifference to society; they have no need to compare themselves with other people or with their own “I”.

However, the extreme antipathy of autistic children to contact with other people is tempered by the joy they often experience when they are treated like very little children. In this case, the child will not shy away from affectionate touches until you insist that he look at you or talk to you.

Autistic children complain much less often than their healthy peers. As a rule, they react to a conflict situation by shouting, aggressive actions, or taking a passive defensive position. Recourse to elders for help is extremely rare.

Many of these children suffer from severe eating disorders. Sometimes they refuse to eat at all. (The parents of a four-year-old girl tried everything to whet her appetite. She refused everything, but at the same time she lay down on the floor next to the dog, took the same position and began to eat from the dog’s bowl, taking food only with her mouth). But this is an extreme case. More often you have to deal with a preference for a certain type of food product.

Also, autistic children may suffer from severe sleep disorders. It is especially difficult, and sometimes impossible, for them to fall asleep. The period of sleep can be reduced to an absolute minimum, in addition, there is no regularity of sleep. Some children cannot fall asleep alone; their father or mother must be with them. Some children cannot fall asleep in their own bed; they fall asleep on a certain chair and only in a sleepy state can they be transferred to bed. There are also children who fall asleep only by touching their parents.

These strange characteristics of children with RDA may be associated with some obsessions or fears, which occupy one of the leading places in the formation of autistic behavior in children. Many ordinary surrounding objects, phenomena and some people cause them a constant feeling of fear. Signs of intense fear in these children are often caused by reasons that seem inexplicable to a superficial observer. If you still try to understand what is happening, it turns out that often the feeling of fear arises as a result of an obsession. For example, children are sometimes obsessed with the idea that all things should be placed in a strictly ordered manner in relation to each other, that everything in the room should have its own specific place, and if they suddenly don’t find this, they begin to experience a strong feeling of fear and panic. Autistic fears distort the objectivity of perception of the surrounding world.

Autistic children also have unusual preferences, fantasies, and drives, and they seem to completely capture the child; they cannot be distracted or taken away from these actions.

Their range is very wide. Some children swing, fiddle with their fingers, fiddle with a string, tear paper, run in circles or from wall to wall. Others have unusual preferences for traffic patterns, street layouts, electrical wiring, etc.

Some have fantastic ideas of transforming into an animal or a fairy-tale character. Some children strive for strange, unpleasant actions at the usual glance: they climb into basements and trash heaps, constantly draw cruel scenes (of executions), show aggressiveness in their actions, and reveal sexual attraction. These special actions, addictions, and fantasies play an important role in the pathological adaptation of such children to the environment and to themselves.

Distortion of development in autistic children can manifest itself in a paradoxical combination, ahead of age norms, of the development of mental operations and, on their basis, one-sided abilities (mathematical, constructive, etc.) and interests and, at the same time, failure in practical life, in mastering everyday skills, methods actions, special difficulties in establishing relationships with others.

Some children with autism, when thoroughly tested, may produce results that are significantly outside their age range; but with some children testing is simply impossible. So, you can get an IQ in the range between 30 and 140.

The monotonous and one-sided nature of the development of these children’s abilities and hobbies is noteworthy: they like to re-read the same books and collect monotonous objects. Based on the nature and content of the relationship of these hobbies to reality, two groups can be distinguished:

Isolation from reality (composing meaningless poems, “reading” books in an incomprehensible language)

Associated with certain aspects of reality, aimed at productive activities (interest in mathematics, languages, chess, music) - which can lead to further development of abilities.

Play activity significantly determines the mental development of a child throughout his childhood, especially in preschool age, when plot-based role-playing play comes to the fore. Children with autism traits do not play story games with their peers at any age, do not take on social roles, and do not reproduce in games situations that reflect real life relationships: professional, family, etc. They have no interest or inclination to reproduce this kind of relationship . The lack of social orientation generated by autism in these children is manifested in a lack of interest not only in role-playing games, but also in watching films and television shows that reflect interpersonal relationships.

In autism, the phenomena of asynchrony in the formation of functions and systems are most clearly manifested: the development of speech often overtakes the development of motor skills, “abstract” thinking is ahead of the development of visually effective and visually imaginative.

Early development of formal logical thinking enhances the ability to abstract and promotes limitless opportunities for mental exercises, not limited by socially significant assessments.

Psychological diagnosis of such children should in no way be reduced to an assessment of mental abilities. Data on intellectual development should be considered only in the context of the characteristics of his general mental development. The focus should be on the interests of the child, the level of formation of voluntary regulation of behavior, and, first of all, regulation associated with orientation towards other people, and social motives.

The issue of opportunities and forms of training is complex, but it should be noted that individual training is recommended only in exceptional cases.

Features of speech development

The use of vocalizations for communication begins long before a child is able to produce words. Normally, the following stages of prelinguistic development are distinguished:

1) 0-1 month. Undifferentiated crying. The first reaction to the environment, the result of a total bodily response;

2) 1-5.6 months. Differentiated crying. Hungry crying, crying associated with abdominal pain, etc.;

1) 3-6.7 months. Booming. Vocal playing stage. The child listens to the sounds around him and produces them himself. However, spectrographic analysis of these sounds showed that they are objectively different from the sounds of adult speech, even when the mother tries to imitate the baby's hum;

4) 6-12 months. Babbling, repetition of audible sounds, syllables;

5) 9-10 months. Echolalia. Repetition of sounds that the child hears. The difference from babbling is that the child repeats what he directly hears from another individual.

Early development in autism is characterized by the following features of prelinguistic development: crying is difficult to interpret, humming is limited or unusual (more like a squeal or scream), and there is no imitation of sounds.

Speech disorders are most clearly visible after 3 years. Some patients remain mute throughout their lives, but even when speech develops, it remains abnormal in many respects. In contrast to healthy children, there is a tendency to repeat the same phrases rather than construct original statements. Delayed or immediate echolalia is typical. Pronounced stereotypies and a tendency towards echolalia lead to specific grammatical phenomena. Personal pronouns are repeated in the same way as they are heard, and there are no answers such as “yes” or “no” for a long time. In the speech of such children, rearrangements of sounds and incorrect use of prepositional constructions are not uncommon.

Language understanding is also limited in children with autism. Around 1 year of age, when healthy children love to hear people talk to them, autistic children pay no more attention to speech than to any other noise. For a long time, the child is unable to follow simple instructions and does not respond to his name.

At the same time, some children with autism demonstrate early and rapid speech development. They listen with pleasure when they are read to, remember long pieces of text almost word for word, and their speech gives the impression of being unchildish due to the use of a large number of expressions inherent in the speech of adults. However, opportunities for productive dialogue remain limited. Understanding speech is largely difficult due to difficulties in understanding figurative meaning, subtext, and metaphors. Such features of speech development are more typical for children with Asperger syndrome.

Features of the intonation side of speech also distinguish these children. They often find it difficult to control the volume of their voice; speech is perceived by others as “wooden,” “boring,” or “mechanical.” The tone and rhythm of speech are disturbed.

Thus, regardless of the level of speech development, in autism, the ability to use it for communication is primarily affected. In addition, it should be emphasized that deviations from normal ontogenesis are observed already at the stage of prelinguistic development. The spectrum of speech disorders varies from complete mutism to advanced (compared to the norm) development.

Nonverbal communication

Observations of healthy infants reveal relationships between specific hand movements, gaze direction, vocalizations, and facial expressions. Already at the age of 9-15 weeks, hand activity in a certain sequence is associated with other behavioral patterns. For example: pointing posture before or after vocalization during face-to-face interaction with the mother, clenching the hand during vocalization, spreading fingers - in those moments when the baby looks away from her face. It is interesting that some manual acts are characterized by right-left differences. The results of experimental studies of healthy children show a connection between the development of gestures and the level of speech development. Obviously, in cases where there is no humming and limited opportunities for eye contact, which is typical for autism, this preparatory stage will proceed abnormally, and this cannot but affect the development of a number of mental functions. Indeed, at an older age, obvious difficulties in non-verbal communication are revealed, namely: the use of gestures, facial expression, and body movements. Very often there is no pointing gesture. The child takes his parents by the hand and leads him to the object, approaches its usual location and waits until he is given the object.

Thus, already at the early stages of development, children with autism show signs of distortion of specific innate behavioral patterns characteristic of normal children.

Peculiarities of perception (Lebedinskaya K.S., Nikolskaya O.S.) Visual perception.

Looking “through” the object. Lack of eye tracking of an object. "Pseudo-blindness." Focusing the gaze on a “non-objective” object: a spot of light, a section of a shiny surface, a pattern of wallpaper, carpet, flickering shadows. Fascinated by such contemplation. Delay at the stage of looking at your hands, fingering your fingers near your face.

Examining and fingering the mother's fingers. Persistent search for certain visual sensations. A persistent desire to contemplate bright objects, their movement, spinning, flickering pages. Long-term induction of stereotypical changes in visual sensations (when turning lights on and off, opening and closing doors, moving glass shelves, spinning wheels, pouring mosaics, etc.).

Early color discrimination. Drawing stereotypical patterns.

Visual hypersynthesis: fright, screaming when turning on the light, opening the curtains; desire for darkness.

Auditory perception.

Lack of response to sound. Fears of individual sounds. Lack of habituation to frightening sounds. The desire for sound autostimulation: crumpling and tearing paper, rustling plastic bags, swinging door leaves. Preference for quiet sounds. Early love for music. The nature of your preferred music. Its role in the implementation of the regime, compensation of behavior. Good ear for music. Hyperpathic negative reaction to music.

Tactile sensitivity.

Changed reaction to wet diapers, bathing, combing hair, cutting nails and hair. Poor tolerance of clothes, shoes, desire to undress. Pleasure from the feeling of tearing, stratifying fabrics, paper, pouring cereals. Examination of the surroundings mainly through palpation.

Taste sensitivity.

Intolerance to many foods. The desire to eat inedible things. Sucking inedible objects, tissues. Inspecting the environment by licking.

Olfactory sensitivity.

Hypersynthetic to odors. Inspecting the surroundings using sniffing.

Proprioceptive sensitivity.

Tendency to autostimulation by tensing the body, limbs, hitting oneself on the ears, pinching them when yawning, hitting the head against the side of the stroller, the headboard of the bed. Attraction to play with an adult, such as spinning, spinning, tossing .

The search for the causes of this disorder of mental development went in several directions.

The first examinations of autistic children did not provide evidence of pathology in their nervous system. In this regard, in the early 50s, the most widespread hypothesis was about the psychogenic origin of suffering. In other words, disruption of the development of emotional connections with people and activity in mastering the surrounding world was associated with early mental trauma, with the wrong, cold attitude of parents towards the child, with inappropriate methods of education. The following characteristic feature can be noted here - it was generally accepted that a child suffering from autism has a typical family background. RDA often occurs in intellectual circles and in the so-called upper strata of society, although it is known that this disease is not limited to one or another social group. Thus, responsibility for the violation of the mental development of a biologically full-fledged child was placed on the parents, which very often was the cause of severe mental trauma to the parents themselves.

Further comparative studies of families of mentally retarded children and children suffering from early childhood autism showed that autistic children suffered no more traumatic situations than others, and parents of autistic children are even more caring and devoted to them than is usually observed in the family of a child with mental retardation .

Currently, most researchers believe that early childhood autism is a consequence of a special pathology, which is based on a deficiency of the central nervous system.

This deficiency can be caused by a wide range of reasons: congenital abnormal constitution, congenital metabolic disorders, organic damage to the central nervous system as a result of pathology of pregnancy and childbirth, early onset schizophrenic process. More than 30 different pathogenic factors are indicated that can lead to the formation of Kanner syndrome.

Of course, the actions of various pathological agents introduce individual features into the picture of early childhood autism syndrome. It can be complicated by varying degrees of mental retardation and severe speech underdevelopment. Different shades can have emotional disturbances. As with any other developmental anomaly, the overall picture of a severe mental defect cannot be directly deduced from its biological underlying causes alone.

Many, even the main manifestations of early childhood autism can be regarded in this sense as secondary, arising in the process of mental dysontogenesis.

The mechanism of formation of secondary disorders is most obvious when considering the clinical picture through the prism of abnormal mental development.

Mental development not only suffers from biological inferiority, but also adapts to it as to external conditions.

An autistic child evaluates most situations of interaction with others as dangerous. Autism in this regard can be presented as the main one of the secondary syndromes, as a compensatory mechanism aimed at protecting from a traumatic external environment. Autistic attitudes are the most significant in the hierarchy of reasons that shape the very abnormal development of such a child.

The development of those aspects of the psyche that are formed in active social contacts suffers the most. As a rule, the development of psychomotor skills is impaired. The period from 1.5 to 3 years, which is normally the time for mastering the skills of neatness, dressing, eating independently, and playing with objects, for a child suffering from autism, often turns out to be a crisis and difficult to overcome. At the same time, unlike other categories of children with motor defects, autistic people have no or almost no independent attempts to compensate for these difficulties.

However, for children with early childhood autism syndrome of various etiologies, the main points of the clinical picture, the general structure of mental development disorders, and the problems facing families remain common.

The manifestations of early childhood autism change with age. The clinical picture develops gradually by 2.5-3 years and remains most pronounced until 5-6 years, representing a complex combination of primary disorders caused by the disease and secondary difficulties arising as a result of incorrect, pathological adaptation to them by both the child and adults.

If you try to trace how difficulties in the mental development of an autistic child arise, most researchers doubt that such children have even a short period of normal development. Although the pediatrician, as a rule, evaluates such a child as healthy, his “specialness” is often noticeable from birth and early signs of developmental disorders are noted already in infancy.

It is known that in infancy, pathologies of physical and mental development are intertwined especially closely. Already at this time, autistic children show disturbances in the simplest instinctive forms of adaptation to life (mentioned above): difficulties falling asleep, shallow intermittent sleep, distortion of the rhythm of sleep and wakefulness. There may be difficulties in feeding such children: sluggish sucking, early breast refusal, selectivity in taking complementary foods. Digestive function is unstable, often disrupted, and there is a tendency to constipation.

Such children can be either overpassive, unresponsive, or excitable, with a tendency to panic reactions. However, the same child can demonstrate both types of behavior. It is possible, for example, that there is no reaction to wet diapers, or complete intolerance to them. Some children, who react little to their surroundings, are suspected of blindness and deafness, while others scream for hours in response to an unusual loud sound and reject bright toys. So, the boy, the envy of all mothers, sits calmly on a blanket, while other kids crawl uncontrollably across the lawn; as it turned out, he was afraid to get off it. Fear inhibits his activity and curiosity, but outwardly he seems calm.

It must be added that once experienced, fear can be fixed in such children for a long time and, after months and even years, influence their behavior. Thus, one girl, who, after a fright that occurred at the age of 3 months, when her mother left home for a short time and they tried to feed her from a bottle for the first time, began screaming every day for several months at precisely this time.

Peculiarities in establishing emotional contact between autistic children and loved ones also appear in the first year of life. Passivity in relationships with relatives is often noted: such a child weakly expresses joy when a loved one appears, asks little to be held, and does not adapt to being held. However, according to observations, in most cases, an autistic child at an early age may not be as active as a healthy child, but he is able to establish a simple emotional connection with loved ones. The only exceptions are the most severe cases, possibly complicated by mental retardation. But in most cases, an autistic child enjoys emotional contact and loves being played with, spun around, and tossed around.

When a child begins to walk, his character changes: from calm he becomes excited, disinhibited, does not obey adults, learns self-care skills with difficulty and with great delay, he has difficulty concentrating on what is happening around him, it is difficult to organize him or teach him something.

For the first time, the danger of a particular delay in the child’s mental development begins to appear.

The main reasons for this distortion of mental development, according to researchers (K.S. Lebedinskaya, E.R. Baenskaya, O.S. Nikolskaya) are the following:

1. Painfully increased sensitivity, vulnerability of the emotional sphere with poor tolerance to ordinary environmental influences, a tendency to fixate on unpleasant impressions, which makes the autistic child prone to anxiety and fears;

2. Weakness of general and mental tone, causing a low ability to concentrate attention, the formation of arbitrary forms of behavior, and increased satiety in contact with others.

Currently, there are a huge number of diseases that are inherited. But it also happens that it is not the disease itself that is transmitted, but a predisposition to it. Let's talk about autism.

Autism concept

Autism is a special mental disorder that most likely occurs due to disorders in the brain and is expressed in an acute deficit of attention and communication. An autistic child does not adapt well socially and practically does not make contact.

This disease is associated with disorders in genes. In some cases, this condition is associated with one gene or In any case, the child is born with an existing pathology in mental development.

Causes of autism

If we consider the genetic aspects of this disease, they are so complex that sometimes it is not at all clear whether it is caused by the interaction of several genes or is it a mutation in one gene.

Still, genetic scientists identify some provoking factors that can lead to the birth of an autistic child:

1. Old age of the father.
2. The country in which the baby was born.
3. Low birth weight.
4. Lack of oxygen during childbirth.
5. Prematurity.
6. Some parents believe that vaccinations can influence the development of the disease, but this fact has not been proven. Perhaps it is simply a coincidence of the timing of vaccination and the manifestation of the disease.
7. It is believed that boys are more likely to suffer from this disease.
8. The influence of substances that cause congenital pathologies that are often associated with autism.
9. Aggravating effects can be caused by: solvents, heavy metals, phenols, pesticides.
10. Infectious diseases suffered during pregnancy can also trigger the development of autism.
11. Smoking, drug use, alcohol, both during pregnancy and before it, which leads to damage to reproductive gametes.

Autistic children are born for various reasons. And, as you can see, there are a huge number of them. It is almost impossible to predict the birth of a baby with such a deviation in mental development. Moreover, there is a possibility that the predisposition to this disease may not be realized. But no one knows how to guarantee this with 100% certainty.

Forms of manifestation of autism

Although most children with this diagnosis have much in common, autism can manifest itself in different ways. These children contact the outside world in different ways. Depending on this, the following forms of autism are distinguished:

Most doctors believe that the most severe forms of autism are quite rare; most often we are dealing with autistic manifestations. If you work with such children and devote enough time to activities with them, then the development of an autistic child will be as close as possible to that of their peers.

Manifestations of the disease

Signs of the disease appear when changes begin in areas of the brain. When and how this happens is still not clear, but most parents notice signs of autistic children already in early childhood. If you take urgent measures when they appear, then it is quite possible to instill in your child communication and self-help skills.

At present, methods for a complete cure for this disease have not yet been found. A small proportion of children enter adulthood on their own, although some of them even achieve some success.

Even doctors are divided into two categories: some believe that it is necessary to continue the search for adequate and effective treatment, and others are convinced that autism is much broader and more than a simple disease.

Surveys of parents have shown that in such children one can often observe:

These qualities were most often demonstrated by older autistic children. Signs that are still often found in such children are certain forms of repetitive behavior, which doctors divide into several categories:

• Stereotypy. It manifests itself in swaying of the body, rotation of the head, and constant swaying of the whole body.
• Strong need for monotony. Such children usually begin to protest even when their parents decide to rearrange the furniture in their room.
• Compulsive behavior. An example is nesting objects and objects in a certain way.
• Auto-aggression. Such manifestations are directed towards oneself and can lead to various injuries.
• Ritual behavior. For such children, all actions are like a ritual, constant and everyday.
• Restricted behavior. for example, it is directed only at one book or one toy, but does not perceive others.

Another manifestation of autism is avoidance of eye contact, they never look into the eyes of the interlocutor.

Symptoms of Autism

This disorder affects the nervous system, and therefore manifests itself primarily as developmental disorders. They are usually noticeable at an early age. Physiologically, autism may not manifest itself in any way; outwardly, such children look quite normal, have the same physique as their peers, but upon careful study, one can see deviations in mental development and behavior.

The main symptoms include:

• Lack of learning ability, although intelligence may be quite normal.
• Seizures that most often begin to appear during adolescence.
• Inability to concentrate.
• Hyperactivity, which may occur when a parent or caregiver tries to assign a specific task.
• Anger, especially in cases where an autistic child cannot articulate what he wants, or strangers interfere with his ritual actions and disrupt his usual routine.
• In rare cases, Savant syndrome occurs when a child has some phenomenal abilities, for example, excellent memory, musical talent, the ability to draw, and others. There is a very small percentage of such children.

Portrait of an autistic child

If parents carefully monitor their baby, they will immediately notice deviations in his development. They may not be able to explain what worries them, but they will say with great accuracy that their child is different from other children.

Autistic children differ significantly from normal and healthy children. The photos clearly demonstrate this. Already in the revival syndrome, they react weakly to any stimuli, for example, to the sound of a rattle.

Such children begin to recognize even the closest person - their mother - much later than their peers. Even when they recognize her, they never reach out, smile, or react in any way to all her attempts to communicate with them.

Such children can lie for hours and look at a toy or a picture on the wall, or they may suddenly become afraid of their own hands. If you look at how autistic children behave, you will notice their frequent rocking in a stroller or crib, and monotonous hand movements.

As they get older, such children do not look more alive; on the contrary, they differ sharply from their peers in their detachment and indifference to everything that happens around them. Most often, when communicating, they do not make eye contact, and if they do look at a person, they look at clothes or facial features.

They do not know how to play group games and prefer loneliness. May be interested in one toy or activity for a long time.

The characteristics of an autistic child may look like this:

1. Closed.
2. Detached.
3. Unsociable.
4. Detached.
5. Indifferent.
6. Those who do not know how to make contact with others.
7. Constantly performing stereotypical mechanical movements.
8. Poor vocabulary. The pronoun “I” is never used in speech. They always talk about themselves in the second or third person.

In the children's group, autistic children are very different from ordinary children, the photos only confirm this.

The world through the eyes of an autist

If children with this disease have the skills to speak and construct sentences, then they say that the world for them is a complete chaos of people and events that is completely incomprehensible to them. This is due not only to mental disorders, but also to perception.

Those stimuli from the outside world that are quite familiar to us are perceived negatively by an autistic child. Since it is difficult for them to perceive the world around them and navigate the environment, this causes them increased anxiety.

When should parents be wary?

By nature, all children are different, even completely healthy children differ in their sociability, pace of development, and ability to perceive new information. But there are some points that should alert you:

If you notice at least some of the signs listed above in your child, then you should show him to the doctor. The psychologist will give the right recommendations for communication and activities with the baby. Helps determine how severe the symptoms of autism are.

Treatment of autism

It will not be possible to almost completely get rid of the symptoms of the disease, but if parents and psychologists make every effort, it is quite possible that autistic children will acquire communication and self-help skills. Treatment must be timely and comprehensive.

Its main goal should be:

• Reduce tension in the family.
• Increase functional independence.
• Improve quality of life.

Any therapy is selected individually for each child. Methods that give excellent results with one child may not work at all with another. Improvements are observed after using psychosocial assistance techniques, which suggests that any treatment is better than no treatment.

There are special programs that help the child master communication skills, self-help, gain work skills, and reduce the symptoms of the disease. The following methods can be used in treatment:

In addition to such programs, drug treatment is usually used. Anti-anxiety medications are prescribed, such as antidepressants, psychotropics, and others. You should not use such medications without a doctor's prescription.

The child’s diet should also undergo changes; it is necessary to exclude foods that have a stimulating effect on the nervous system. The body must receive a sufficient amount of vitamins and minerals.

Cheat sheet for parents of autism

When communicating, parents must take into account the characteristics of autistic children. Here are some brief recommendations that will help you establish contact with your child:

1. You must love your baby for who he is.
2. Always consider the child's interests.
3. Strictly observe the rhythm of life.
4. Try to develop and observe certain rituals that will be repeated every day.
5. Visit the group or class where your child is studying more often.
6. Talk to your baby, even if he doesn't answer you.
7. Try to create a comfortable environment for games and learning.
8. Always patiently explain the stages of the activity to your child, preferably supporting this with pictures.
9. Don't get overtired.

If your child has been diagnosed with autism, then do not despair. The main thing is to love him and accept him for who he is, and also to constantly study and visit a psychologist. Who knows, maybe you have a future genius growing up.