This article was revised and reviewed by Dr. Yang Bin, director of the Children's Health and Mental Health Center of Shenzhen Children's Hospital
When children of the same age begin to learn to speak, but their children still can't look at people, they can't look at each other, what is wrong?
When children of the same age can play with their peers, but my child only loves to play by himself, is he autistic?
What exactly is autism? From suspected to confirmed, how to put the confusion and panic of parents?
We have found the most authoritative answer to these dilemmas.
In 2010, the Ministry of Health (now the National Health Commission) commissioned the Chinese Medical Association to formulate the "Guidelines for the Diagnosis and Treatment and Rehabilitation of Children's Autism", which details the symptoms, treatment methods and prognosis of autism at different stages. This article can help you identify the above problems and provide a more comprehensive rehabilitation guide.
A brief description of autism
Childhood autism, also known as childhood autism, is a neurodevelopmental disorder that begins early in the onset (usually before the age of 3 years) and is characterized by disorders of social communication and social interaction, narrow interests, repetitive stereotypes, and sensory abnormalities.
In DSM-5, autism spectrum disorder (ASD) replaces the concept of pervasive developmental disorder (PDD). Autism, Asperger's syndrome, Rett's syndrome, childhood disintegration disorder, and generalized developmental disorders unclassified in DSM-IV are no longer listed separately and are collectively referred to as autism spectrum disorders.
The results of the second national sampling survey of persons with disabilities show that children with mental disabilities (including multiplex) aged 0-6 in China account for 1.10 ‰ of the total number of children aged 0-6, about 111,000, of which 36.9% are mentally disabled children caused by autism, about 41,000. Childhood autism is more common in boys, and its prevalence is not related to race, geography, culture and socio-economic development.
Childhood autism is a biologically based developmental disorder caused by a variety of factors, and is a disease that occurs under the influence of specific environmental factors in individuals with genetic predisposition. Genetic factors are the main cause of autism in children. Environmental factors, especially those exposed to during critical periods of fetal brain development, can also lead to an increased likelihood of morbidity.
Manifestations of autism in life
Childhood autism begins early in the onset (usually before the age of 3 years), of which about 2/3 of children gradually onset after birth, and about 1/3 of children undergo 1 to 2 years of normal developmental degenerative onset.
The symptoms of autism in children are complex, but they are mainly manifested as the following 2 groups of core symptoms.
01
Social communication and social interaction disorders
Children with autism have qualitative defects in social interaction, and they lack interest in interacting with people to varying degrees, and also lack normal communication methods and skills. Specific manifestations vary with age and severity of the disease, with communication disorders with children of the same age being the most prominent.
(1) Infancy
The child avoids eye contact, lacks interest and response to the calls and teasing of others, does not expect to be picked up or is stiff when picked up, does not want to be close to people, lacks a social smile, and does not observe and imitate the simple movements of others.
(2) Early childhood
Children still avoid eye contact, often ignore them, often do not develop attachment to the main caregiver, lack of fear of strangers, lack of interest in interacting and playing with children of the same age, and there are problems with communication methods and skills. Children do not draw attention to what they are referring to through their eyes and voices, do not share happiness with others, do not seek comfort, do not express comfort and concern for the physical discomfort or unhappiness of others, and often do not play imaginative and role-playing games.
(3) School age
With age and improvement of the disease, children may become friendly and affectionate with their parents and compatriots, but still lack interest and behavior in active interaction with others to varying degrees. Although some children are willing to interact with others, there are still problems with communication methods and skills. They often entertain themselves, come and go alone, go their own way, do not understand and it is difficult to learn and follow the general rules of society.
(4) Adulthood
Patients still lack interest and skills in social interaction, although some patients are eager to make friends, and may also be interested in the opposite sex, but because of the lack of due understanding of social situations, lack of appropriate response to the interests and emotions of others, it is difficult to understand humor and metaphors, etc., it is more difficult to establish friendships, love and marriage relationships.
Children with autism may have barriers to verbal and nonverbal communication. Among them, verbal communication disorders are often the most important reason for children to see a doctor.
(1) Speech communication disorders
The main manifestations of speech communication disorders are delayed or absent speech development, impaired speech comprehension, abnormal speech form and content, and abnormalities in intonation, speed, rhythm, and stress.
Children often speak late and speak slowly after speaking. Children with late onset may have a relatively normal stage of speech development, and speech may gradually decrease or even disappear completely after onset. Some children remain speechless for life.
Children's speech comprehension ability is impaired to varying degrees, and those with mild diseases are often unable to understand humor, idioms, metaphors, etc.
For children with speech, there are often obvious abnormalities in the form and content of speech. Children often have immediate imitation of speech, that is, repeating what others have just said; delayed imitation of speech, that is, repeating words or advertising slogans that have been heard in the past; stereotyped repetition of speech, that is, repeated repetition of some words, saying a thing, or asking a question.
Children may communicate with others in special, fixed verbal forms, and there are manifestations such as non-answers, lack of connection between sentences, incorrect grammatical structures, and unclear identification of personal pronouns.
Children's intonation is often relatively flat, lack of depression and frustration, can not use intonation, tone of voice changes to assist communication, often have problems with speed and rhythm.
At the same time, the child's speech organization and use ability are significantly impaired. Children with fewer active speeches will not express wishes or describe events with the words they have learned, will not take the initiative to propose topics, maintain topics, or communicate only on the stereotypical words that they are interested in, repeatedly telling the same thing or entangled in the same topic. Some children use specific self-created phrases to express fixed meanings.
(2) Nonverbal communication disorders
Children with autism often hold other people's hands and reach out to the objects he wants, but other expressions, movements, and postures for communication and communication are few and difficult to integrate effectively with verbal communication. Most of them do not use nods, shakes of the head, gestures and movements to express their thoughts, and their expressions often lack change when interacting with people.
02
Narrow interests and stereotyped behavior
Children with autism tend to respond to their daily lives in a rigid, stereotyped way. The specific performance is as follows:
(1) Narrow range of interests
Children have less interest and are often different from what they are interested in. Children are usually not interested in toys, cartoons and other things that are of interest to normal children, but are obsessed with watching TV commercials, weather forecasts, rotating objects, arranging objects or listening to a certain piece of music, a kind of monotonous repetitive sound, etc.
Some children can focus on text, numbers, dates, timetable calculations, maps, drawings, instrument playing, etc., and can show unique abilities.
(2) Stereotypical repetition of behavior
Children often insist on doing things the same way, rejecting the laws of daily life or changes in the environment. If the routine of daily life or the environment changes, the child will be irritable.
Children will play with toys in the same way repeatedly, draw a picture or write a few words repeatedly, insist on taking a fixed route, insist on putting objects in a fixed position, refuse to change other clothes or eat only a few foods.
(3) Special attachment to inanimate objects
Children usually lack interest in humans or animals, but may have a strong attachment to some inanimate objects, such as bottles, boxes, ropes, etc. may make children love and carry them at any time. If it is taken away, it will be irritable, crying, anxious.
(4) Stereotyped repetitive weird behavior or perceptual abnormalities
Children often have stereotyped repetitive and strange movements, such as repeated jumping, clapping, placing their hands in front of their eyes to flutter and stare, and walking on tiptoes. There may also be special interests and behaviors in some non-primary, non-functional properties (smell, texture) of objects, such as repeatedly smelling objects or touching smooth surfaces. Sluggishness of pain, temperature, sensitivity to specific sounds, gazing at light or movement, and fond of smelling it with his nose.
03
Other manifestations
In addition to the above core symptoms, children with autism often have self-laughter, emotional instability, impulsive aggression, self-injury and other behaviors. Cognitive development is often unbalanced, and music, mechanical memory (especially text memory), and computing ability are relatively good or even abnormal.
Most children also have comorbidities such as sleep disturbances, mental retardation, attention deficits, Tourette's syndrome, and epilepsy. The above symptoms and concomitant diseases make the child's condition complex, increase the difficulty of diagnosis, and require more treatment and intervention.
How is autism diagnosed?
Childhood autism is diagnosed primarily through the collection of medical history, psychiatric examination, physical examination, psychological assessment and other ancillary tests, and is based on diagnostic criteria.
Take a history
First of all, we must understand the growth and development process of the child in detail, including the development of movement, speech, cognitive ability and so on. Interviews are then conducted on areas of developmental backwardness and behaviors that cause parents to feel abnormal, noting the age, duration, frequency, and extent of their impact on daily life.
At the same time, it is also necessary to collect information such as maternal history, family history, previous disease history and medical history.
The main points of consultation are as follows:
(1) The most important problem for children at present? When did it start?
(2) History of speech development
When is there a reaction to calling him/her by name? When will I start learning to speak, such as pronouncing a single sound of "dada, mama"? When can I talk about phrases? When can I speak a sentence? Is there a regression in speech function? Are there any inflection abnormalities?
(3) Verbal communication skills
Will you answer questions from others? Will you actively communicate with others? Is there difficulty communicating? Is there self-talk, repetitive imitation speech? Are there meaningless sounds such as twitter and grunt?
(4) Non-verbal communication ability
Do you use gestures and gestures to express your needs? When do you point your finger at an object, an image? Is there a tendency to replace verbal communication with nonverbal communication? Are facial expressions as rich as those of children of the same age?
(5) Social communication skills
When can I distinguish between a loved one and a stranger? When did you start to be afraid of life? Is there an attachment to the primary dependant? When will you point something with your finger to get someone's attention? Do you respond to a call? Do you avoid making eye contact with people? Have you ever played imaginative games such as home? Can I play with other children and how can I play with them? Will you comfort others or ask for help?
(6) Cognitive ability
Is there a regression in cognitive ability? Is there an extraordinary ability? What about the ability to take care of yourself in life? Is there a regression in the ability to take care of oneself?
(7) Interest behavior
What is the game ability? Is it age-equivalent? Are there special interests or quirks? Is there too much or too little activity? Are there repetitive weird hand or body movements? Do you rotate objects repeatedly? Is there a special attachment to an object?
(8) Athletic ability
When can I look up, sit alone, climb, and walk? How coordinated is the movement? Is there a deterioration or ataxia of motor skills?
(9) Family history
Are there any parents or other relatives with strange personalities, cold, stereotypical, sensitive, anxious, stubborn, lack of verbal communication, social interaction disorders or speech development disorders? Is there a history of mental illness?
(10) Others
What is the family nurturing environment? Have you ever had significant psychological trauma or shock? Do you go to school or kindergarten? Adapting to the situation in school? Have you ever had a serious medical condition? Have you experienced malnutrition, hospitalization, or separation from a loved one due to a physical illness? Do you have seizures? Are there any special medications used? Is it partial to food? How about sleep?
Psychiatric examination
Observational methods are mainly used, and children with speech skills should be combined with conversation.
The key points of the inspection are as follows:
(1) How does the child react to the unfamiliar environment, strangers and parents leaving?
(2) Is the child's speech comprehension and expression development level comparable to age? Is there stereotypical repetitive speech, immediate or delayed imitation speech, and self-stimulating speech? Is it possible to talk around a topic and follow instructions?
(3) Does the child avoid making eye contact with others? Do you use gestures, dotted shaking or other movements, poses, and facial expressions to communicate?
(4) Does the child have empathy? If the parent or examiner pretends to be injured and painful, does the child react? What was the reaction?
(5) Is the child interested in toys and surrounding objects? How are toys used and how can they be played?
(6) Does the child have stereotyped movements, compulsive ritual behaviors, and self-injurious behaviors?
(7) Is the level of the child's intelligent development comparable to age? Are there relatively good or special abilities?
physical examination
It is mainly physical development, such as head circumference, facial features, height, weight, presence or absence of congenital malformations, audiovisual accessibility, and whether there are positive signs of the nervous system.
04
Psychological assessment
(1) Commonly used screening scales
Autism Behavior Scale (ABC): A total of 57 items, each with a 4-level score, a total score of ≥31 to indicate the presence of suspicious autism-like symptoms, and a total score of ≥ 67 to indicate the presence of autism-like symptoms, suitable for people aged 8 months to 28 years.
Autism Behavior Scale (CABS): 14 items in total, each with a 2 or 3 grade rating. The overall score of the 2th grade ≥ 7 or the 3rd score ≥ 14 points, suggesting a suspicious autism problem. This scale is aimed at people aged 2 to 15 years old and is suitable for rapid screening of children in child care clinics, kindergartens, schools, etc.
When the results of the above screening scale are abnormal, the child should be referred to a professional institution for further diagnosis in a timely manner.
(2) Commonly used diagnostic scales
The Childhood Autism Assessment Scale (CARS) is a commonly used diagnostic tool. The scale consisted of 15 items, each with a 4-level rating. The total score < 30 is non-autistic, the total score of 30 to 36 is mild to moderate autism, and the total score is ≥ 36 is severe autism. This scale is suitable for people over 2 years of age.
When using the screening scale, full account of possible false-positive or false-negative results. The results of the diagnostic scale are also used only as a reference for the diagnosis of autism in children and are not a substitute for the clinician's comprehensive medical history, psychiatric examination and diagnosis based on diagnostic criteria.
(3) Developmental assessment and intelligence test scale
Scales available for developmental assessment are the Denver Developmental Screening Test (DDST), the Geisel Developmental Diagnostic Scale (GDDS), the Portchi Early DevelopmentAlity Checklist, and the Psychoeducational Scale (PEP). Commonly used intelligence test scales include The Merriam-Webster Children's Intelligence Scale (WISC), Wechsler Preschool Children's Intelligence Scale (WPPSI), Stanford-Thani Intelligence Scale, Peabody Picture Vocabulary Test, Raven Progressive Model Test (RPM) and so on.
05
Adjunctive testing
Laboratory tests can be selected according to the clinical presentation, including electrophysiological tests (eg, EEG, evoked potential), imaging tests (eg, cranial CT or magnetic resonance), genetic tests (eg, karyotype analysis of chromosomes, fragility x chromosomes), metabolic disease screening, etc.
Diagnostic criteria for autism spectrum disorders
In DSM-5, patients collectively referred to as ASD must meet the following criteria A, B, C, and D.
A. There are persistent deficiencies in social communication and social interaction in a variety of settings, manifested in the present or in the past. (The following are exemplary examples, but not all)
(1) Social-emotional interaction defects: mild people are manifested as abnormal social contact and inability to carry out back-and-forth dialogue, moderate performance is manifested as lack of shared sexual interest, emotions and emotions, social response is reduced, and heavy people are completely unable to initiate social interaction.
(2) Nonverbal communication behavior defects for social interaction: mild manifestations are difficulty integrating verbal and nonverbal communication, moderate manifestations are eye contact and body language abnormalities, or defects in understanding and use of nonverbal communication, and severe cases are completely lacking in facial expressions or gestures.
(3) Establish or maintain interpersonal defects consistent with their level of development (except for relationships with the caregiver): the light ones show difficulty adjusting their own behavior to adapt to different social scenarios, the moderate ones show difficulties in playing imaginative games and making friends, and the heavy ones have obviously no interest in others.
B. Restricted, repetitive patterns of behavior, interests, or activities (present or past, at least in one of the following aspects).
(1) The use of stereotypes or repetitions of language, actions or objects (such as simple stereotyped actions, echo language, repeated use of objects, strange sentences).
(2) Excessive adherence to certain conventional and verbal or non-verbal ritual behaviors, or excessive resistance to change (e.g., athletic ritual behavior, adherence to the same route or food, repeated questioning, or extreme pain for subtle changes).
(3) Highly narrow, fixed interests that are abnormal in intensity and attention (such as strong attachment or obsession with unusual objects, excessive limitations or sustained interest).
(4) Overreacting or low response to sensory stimuli, showing abnormal interest in sensory stimuli in the environment (such as numbness to pain, heat, and cold sensations, negative reactions to certain specific sounds or materials, excessive sniffing or touching of certain objects, addiction to light or rotating objects).
C. Symptoms must be present early in development (but the deficit may not be fully apparent until social needs exceed limited capacity, or may be masked by acquired strategies).
These symptoms cannot be better explained by intellectual disability or generalized developmental delay.
When making a combined diagnosis of intellectual disability and ASD, social communication should be lower than the expected overall level of development. These symptoms cannot be better explained by intellectual disability or general developmental delay. When making a combined diagnosis of intellectual disability and ASD, social communication should be lower than the expected overall level of development.
differential diagnosis
Childhood autism needs to be distinguished from other common psychiatric and neurological disorders in children.
Speech and language development disorders
The disorder is manifested by significantly lower than desirable levels of verbal comprehension or presentation skills. Children have no obvious barriers to nonverbal communication, good social interactions, and no narrow interests and stereotyped repetitive behaviors.
Intellectual developmental disorders
The main manifestations of children with intellectual developmental disabilities are mental retardation and poor social adaptability, but still retain communication skills comparable to their intelligence, there is no impairment of social interaction and verbal communication characteristic of autism, and narrow interests and stereotyped, repetitive behaviors are not as prominent as those of children with autism.
Schizophrenia in children and adolescents
Schizophrenia in children and adolescents occurs in adolescence, and rarely in the preschool period, and no onset before the age of 3 years has been reported, which is different from the usual onset of autism in children in infancy and early childhood.
Some of the clinical manifestations of this disease are similar to those of children, such as isolation, self-laughter, emotional indifference, etc., and there are also psychotic symptoms such as hallucinations, pathological fantasies or delusions.
Children with this disorder may have reduced speech or even silence, but speech function is not substantially impaired, and speech function can be gradually restored as the disease remissions. The therapeutic effect of schizophrenia in children and adolescents is significantly better than that of children with autism, and some children can reach the level of full recovery after drug treatment.
Attention deficit hyperactivity disorder
The main clinical features of attention deficit hyperactivity disorder are attention deficits and hyperactivity, impulsive behavior, but normal intelligence. Children with autism, especially those with normal intelligence, also often have behavioral manifestations such as inattention and hyperactivity, which are easily confused with children with attention deficit hyperactivity disorder.
The main point of identification is that children with attention deficit hyperactivity disorder do not have impairment of social communication ability, stereotyped behavior, and narrow interests.
other
Other conditions that need to be distinguished from childhood autism include severe learning disabilities, selective mutism, and obsessive-compulsive disorder.
How is autism treated?
Treatment of autism in children is based on educational interventions, and pharmacotherapy is used for the treatment of comorbidities. Because children with autism in children have many developmental disorders and emotional and behavioral abnormalities, comprehensive interventions combining educational interventions, behavior modification, and drug therapy should be used according to the specific conditions of the children.
Educational interventions
The purpose of educational interventions is to improve core symptoms while promoting intellectual development, cultivating the ability to live independently and independently, reducing the degree of disability, improving the quality of life, and striving to enable some children to have the ability to study, work and live independently in adulthood.
1. Principles of intervention
(1) Early long-range. Early diagnosis, early intervention, long-term treatment, and an emphasis on daily interventions should be made. Timely educational intervention should also be carried out for suspicious children.
(2) Scientific system. Clear and effective methods should be used to carry out systematic educational interventions for children, including intervention training for the core symptoms of autism, as well as training in promoting children's physical development, preventing and treating diseases, reducing nuisance behavior, improving intelligence, and promoting self-care and social adaptability.
(3) Individual training. For children with autism in children with symptoms, intelligence, behavior and other problems, on the basis of assessment, planned individual training is carried out. For children with severe childhood autism, the teacher-student ratio should be 1:1 during early training. Group training should also be grouped according to the child's developmental level and behavioral characteristics.
(4) Family participation. Families should be given a full range of support and education, increase family participation, help families assess the appropriateness and feasibility of educational interventions, and guide families to choose scientific training methods. Family financial situation, parental mentality, environmental and social support can all affect the prognosis of the child. Parents should accept the facts and properly handle the relationship between the child's educational intervention and life and work.
Intervention methods
1. Behavioral Analysis Therapy (ABA)
ABA adopts the principle of behaviorism, focusing on positive reinforcement, negative reinforcement, differentiated reinforcement, regression, differentiation training, generalization training, punishment and other techniques to correct various abnormal behaviors in children with autism and promote the development of children's abilities.
At the heart of the classical ABA is the Behavioral Turn-Based Training Method (DTT), which is characterized by specificity and practicality, with the main steps including the trainer giving instructions, the child's response, and the trainer's response to the response and pausing.
Modern ABA incorporates other technologies on the basis of the classic ABA, with more emphasis on emotional and interpersonal development, taking different steps and approaches according to different goals.
The following steps are taken to promote the development of children with autism and help children learn new skills:
The child's behavior and abilities are assessed and the target behavior is analyzed.
Decompose the task and gradually intensify the training, and train only one decomposition task in a certain period of time.
Each child must give a reward (positive reinforcement) for completing a decomposition task, and the rewards are mainly food, toys, and verbal and physical posture praise, and the reward gradually fades with the child's progress.
Using hinting and fading techniques, different levels of prompting or help are given according to the child's ability, and the prompts and help are gradually reduced as the child becomes proficient in what he or she has learned.
A short break is required between the two tasks.
(2) Treatment education course for children with autism and related disorders (TEACCH)
Principle and purpose: Although children with autism in children have extensive developmental disorders, they have certain advantages in vision. The child's visual advantages should be fully utilized to arrange the educational environment and training procedures to improve the child's understanding and obedience to the environment, education and training content, so as to comprehensively improve the child's defects in language, communication, perception and movement.
steps:
Arrange training venues according to different training contents, and emphasize visual cues, that is, special arrangements for training sites, special placement of toys and other items.
Establish a training schedule and pay attention to the proceduralization of training.
Determine the training content, including children's imitation, coarse and fine movements, perception, cognition, hand-eye coordination, language comprehension and expression, life self-care, social and emotional emotions.
In terms of teaching methods, it is required to make full use of various methods such as language, body posture, prompts, labels, charts, and words to improve children's understanding and mastery of training content. At the same time, the principle of behavior reinforcement and other behavior modification techniques are used to help children overcome abnormal behaviors and increase good behavior.
The course is suitable for use in hospitals, rehabilitation institutions and at home.
(3) Interpersonal Development Intervention (RDI)
RDI is representative of interpersonal training. Other methods include floor time, picture exchange communication system, and joint attention training.
Principle: It is currently believed that the deficit of common attention and the defect of psychological theory are the core defects of childhood autism. Common attention deficit is when a child is unable to develop the ability to pay attention to something at the same time as a caregiver from infancy, as a normal infant does. Psychological theory defects mainly refer to the lack of ability of children to speculate on the psychology of others, which is manifested by lack of eye contact, inability to form common attention, inability to distinguish the facial expressions of others, etc., so the children have no social reference ability, cannot share feelings and experiences with others, and cannot establish feelings and friendships with relatives.
Through interpersonal relationship training, RDI improves the common attention ability of the child, deepens the child's understanding of the psychology of others, and improves the child's interpersonal skills.
Assessment determines the child's level of interpersonal development.
According to the assessment results, in accordance with the law and order of normal children's interpersonal development, the ability training such as gaze, social reference, interaction, coordination, emotional experience sharing and friendship is gradually carried out in turn.
Carry out a gradual and diversified training and game activity program. The activities are mostly led by parents or training teachers, and include a variety of interactive games, such as eye contact, expression recognition, hide-and-seek, "two people and three legs", throwing and catching balls, etc. Trainers are required to have rich and exaggerated expressions in training, but they are real, and their tone is depressed.
(4) Other intervention methods
Floor time training also takes interpersonal and social interaction as the main content of training, unlike RDI, floor time training is based on the activities and interests of the child to determine the content of training.
During the training, the trainers constantly create changes, surprises and difficulties while cooperating with the children's activities, and guide the children to improve their problem-solving skills and social communication skills in a free and pleasant time. Training activities are distributed at various times of daily life.
Time, economy and other factors should be fully considered, and adjuvant treatment methods such as sensory integration therapy and auditory integration therapy should be carefully selected.
drug therapy
There is a lack of drugs that target the core symptoms of autism in children, and are symptomatic treatments for comorbidities or aggressive behaviors. When using drugs to treat autism in children, the principle of weighing development, the principle of balancing the side effects and efficacy of the drug, the principle of informed consent, the principle of single symptomatic medication, and the principle of gradual dose increase should be observed.
What determines the future of a child with autism?
In recent years, with the improvement of diagnostic ability, early intervention, and the quality of rehabilitation training, the prognosis of autism in children is gradually improving. Some children with autism can achieve normal levels of cognition, social adaptability, and social skills.
The prognosis of childhood autism is influenced by a number of factors, including:
Time of diagnosis and intervention
Early diagnosis and long-term systematic intervention in children during periods of strongest developmental plasticity (generally before the age of 6 years) can maximize prognosis. Early diagnosis and early intervention are particularly important in children with mild, mentally normal, or near-normal autism.
Early verbal communication skills
Early verbal communication ability is closely related to the prognosis of childhood autism, and those who have better speech function in the early stages (before the age of 5 years) or before the diagnosis of childhood autism are generally better.
Severity of illness and level of intelligence
The prognosis of children with autism is greatly influenced by the severity of the disease and the level of intelligence. The more severe the disease, the lower the intelligence, the worse the prognosis; conversely, the milder the child's illness, the higher the intelligence, and the better the prognosis.
Whether there is a concomitant disease
The prognosis of children with autism in children is also associated with concomitant disease. If the child is accompanied by diseases such as nodular sclerosis, mental retardation, epilepsy, etc., the prognosis is poor. Fully understanding the factors affecting the prognosis of children and actively taking therapeutic measures are of great significance to improving the child's condition and promoting the development of children.
In the next issue, we will continue to explore whether there is a need for medication in the autistic community. Have you ever struggled with medication when you were rehabilitating your child? Feel free to share your experience in the comments section
Resources:
Chen Shunsen,Bai Xuejun,Zhang Risheng. Symptoms, diagnosis and intervention of autism spectrum disorder[J].Advances in Psychological Science,2011,19(01):60-72.
[2] Zou Xiaobing,Deng Hongzhu. Interpretation of "Diagnostic Criteria for Autism Spectrum Disorders", 5th Edition of the American Diagnostic Classification Manual for Mental Disorders[J].Chinese Journal of Practical Pediatrics,2013,28(08):561-563.
[3] American Psychiatric Association, American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5[J]. Arlington, VA, 2013.
[4]http://www.gov.cn/zwgk/2010-08/16/content_1680727.htm
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Editor| Yuyu Dangdang Editor-in-Chief | Qin Yu