Children with autism are as simple and beautiful as stars, but they hang out of reach in the sky. They don't want to be so far away from their loved ones simply because they have a neurodevelopmental disorder called autism spectrum disorder (ASD) or autism for short.
In December 2007, the United Nations General Assembly adopted a resolution to designate April 2 as World Autism Awareness Day from 2008 onwards to raise awareness of the prevention, diagnosis, treatment and social integration of people with autism, and this year marks the 15th World Autism Day.
Guo Xuesong, director of the Rehabilitation Department of Harbin Children's Hospital, introduced that autism spectrum disorder is a complex neurodevelopmental disorder that can affect children's brain development, immune system, gastrointestinal function and other sensory systems. In recent years, the global prevalence of ASD has shown a significant increase trend. Statistics from the U.S. Centers for Disease Control and Prevention (CDC) report that the prevalence of ASD in eight-year-old U.S. children was 1 in 59 in 2018, 1 in 54 in 2020, and 1 in 44 on December 3, 2021. According to local epidemiological surveys in the mainland, the incidence of autism in China is 0.7%. As many as two million children with autism in children under the age of 14, accounting for the largest number of all types of mental disabilities. Its incidence is not related to race, region, culture, or level of economic development
ASD children are mainly unable to speak, talk late to see the doctor, the current parent awareness is also improving, there will be a small number of parents concerned that their children do not interact with friends of the same age and seek medical treatment. Although most parents find that their children are lagging behind, they still believe that "noble people are late" or have been diagnosed with language development delay, and do not receive systematic rehabilitation treatment in time. There are also many children who present early with onset of ongoing developmental delay with a partial prognosis of ASD and intellectual disability.
Director Guo Xuesong pointed out that in view of the fact that THERE are usually no significant features before the onset of ASD, it is easy to be ignored by parents, and if the following conditions occur before the age of 2, further evaluation is needed:
1. Lack of response to language laughter but are particularly sensitive to music and like to watch spinning things.
2, lack of interest in ordinary toys but very fascinated by some unconventional toys and items.
3, like to run back and forth or spin, will not play interactive games with people.
4. Lack of visual contact with people, no response.
5, will not take the initiative to use finger objects, when necessary to grab the adult hand to drag to the needed items.
6, until 18 months will not call Mom and Dad.
When we find something abnormal, we must go to a professional hospital as soon as possible to be diagnosed by a professional doctor. ASD is the result of early brain developmental changes and neural recombination, there are currently no biomarkers, ASD diagnosis is based on behavioral performance, based on DSM-V or ICD-10 as the standard, through medical history collection, psychiatric examination, physical examination, psychological assessment and other auxiliary tests (CT, MRI, EEG, evoked potential, etc.) to diagnose. Based on the fact that ASD has the characteristics of obvious polygenic diseases, it is recommended to do genetic metabolic screening such as total exons and CNV. Neuropsychological examination can understand the abnormalities of neuropsychological in children with autism, so as to judge the severity and prognosis of the disease, and it is of great significance to develop an individualized training plan, commonly used screening scaleS M-CHAT, CABS, ABC, autism spectrum screening questionnaire, autism quotient, etc.
Gold dry expectations are divided into three phases
1. Early intensive stage: mainly to improve children's basic learning skills
2. Integration preparatory stage: mainly train children to enter the reserve skills of the collective environment
3. Preschool integration stage: mainly to improve children's self-learning ability and self-learning ability in a collective environment
Theoretical ability, social skills between peers
Early high-risk prediction, enabling ultra-early screening
The Rehabilitation Department of Harbin Children's Hospital carried out the STAT scale to predict the early risk of 14-month-old infants, and achieved ultra-early screening. Diagnostic scales include CARS, ADI-R, and ADOS, of which ADI-R and ADOS are the "gold standards" for diagnosing ASD.
At the same time, the comprehensive psychological assessment also includes intelligence assessment (Wechsler intelligence test), social adaptability assessment (ABAS, S-M), social ability assessment (SRS), etc. Language-behavior assessment (VB-MAPP) and psycho-educational assessment for children with autism (PEP-3) provide scientific basis for formulating rehabilitation programs and determining efficacy. The above tests and diagnostic scales can be completed in hospitals.
Parents should not tangle in the diagnosis, because the child's state is developing and changing, the brain is in a period of rapid development, and the plasticity is strong. Countless examples tell us that early detection, early behavioral intervention and education can significantly improve the poor prognosis of children with ASD, and it is generally believed that the intervention effect before the age of 6 is more obvious, and the best dry expectation before the age of 4 years, the younger the age, the higher the training intensity, the better the effect. It is hoped that medical, educational, family, and social aspects will work together to hold up a blue sky for children with autism spectrum disorder.
Source: Harbin Children's Hospital
Author: Wei Ran
Editor-in-Charge: Xiao Fei