Click on the Shaw Hospital star
There is a group of children
They are called "children of the stars"
They are lonely people with autism
April 2, 2022
It is the 15th World Autism Day
Is autism far away from us?
Do you also have a lot of misunderstandings about autism?
Do you think so
Is autism an introvert?
In fact, autism spectrum disorder (ASD) is a type of neurodevelopmental disorder that begins in infancy and childhood, with social interaction disorders, communication disorders, limited interests, and stereotyped repetitive behaviors as the main clinical manifestations, and most patients have intellectual disabilities, which is completely different from simple personality introversion.
Children without a family history of autism
Won't autism occur?
Not.
Autism is caused by a combination of environmental, biological and genetic factors, but the pathogenesis mechanism has not been fully elucidated.
Genetic factors can explain about 10% to 30% of the causes of autism.
However, the study found that heavy metals and biological heterologous substances (such as pesticides, preservatives, etc.), exposure to chemicals during pregnancy, intestinal abnormalities, intestinal microbial abnormalities, poor diet and nutrition habits, metabolic abnormalities, and immune abnormalities are all related to the occurrence of autism.
Causative factor of autism
1
Bio-heterologous substances/heavy metals
Pesticides, pesticides, additives and preservatives; heavy metals such as arsenic, lead, mercury, cadmium, antimony and manganese.
2
Pregnancy
Uterine infections, pregnancy complications, chemicals, environmental pollution, perinatal and postpartum health status, nutritional intake, age, medications.
3
Intestinal
Inflammation, breakage and ulceration of the intestine, leaky gut.
4
Gut microbes
Clostridium (Clastndlum)
Vibrio desulfurization (Desulfovibrio)
Sutterella
Ruminococcus spp. (Ruminocaccus)
Yeast
Firmicules
and Bacteroidetes
5
Diet and health
Partial eating, picky eaters; protein, amino acids, vitamins, trace elements, essential unsaturated fatty acids.
6
metabolism
Indole, faecourin, tyrosine, tryptophan, glutathione, dopamine, serotonin, norepinephrine, sulfates, fatty acids, short-chain fatty acids.
7
Allergies and autoimmunity
Autoantibodies, immune cytokines, hygiene hypothesis.
8
Genes, chromosomal abnormalities, etc
GENES such as CNTNAP2, SHANKs, NLGN4X, NRXN1 and TOP1 as well as fragile X chromosomes, mental retardation-related protein genes, etc.
Is autism rare or far away from you?
The incidence of autism on the mainland is about 1%, which is not a negligible number.
The 2019 "Report on the Development of Autism Education and Rehabilitation Industry in China" shows that the number of autistic children aged 0 to 14 years may have exceeded 2 million, and showed an upward trend year by year (Sun et al., 2019).
Is autism a hurtful and abrasive disease?
This is indeed the case for the primary caregivers of children with autism.
Surveys have confirmed that the quality of life of primary caregivers of children with autism is significantly affected, possibly due to the unsatisfactory prognosis of autistic patients, the need for long-term companionship, and long-term treatment. There are reports that the economic expenditure of people with autism in the United States is as high as $137 billion per year.
How to determine whether a child is autistic or not?
Here, we propose some of the core symptoms of autism that need to be vigilant if your child (18 to 24 months old) has the following manifestations:
● Do not like to play with other children;
● Dislike of playing imaginary games (such as passing the house);
● Do not point your finger at something of interest;
● Won't show you anything;
● Will not imitate your movements or expressions;
● When you point to the toy on the other side, he or she will not look at that side;
When he or she is exposed to something new, he or she does not look at your expression or pay attention to your reaction.
When you observe and think that your child meets the above 2 or more items, he or she is more likely to have autism, and it is recommended to seek medical attention as soon as possible.
If your child is older than 18 to 24 months old, but has had or currently exhibited 2 or more of the above manifestations at this age, we recommend that you take your child to the hospital's pediatric department or mental health center for medical evaluation.
Graded screening process for autism
Here's the recommended graded screening process: The 2020 Clinical Report from the American Academy of Pediatrics recommends standardized screening for ASD at 18 and 24 months of age, with ongoing developmental monitoring.
Domestic researchers have developed a set of procedures for autism screening in children in the community: when young children undergo vaccination or routine physical examination at 18 months, they use the "Early Childhood Autism Screening Form (Chinese Edition)" (CHAT-23) to do preliminary screening in community hospitals; those who are positive for screening need to be transferred to secondary or tertiary hospitals for further screening with part B of CHAT-23; those who are positive for initial screening and anyone who passes screening but is screened by non-specialists, Children suspected of ASD by teachers or parents are evaluated and diagnosed by a tertiary hospital specialist, and a specialist history is established for those who are abnormal, and they are listed as follow-up interventions.
Is autism an incurable disease?
For the treatment of autism, contemporary treatment methods focus on three major aspects: behavior modification treatment, special education training, and drug treatment. Both behavior modification and special education training require a lot of time and effort, so it is closely related to the family's financial situation and the attitude of parents. In terms of drugs, there are currently no specific drugs approved to treat autism.
Although there is currently no definitive cure for autism, this does not mean that autism cannot be improved.
Studies have found that repeated transcranial magnetic stimulation therapy and oxytocin intervention have great potential in the treatment of autism.
Repeat transcranial magnetic stimulation (rTMS)
Repetitive transcranial magnetic stimulation (rTMS) is a kind of use of pulsed magnetic field to act on the central nervous system, through the rapidly changing extracranial magnetic field to induce a sufficiently large local intracranial current, causing short-term functional reorganization of neurons in the cerebral cortex, and causing temporary changes in the structure and function of the interconnected cerebral cortex, which in turn produces therapeutic effects.
In recent years, more and more researchers have believed that lesions or deformities in the functional column of the brain and intracellular GABA may be responsible for autism. On this basis, the researchers found that rTMS stimulation is suitable for intervening in the brain function column, and the lower frequency rTMS is more sensitive. Foreign studies have found that after rTMS intervention, the typical behavioral symptoms of autistic individuals such as high mobility, irritability, stereotypes and obsessive behaviors have been significantly reduced, and brain function and autonomic nervous system have also improved to a certain extent.
Relevant studies in China have also found that after the rTMS intervention, the behavior and sleep status of children with autism have improved significantly.
Repeat the transcranial magnetic stimulation (rTMS).
How secure is it?
rTMS has the characteristics of non-invasive, safe and clear efficacy, and has been widely used in the treatment of various neuropsychiatric diseases such as post-stroke rehabilitation, depression, and obsessive-compulsive disorder.
The side effects of rTMS treatment are mostly some mild discomfort symptoms such as headache, drowsiness, facial discomfort, etc. Epilepsy may be the most serious side effect caused by rTMS, mainly induced by high-frequency rTMS, but low-frequency rTMS can inhibit seizures.
All in all, low-frequency rTMS is a relatively safe intracranial stimulation technique with good tolerance and high safety in the treatment of pediatric and adolescent patients, suitable for autistic patients of lower age groups such as children and adolescents.
Oxytocin
Oxytocin is a neuropeptide hormone synthesized by the hypothalamus and released by the posterior lobe of the pituitary gland, which is common in humans and animals, both men and women.
As the name suggests, oxytocin has a oxytocin and lactation effect, but in addition to this, oxytocin also helps to build trust and social relationships between individuals, so it is also called "social hormone".
Oxytocin levels differ markedly between autistic and healthy children, and children with low oxytocin show more social barriers.
Studies have confirmed that exogenous and induced oxytocin can restore the social behavior of mouse models of autism, and a number of clinical studies abroad have shown that intranasal oxytocin spray administration has an improving effect on the social ability and executive ability of autism, and the concentration of blood oxytocin before treatment may also predict the response to treatment. Oxytocin therapy is well tolerated and has great research prospects for the treatment of autism.
The research team of the Department of Mental Health at Run Run Shaw Hospital is conducting a study that innovatively adopts a new rTMS technology based on resting state functional magnetic resonance localization, combined with oxytocin to treat autism, aiming to develop effective treatments to improve brain function and clinical symptoms in autistic patients, promote the improvement of patients' social communication skills, and reduce family and social burdens.
Clinical trial recruitment information
Enrollment criteria
Autistic patients over the age of 9 years;
Both male and female;
In line with the diagnosis of autism spectrum disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), the Merriam-Webster Intelligence Scale score > 70 points and the Childhood Autism Rating Scale (CARS) > 30 points.
Patient benefits
Free comprehensive assessment of multiple autism specialties and specialist treatment guidance;
Free head MRI;
Depending on the individual situation, there is a chance to receive free 4 weeks of repeated transcranial magnetic stimulation therapy or 4 weeks of continuous oxytocin therapy.
Source: Run Run Shaw Hospital
Author: Department of Mental Health Tang Jinsong
Original works, reprinted please indicate the source and source
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