Don't let the "noble people speak late" delay the child, early recovery of autism is crucial

Teachers learn with children with autism in games. Beijing News reporter Wang Zicheng photographed

When Yang Yang was more than 2 years old, his mother noticed that he was different: he didn't talk much, he was a bit stubborn, and he didn't like to sleep. However, the idea of "noble people speaking late" made her ignore the strangeness of the child. It was not until the age of 4 that Yang Yang was diagnosed with typical autism at Beijing Children's Hospital.

April 2 is World Autism Day, experts remind that do not be delayed by the old concepts of "noble people speak late" and "boys talk late", and the early diagnosis and early rehabilitation of autistic children are crucial.

Most children with autism are accompanied by language problems

The diagnostic name of the autism norm is Autism Spectrum Disorder (ASD), which is a group of comprehensive mental development disorders that occur in infancy and childhood, and the prevalence of which is increasing year by year. Zhang Yan, an expert at the National Autism Rehabilitation Research Center of the China Rehabilitation Research Center, once pointed out in an interview with the Beijing News that it is generally believed that autism is a congenital brain development disorder caused by genetic abnormalities, and the specific gene type and pathogenic principle are still unclear and are still in the research stage.

Language development, like other neuropsychological developments, has certain regularities, and there will be multiple "developmental milestones" in the baby's growth process. For example, most babies can pronounce syllables such as "mama", "baba", "dada" and other unambiguous syllables at the age of 6 months; they can meaningfully call "daddy, mom" at the age of 1; and they can speak short sentences at the age of 2... "However, most children with autism will be accompanied by language problems, such as language delay or language regression. Ma Yang, deputy chief physician of the health center of Beijing Children's Hospital, said.

"Baby language development delay is only a symptomatic description, and the speech delay caused by different causes often behaves differently." For example, Ma Yang's language development process in children with autism is actually the most significant nonverbal communication disorder, that is, children may be prone to signs and postureal language development at the same time, such as bad eye contact, nod, shake head, etc., and there will be impaired language comprehension or no language. They also have a very important feature, that is, they are often accompanied by social disorders and lack of interest.

Children with mental retardation and dysarthria are slow in language development, and although they speak late, they basically have a willingness to socialize, are willing to communicate with others or can understand instructions. Ma Yang stressed that the clinical complexity is that the intellectual development is backward, dysarthria, autism, etc., and some clinical manifestations and symptoms are often intertwined and not easy to distinguish.

Ma Yang reminded parents that if the baby at home "talks late", do not go to language training after a simple assessment, but should check the real reasons behind it, choose the correct treatment plan and language training method, in order to achieve more with less.

Asperger's syndrome is not all genius

Among the loneliness spectrum disorders, 1/4-1/2 of the people with normal intelligence are called high-functioning autism, such children speak late and develop language slowly; there is also a class of autism with normal intelligence and almost no language disorder called Asperger's syndrome, which is also known as "genius disease". Cui Yonghua, director of the Department of Psychiatry at Beijing Children's Hospital, stressed that not every Asperger's syndrome is a genius, and only 15% of patients have extraordinary intelligence, such as Newton, Einstein, US President Jefferson, Beethoven, Mozart, Andersen, etc.

The prevalence of Asperger's syndrome is about 1%, of which the incidence in newborns is 0.7%, and the incidence in infancy is 1% to 1.2%, which is a widespread developmental disorder of the brain. As with common autism, Asperger's syndrome has more boys than girls because girls are better at adapting and pretending, they tend to be less active, and they are often mistaken for just being introverts.

Cui Yonghua said that clinically, asperger's syndrome is prominently misdiagnosed, and the diagnostic age is often 8-11 years old or even adolescents or adults. Many children who "curve to see a doctor" because they are "unsocial, isolated by their classmates, depressed, and not going to school" are treated as "depression or anxiety" and "ADHD" in most cases. Some children are even diagnosed with "anorexia" because of stereotypical behavior of eating only one or two foods. Between 18% and 23% of adolescent girls with anorexia nervosa also have symptoms of Asperger's syndrome.

Cui Yonghua introduced that the common symptoms of Asperger's syndrome include difficulty in language communication, difficulty in interpersonal communication, stereotyped behavior patterns, clumsy and unique movements, and slow emotional maturity. Although children with Asperger's syndrome can speak and speak fluently, their language development is slow, they can only state the language perfectly on the surface, they speak like endorsements, they have difficulty communicating in language, they can only understand the superficial literal meaning, they cannot joke, and their reading ability is poor. Because they have no communication skills, they are often regarded as "aliens". Some children fall into mental depression because they are aware of the difficulties of integrating with society, and about 1 in 3 children with Asperger's syndrome develop clinical depressive symptoms. Some children are addicted to imagination or show resistance, arrogance, etc.

Early recovery is essential for a child's development

Judging whether a child has autism can be judged by a test scale, social impairment, and abnormal behavior. Social disorders mainly refer to children's social communication and social communication skills; abnormal behaviors mostly refer to stereotyped behaviors and limited interests in children.

Parents can identify their children early through the "five no-behaviors", that is, "do not see, should not, do not refer, do not speak, inappropriate". Not seeing/seeing less refers to abnormal eye contact, decreased gaze on people, especially the eye area; should not/should be less, that is, the child's hearing is normal, but the parents' call is deaf, lack of common attention; no finger/little finger, refers to the child's lack of appropriate body movements to indicate needs, such as not shaking the head to indicate no, nodding to indicate need, etc.; no language / less language, that is, most children with autism will have language delays and other phenomena; improper, it is inappropriate use of objects, or related perceptual abnormalities.

Once the child is found to be abnormal, you should seek medical treatment as soon as possible, early rehabilitation training has a vital role in the development of the child, the smaller the child, the greater the plasticity. Cui Yonghua pointed out that the treatment of the core symptoms of autism currently only has individualized rehabilitation training, including language, social skills, life ability, cognitive ability and so on. Parents should first learn to master the training methods at the institution, and then practice at home. If the child has various psychiatric symptoms, such as abnormal hyperactivity, self-talk, self-injurious behavior, and impulsivity, these cannot be changed by rehabilitation training alone, and it is also necessary to cooperate with psychiatric prescription medication. For children with emotional problems and psychological trauma, it is necessary to combine psychotherapy methods.

Zhang Yan added that for young children in the early stage, the most used basic rehabilitation methods such as natural situational intervention, key behavior training, language and behavior therapy, and pre-intervention methods are used. Whether it is medical rehabilitation or special education, it is difficult to achieve the desired effect without the cooperation of parents. Parents of children with autism should not rely too much on educational training institutions, but should let children improve their situation through basic education and training methods while carrying out professional training, such as eye contact training, call response training, social communication training, etc.

Beijing News reporter Wang Kara

Proofread by Zhao Lin