One in a hundred people is a person with autism spectrum disorder, how can autistic children get better treatment? On the occasion of the "World Autism Awareness Day" on April 2, Nandu Health Lecture Hall, together with Zou Xiaobing, the discipline leader of the Child Development and Behavior Center of the Third Affiliated Hospital of Sun Yat-sen University, brought a live lecture on "Natural Development Behavior Intervention for Children with Autism". The live broadcast received strong support from autistic parents across the country, receiving 24W+ of traffic.
Zou Xiaobing (left), the discipline leader of the Child Development and Behavior Center of the Third Affiliated Hospital of Sun Yat-sen University, was interviewed by Sister Zeng, the host of the Nandu Health Lecture Hall
The prognosis for childhood autism will change significantly over the next decade
People have always had a pessimistic understanding of autism, that is, if a child is diagnosed with autism, then he will become a burden on a family and even the whole society, but in fact, "autistic children have their own defects at the same time, there are also advantages", Zou Xiaobing believes that if parents can explore the advantages and cultivate, these children will also get a good development. "There are a lot of real cases on the Internet, such as Yo-Yo, who suffers from severe autism, but he is now a very good pastry chef; Yi Zhe is also a severe child autism, his parents once thought they were going to support him for a lifetime, but he showed talent in art, and now in his twenties he has become a qualified tuner and can earn money to support himself independently."
"The prognosis of autism in children will improve significantly over the next decade, and although biological research has failed to advance autism treatment, effective, evidence-based psychosocial interventions for autism are already in place." According to Zou Xiaobing, there are also many successful clinical cases, such as the author of the public account "Asdi Cultivation Road" is a father who was diagnosed as an autistic child more than ten years ago, this father continues to learn and establish: a theory, a concept, a set of methods, and now his children have studied at a key university in Guangzhou; there is also "Xixi Dad" who shares the intervention experience of autistic children on the Internet, and also through his own efforts, his children successfully "take off the hat". Now I have returned to school like a normal child to continue my studies. Zou Xiaobing said that if children's autism can be detected early and intervened early, many children with low-age autism can be well improved, and some autistic children can grow up as healthy and happy as normal children after receiving scientific intervention.
Let every minute of your life be an intervention
"At present, effective and evidence-based psychosocial intervention methods for autism have been established, which is the natural development behavior intervention model." Zou Xiaobing believes that professional interventionist resources are limited, parents can implement high-intensity emotional interaction and natural intervention in daily life through training and learning, so that children are learning at every moment of waking.
"Parents should learn to combine organized and planned training with random training." Zou Xiaobing pointed out that in the early stage of training, children may not be able to sit still at all, running around, at this time, it is necessary to follow the child's interests and randomly carry out happy and planned interventions. "For example, if the child wants to play with water, play with the car, play with the mud, the parents will follow and intervene in the process of the child's play." As your child's condition improves, you can begin to carry out training in an organized and planned manner according to your child's interests and likes, clarifying the person, time, place and training content. For example, if you want to train your child to use your fingers, see that things can make sounds, you have to put his favorite chocolate in the place where he can't see it, through such an environmental design, the child will use his eyes to ask parents for help, at this time parents can hold the child's finger to the chocolate, read out the "chocolate", and then help the child take it down. "The purpose of this is to let the child know that if he wants to get chocolate, he needs to use his eyes, use gestures, need to find parents, and need to make a sound that suits the scene."
Zou Xiaobing is explaining behavioral therapy
As the main means of behavioral therapy, Director Zou summed it up as "four awards, seven noes, eight punishments". "We have to reward our children 90 percent of the time, especially with natural results." For example, children used to ask for chocolate through crying, rolling, head bumping and other behaviors, but now these behaviors are ignored, only the "finger" behavior will get chocolate, at this time chocolate is the natural result reward. "In addition, we can also reward children with snacks, toys, compliments, kisses, hugs." For children's problem behavior, many parents will use rough ways to solve, but this can not really make children improve, so Director Zou suggested that parents should do "seven noes": do not hit, do not scold, do not nagging, do not cheat, do not threaten, do not induce, do not confront. Replacing rough scolding with mild punishments such as simple verbal criticism, temporary isolation (activity cancellation, toy deprivation), and systematic neglect makes it easier for children to correct wrong behavior.
How to choose a child autism intervention institution
There is already a large amount of data showing that training in family and natural situations is effective and sustainable, so is it necessary to bring autistic children to the institution for intervention?
Zou Xiaobing believes that institutional intervention can be used as a supplement to family intervention. "Because parents accompany autistic children for twenty-four hours, it is often stressful, if you can combine institutions to carry out family intervention on weekends or holidays and when you go home from work at night, you can also make children get sustainable high-intensity intervention." In terms of institutional selection, Zou Xiaobing recommends those institutions that simulate the natural situation of the family to carry out developmental behavior intervention, or institutions that pay attention to guiding parents to carry out family intervention while carrying out institutional intervention. "And simple institutional and hospital interventions, even if high-quality, often do not reach high intensity, and if the price of institutional training is too high, many families are often difficult to bear and recommend." There are also institutions that implement methods that are not recommended by our mainstream science, especially those that always use various banners and claim to be able to cure autism quickly in a short period of time cannot be trusted and do not recommend. ”
Zou Xiaobing also particularly stressed that at present, some institutions allow autistic children with speech disorders to do oral muscle training regardless of the situation, which is unscientific and incorrect. Many parents believe that as long as the problem of autistic children speaking is solved, the children will return to normal. But in fact, the core obstacle of autism is not whether the child can speak, but the social communication ability defects, for autistic children who have not yet produced language, first of all, through intervention to promote the child's "pre-language" ability, that is, "see, point, should" and other body gesture language. "The inability of children with autism to speak is not due to dysarthria due to problems with oral muscle development, and the vast majority do not require oral muscle training."
Children with autism can remove their hats if they meet such criteria
In the fan question session, many parents are very concerned about the problem that their children will not speak, and Zou Xiaobing reminded parents that in fact, social communication defects should be taken as the core of intervention. Social impairment is the core symptom of autism, but also the root of many problem behaviors, parents can evaluate their children's social skills, find the missing parts of the ability, and train with this as the goal.
Some parents asked, "What should I do if my child always asks the same question repeatedly?" Zou Xiaobing suggested that parents can answer the first time, ask questions the second time, and ignore or transfer the third time. If the child is going to lose his temper in the future, parents can take the neglect method, and at the same time make some safety preparations for the child who is grumpy and aggressive, and firmly let the child feel that his repeated questions or tantrums do not respond. "But this is also the on-site treatment of problem behavior, in the long-term intervention of autism, parents can not be in a passive defense all day, he has this problem, I will solve this problem, like firefighters fighting fires, we must take the initiative, so that children's daily activities are in the happy activities planned by parents, at this time the child may correspondingly reduce the repetitive, compulsive, say a word must be the state of parent response."
Zou Xiaobing answers fan questions
There are also some fans who want to understand the "process of diagnosing autism", Zou Xiaobing said, the first step in the diagnosis of autism is screening, and the second step is to confirm the diagnosis. He also reminded parents that since it is screening, we must pay attention to false positives and false negatives, recently due to the popularity of autism science publicity, there have also been some overly nervous parents, the child's developmental differences in the normal range as autism, resulting in false positives; there are also some children's social communication disorders have been obvious, but parents feel that children will be better, the results appear false negative in screening; for children who are screened positive, they generally need to be referred to a higher-level hospital to continue to make a clear diagnosis by professional doctors. However, due to the long waiting time for referrals, during the waiting period, it is best for parents to increase the opportunity to interact with their children and not to let the child always be in a state of being idle or busy alone. Some fans are very concerned about "what is 'hat removal'?" What are the specific criteria? Zou Xiaobing believes that the diagnosis of autism has strict diagnostic criteria, to meet all three social communication disorders and four narrow interests and repetitive stereotypes of two, there is obvious functional damage, if the child after receiving intervention treatment, re-evaluation found that he can not meet the above criteria, function is not damaged, it does not meet the diagnostic criteria, in a sense, you can take off the hat.
If you missed the live stream, you can watch the live replay by scanning the QR code below.
Live/Writing: Nandu reporter Zeng Wenqiong
Photograph: Feng Zhufeng
Intern: Tang Jingyang
Correspondent: Zhen Xiaozhou