Is autism cured well? Are all children with Asperger's syndrome "geniuses"? Can children talk a lot also be autism? On April 2, World Autism Day, Cui Yonghua, director of the Department of Psychiatry at Beijing Children's Hospital of the National Children's Medical Center, answered questions about public concerns.
【Cognition】
1. What is autism and what are its manifestations?
Autism spectrum disorder is a neurodevelopmental disorder with two core symptoms: social communication disorders, narrow interests, and repetitive stereotyped behaviors, most of which begin before the age of 3 years, and the prevalence is higher in boys than in girls, about 3-4:1. Autism spectrum disorder can be divided into low-functioning autism spectrum disorder and high-functioning autism spectrum disorder according to intelligence level and ability. If your child has the following "five not one repeat" situation, you need to be vigilant:
Don't speak, don't speak: Don't speak or speak late, and don't use gestures, expressions, different intonations and other non-verbal forms of communication.
Don't look: avoid eye contact, don't look at people, lack of response to calls, teasing, etc.
Don't play: Don't play, interact with others, or interact in inappropriate ways such as pushing, jogging, etc.
Non-sharing: Not sharing with others, often not seeking comfort when unpleasant or hurt.
Not understanding: unable to understand the meaning behind humor, jokes, etc., unable to understand the psychology and emotions of others.
Repetitive stereotypical behavior: Excessive attention to or obsession with an object or activity of interest, such as spinning objects, weather forecasts, repeatedly opening doors, turning on faucets, taking elevators, or eating only a few foods.
2. Why do children get autism?
"Is it caused by our improper parenting?" "Does it matter if you stay at home for a long time with your children and play without friends?" ...... In the outpatient clinic, many parents consult like this. Actually, the answer is no.
Although the specific pathogenesis of autism is not fully understood, studies have shown that the disease is caused by a combination of genetic and environmental factors to cause changes in brain development, especially changes in brain nerve connections. Genetic factors involve the interaction of multiple genes and combinations of genes, increasing the risk but not 100% inherited; Environmental factors such as high gestational age of parents, threatened miscarriage during maternal pregnancy, viral infections, birth asphyxia, and low birth weight may increase the risk.
3. What is Asperger's syndrome and are these children geniuses?
Asperger's syndrome belongs to the high-functioning autism spectrum disorder. Einstein, Mozart and other celebrities are thought to have the disease. Many children visit the doctor because they do not go to school and love conflicts with others. We affectionately refer to these patients as "As".
"As" are eager to interact with people in their hearts, but because of illness, the way of communication is stiff, and it is difficult to have good interpersonal relationships; Have a strong memory and concentration on things that interest you, but it is difficult to be "reasonable" for things you don't agree with; Easy to fluctuate emotionally, often conflict with people... It can be said that most of these children are not "geniuses", have ordinary intelligence, and often face great challenges in study and work, but may have some specialties.
4. Will the child just talk late and be introverted?
This is a misunderstanding of many people's understanding of autism, and even many delay treatment. Children who simply speak late often express their needs through their fingers and respond to the calls of others; Introverted children can also easily read other people's facial expressions and read jokes, but these autistic children may not be able to do it.
The diagnosis of autism is a "systems engineering" that needs to be carried out by an experienced professional physician. Roughly including: a detailed history to understand developmental and behavioral characteristics; Check your child's language, behavior, interactions, intonation, etc.; Conduct scale evaluations; Investigate developmental delays caused by neurological disorders, audiovisual impairments, and other problems. Finally, comprehensive judgment is made according to the child's medical history, clinical manifestations, and examination results, combined with special diagnostic criteria.
5. Why are some children talking a lot and also diagnosed with autism?
"Social phobia" and "social cow" may be autism spectrum disorders. Some "social cows" talk endlessly about things they are interested in, but in social activities, there may be qualitative flaws. For example, the tone of voice and expression of speech are not as rich as normal children; inability to understand the thoughts and feelings of others; He cannot adjust his behavior according to the environment and the reaction of others, only say what he wants to say, even if the other party obviously expresses that he is not interested in listening, he still continues to tell, indicating that there is an obvious social communication disorder.
6. If you want to have a second child, is there a high probability of autism?
Genetic factors increase the risk of autism, but genetic testing methods are not yet fully predictable. From the current data, overall, the first child is an autistic family, if the other members of the family do not have autism, the probability of the second child suffering from autism is higher than that of non-autistic families, and those who are ready to have a second child are best to consult professionals first.
【Treatment】
1. Can autism be cured and is there any medicine available?
Unfortunately, there is currently no specific drug or any overnight treatment for autism, and persistent education and behavioral intervention are still the most effective. Drug treatment is a short-term symptomatic auxiliary measure, and drugs alone cannot fundamentally reverse or change the core problem of autism. When certain symptoms are particularly prominent, such as stereotyping, repetition, aggression, self-injury, extreme hyperactivity, etc., the lowest possible but clinically effective drug treatment can be taken, including antipsychotics, antidepressants, attention improvement drugs, etc., but must be prescribed under the guidance of a doctor.
2. Does autism have to be intervened?
Yes, this has been confirmed by a lot of research. Early training interventions are more helpful for children, and the optimal age for intervention before the age of 6 is at least 3 hours per day. Autism is a chronic neurodevelopmental disorder that is a life-cycle disease that, as we age, not only does not heal on its own, but may have more prominent social problems and is more likely to accompany emotional problems. At the heart of the intervention is to help the child function better socially.
3. Can autism be trained at home?
Based on the intervention of specialized rehabilitation institutions, home rehabilitation training helps children to make faster progress. Home training can start with a structured schedule and design daily training content, including: self-care ability training, such as washing hands, dressing, etc.; Imitation ability training, such as action imitation, sound imitation, etc., the process is to issue instructions, demonstration, assistance and encouragement; Big motor and fine motor training, such as skipping rope, kicking a ball, picking beans, origami, etc.; Social skills training such as role-playing. Parents can adjust or add new tasks according to their children's interests while adhering to the principles, and give material or spiritual rewards when completing the tasks.
4. What are the new technologies and methods for treating autism?
At present, the medical literature on supplemental and alternative therapies for autism is limited, and many support bases are insufficient. Studies suggest that specific music therapy, oxytocin, pet therapy, transcranial magnetic stimulation, massage, and biofeedback may be beneficial and less risky; The benefits of auditory integration training, probiotics, and dietary supplements are low risk; The benefits of intravenous immunoglobulin, chelating agent therapy, hyperbaric oxygen therapy, vagus nerve stimulation, and stem cell transplantation are unclear and potential risks remain to be explored.
【Psychology】
1. My child has autism and I feel very anxious or even hopeless, what should I do?
Accepting that your child has autism can be said to be a lifelong issue for a family. Here are some suggestions that may help:
Seek professional help: Consult a professional psychiatrist as soon as possible to determine your child's diagnosis and treatment plan as soon as possible.
Understanding autism: such as watching documentaries, reading popular science books, participating in autism-related training and offline activities, and learning more about autism, which will greatly alleviate confusion and anxiety.
Give the child enough love and support: accept the child's abnormalities, encourage him when he behaves well, correct or ignore it appropriately with scientific methods when he is bad, and help him learn social rules to the greatest extent.
Find support: Connect with other families of children with autism, disabled persons' federations or autism-related organizations to gain more information, exchange experiences and tips.
Pay attention to your own health: When you feel too stressed to cope and it is almost difficult to cheer up, seek help from a psychiatric professional in time.
2. What can be better when communicating with autistic children?
Communicating with children with autism requires patience, affection, and understanding:
Try to be concise and simple in tone, avoid speaking too quickly, and use less metaphors, metaphors and humor;
When communicating, adding body language, facial expressions and gestures, etc., and using more pictures, comics, etc., autistic children may be more sensitive to non-verbal communication methods and visual information;
Avoid too many sound and light stimuli, some children are very sensitive to this, try to communicate with them in a calm and stable environment;
Avoid negative language and accusations and use more encouraging language to help children build self-confidence and positive attitudes.
3. What problems are prone to occur when "As" goes to school and how to deal with them?
After entering primary school, the "emergencies" or "troublesome events" of the "As" often exhaust parents and teachers, such as poor awareness of rules, inappropriate behavior or language, immature mind, lack of social motivation and social skills, etc.
It is recommended that parents try to abandon their children's original cognition and expectations, avoid "transforming" them, face and accept the "particularity" of their children, and thus form their own unique set of "Ace parenting strategies".
4. Do I have to tell the teacher that he has autism?
Home-school co-education can help children better adapt and grow. We recommend telling the teacher truthfully about the child's condition, introducing the basic knowledge of the disease, the child's behavior and thinking characteristics to the teacher, guiding the teacher to understand and deal with the child's sudden bad behavior (such as talking endlessly, always conflicting with other children, etc., not because of his intention, but caused by the disease), and ask the teacher to give the child more attention and help. At the same time, communicate with the teacher with a grateful and sincere heart, the child is likely to bring a lot of trouble to the teacher and the class, parents should believe that the teacher loves the child and explore the solution together.
5. Can the social skills of "As" be improved and how to do it?
To improve the social situation of "As", there are three basic strategies:
Role play: By simulating real-life situations and role-playing, children can practice how to communicate and communicate with others and learn basic social skills.
Interest groups: "As" tend to show some interest in extracurricular activities and are good at increasing their opportunities to interact with other children of the same age.
Social skills training: such as listening, expressing rejection, maintaining eye contact, expressing one's thoughts and feelings, understanding the emotions and expressions of others, expressing praise and appreciation, etc.
6. How can we give full play to the advantages of children and raise autistic children well?
Children with autism spectrum disorder are generally more orderly, and some children have a very good memory and are very focused on things of interest. Parents can find the child's area of interest, use his unique way of thinking and behavior characteristics, so that the child's advantages can be brought into play, so that the child's shining points can be seen by everyone, improve the child's self-esteem, and help him better integrate into social life.
Source | Beijing Daily client
Responsible Editor | Xie Zhe
Editor: Xie Zhe
Source: Beijing Daily client