About 3 million children are troubled by autism! Parents should be alert if their children have these conditions!

Author: Sheng Juan, deputy chief physician of Jingzhou Mental Health Center, member of the Family and Youth Branch of China Association for the Prevention and Treatment of Substance Abuse, member of the Child Psychiatry Group of Hubei Province

Yu Yanyun Jingzhou Mental Health Center

Chen Xiangzhan Jingzhou Mental Health Center

Illustration: Qin Lixuan

Reviewer: Tu Zheming, Chief Physician, Jingzhou Mental Health Center

Do you know? There is a group of people in this world who are not deaf, but turn a deaf ear to sounds; they are not blind, but turn a blind eye to the surroundings; they are not dumb, but do not know how to speak. They are called "lonely angels" and are also likened to "children from the stars". They are unwilling to talk to anyone since they were young. They only play with one toy; they must take the same route home; no matter what they have, they must put it in a fixed place; they only eat a few specific foods for meals. Sometimes they even hurt themselves and beat their family members. They are like stars in the sky, each on their own planet, looking at each other from afar, existing silently, and emitting weak light alone. They are autistic patients, which is what we often call autism.

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Autism spectrum disorders are a group of diseases with autism-like symptoms. Autism spectrum disorders include autism. Typical autism mainly has social function disorders, language communication disorders, stereotyped behaviors and narrow interests. Not only do they not have the desire to communicate with others, but they also unconsciously repeat what they do. Some core symptoms of autism can seriously affect children's social functions and quality of life.

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According to current survey data, there are approximately 67 million autistic people in the world, and approximately 10 million autistic people in my country, of which 3 million are children. In the survey on gender incidence, the incidence rate in males is higher than that in females, with a ratio of approximately 4:1.

Autism usually begins in infancy and has completely different manifestations at different stages of childhood. There are corresponding behavioral warnings for autistic children in the early prevention stage. Once a baby between 3 months and 3 years old shows the following symptoms, parents must take their children to the psychology department of a regular hospital for timely examination.

Many people think it is normal for boys to learn to speak late, which makes them miss the best time for treatment. In fact, there is not much difference between boys and girls in language learning.

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However, the various symptoms of autism are only fully manifested when the child's social needs exceed his or her current limited abilities, which brings significant adverse effects to the child in interpersonal communication, emotional needs during growth or other aspects.

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The cause and pathogenesis of autism are very complex. Previous studies have shown that this type of disease is related to brain nerve development and is mainly caused by genetic factors, and the interaction of genetic factors and environmental factors. In particular, the probability of autistic children developing symptoms will increase significantly in an environment that affects the early brain development of the fetus.

Autism is the most common and representative disease among pervasive developmental disorders. my country's recognition of autism was relatively late, and there are some wrong assumptions about this type of disease. The common wrong assumptions are as follows.

1. Autism means being introverted and not good at socializing. It is not a disease and has nothing to do with anything.

People who don't know much about autism tend to associate it with lonely or introverted personalities, linking autism with psychological disorders, and believing that autistic children develop lonely personalities due to some kind of external stimulation. However, research shows that autism is a neurodevelopmental disorder, not a purely psychological disorder.

2. Autism is a terminal illness and education does not work for autistic children.

The vast majority of research and experience show that education is still the most effective means of intervening in autism. Children with autism can not only acquire knowledge and skills through education like normal children, but also master the ability to live independently and eventually integrate into society. Education is one of the most effective ways to help children with autism integrate into and return to society.

3. Autism is caused by too little care and love from parents.

Autism was once thought to be caused by so-called "refrigerator moms." This theory places the blame for autism in children on mothers who give their children too little attention and love. In fact, autism is a brain development disorder, not the result of parenting style.

4. Some people believe that autism only occurs in children and adolescents, and that children will no longer be autistic when they grow up and will recover naturally.

In fact, autism is a chronic disease that seriously affects the social function of children. Early detection and early intervention are of great significance to improving the prognosis of children.

So, if you suspect your child has autism, where should parents take their child to see a doctor? What are the tests for autism, and what methods can be used to treat autism? Can autism be completely cured? Let's answer these questions one by one.

1. Who should I consult if I suspect autism?

（1）Neuropsychologist.

(2) Clinical psychologist.

(3) Pediatric behavioral specialist.

（4）Neurologist.

2. What examinations are needed when seeking medical treatment?

(1) Physical examination: Check the child's physical development, whether there are any congenital malformations, whether there are any visual or hearing impairments, and whether there are any positive signs of the nervous system.

(2) Psychological assessment: Autism Behavior Checklist, Childhood Autism Rating Scale, Developmental Assessment and Intelligence Test Scale.

3. What are the treatments for autism?

Through the doctor's systematic evaluation, if the child is diagnosed with autism, what are the effective treatments? This is the issue that we all care about most. The treatment of autism in children is still based on the principle of educational intervention as the main method, supplemented by drug treatment, teaching according to the child's needs, promoting social and parent-child activities, and increasing outdoor play and sports activities.

(1) Current status of clinical treatment of autism: There is no single specific treatment for autism, so a multi-pronged comprehensive treatment has gradually been widely recognized. Training and education are the preferred method, followed by equally important drug treatment. The main goal of treating children with autism is to reduce related life stress and improve quality of life and functional independence. Many drugs can be used to treat the symptoms of autism, the most common of which are antidepressants, stimulants, and antipsychotics. Unfortunately, there is currently no known drug that can alleviate the core symptoms of social and communication disorders in autism.

(2) Proven treatments for childhood autism: ① Applied Behavior Analysis (ABA). a. Break down the target task into multiple small and basic segments for intensive training; b. Reduce repetitive and stereotyped behaviors; c. Increase opportunities for speaking, playing and socializing. ② Speech-language therapy. a. Strengthen the connection between language and actual functions; b. Strengthen gestures, intonation and other skills that can assist language expression; c. Try to induce children to express their needs and interests; d. Improve language comprehension and social skills. ③ Occupational therapy (OT). a. Enhance motor skills by completing manual tasks; b. Improve sensory integration ability; c. Target cognitive flexibility and daily activity enthusiasm; d. Improve environmental adaptability. ④ Physical therapy (PT). a. Focus on forming motor functions suitable for each age group; b. Improve strength, coordination, balance and motor planning; ⑤ Social training. a. Mainly for children with autism who already have relatively complete motor and language functions; b. Increase communication and interaction with the surrounding environment; c. Improve social skills.

(3) Prognosis and influencing factors: Previous studies have shown that autism or autism spectrum disorder presents a long-term chronic course. Although a few children have a better prognosis, or are no longer diagnosed with autism or autism spectrum disorder, the diagnosis of the vast majority of children remains stable and the disease accompanies them throughout their lives. Compared with autism spectrum disorder, autism has a worse prognosis. About 80% of autistic patients have impaired social function, and about 50% of autistic patients require lifelong care and maintenance. These patients have obvious communication barriers and cannot live independently. 17% of patients experience degenerative changes in their abilities during adolescence, and half of these patients are difficult to recover from the degeneration.

Because autism or autism spectrum disorder has a poor prognosis, it is very important to actively explore prognostic factors. Previous studies have shown that there are many factors that affect the prognosis of autism or autism spectrum disorder, mainly including diagnosis and intervention time, early verbal communication ability, severity of the disease, intelligence level, and the presence or absence of concomitant diseases. Among the above prognostic factors, diagnosis and intervention are the only factors that can be controlled artificially. Therefore, strengthening the early diagnosis and early intervention of autism or autistic children is of great significance to improving the prognosis of children with autism and autism spectrum disorder.