Autism

Introduction to autism Autism is a special mental disorder that occurs in infancy, also known as infant autism. It is related to psychological activities in children's perception, language and thinking, emotion, movement and social, and belongs to developmental disorders. It is currently classified into psychological developmental disorders in taxonomy, called pervasive developmental disorder. According to the Western report, the prevalence rate is about 4 to 10/10,000 for children. In the past, there have been very few reports in China, and it has gradually increased in recent years. More common in boys (male: female is about 5:1), the cause of this disease is unknown. basic knowledge The proportion of sickness: 0.01% - 0.03% Susceptible people: more common in children. Mode of infection: non-infectious Complications: autism

Cause of autism

Causes:

The current cause is still unclear. Many foreign studies believe that the incidence of childhood autism may be related to genetics, family characteristics, psychosocial, physiological anatomy, biochemistry and other factors.

(1) Genetic factors

The study found that the same rate of twins was higher than that of twins. The single-female twins with autism have a co-incidence rate of 82% and the twin-ovid twins have a similar rate of 10%. There are more autistic patients in the family than in the average family. Adolescent siblings and parents have similar cognitive deficits and specific personality traits, which indicate the genetic basis of autism.

Further studies have found that symptoms of hereditary diseases such as fragile X syndrome, phenylketonuria, tuberous sclerosis, and Rett syndrome are associated with autism. However, most children with autism do not have the above-mentioned hereditary diseases. The study found that the cause may be related to other chromosomal and genetic abnormalities. The abnormalities of the long arm of chromosome 15 from the mother, the X chromosome, and the long arm region of chromosome 7 are considered to be related to autism, and the long arm of chromosome 15 is It is considered to be related to dyslexia, and dyslexia is one of the manifestations of autism and is therefore valued. Further research found that autism does not conform to the characteristics of single gene inheritance, and the possibility of polygene inheritance is greater.

(2) Biological factors

Children with a history of perinatal damage more than normal birth, including congenital rubella, cytomegalovirus infection, premature delivery, dystocia, birth injury, asphyxia. Children with autism have more epilepsy (10%-15%), and there are many abnormal EEG. The study found that there were more enlargement of the left temporal lobe of the child, suggesting that there may be lesions in the temporal lobe of the brain.

Because of the high incidence of autoimmune diseases in children with autism, the T lymphocyte subsets are also different from the normal population, suggesting that autism is associated with abnormal immune system. However, the results of the study are different, and the significance in the etiology of autism is still unclear.

(3) Biochemical factors

Dopamine and serotonin in children with autism can be increased, plasma adrenaline and norepinephrine are elevated, opioids and other neurotransmitters are abnormal, but lack specificity; brain tissue is found to have abnormal neuronal migration in the cerebellum, Puken The number of cells in the wild is reduced. Another study reported that autism may be related to the limbic system, amygdala, and hippocampus. There are also studies that consider autism associated with excessive brain growth in the first year after birth.

(4) Family factors

It may be because parents have a poor approach to children's education or because of a special form of inheritance in their parents' personality, or both. Parents parents cultural level is mostly high, their parents are more introverted, their children are cold and stubborn, and their families lack warmth. It has nothing to do with parental parenting, and the so-called indifference and parental formalization of some autistic parents actually indicate that parents may have similar obstacles of light weight.

Autism prevention

prevention

Children with autism should start from the gestation period, because brain damage caused by many factors such as pregnancy and perinatal period is closely related to the incidence of autism in children. The key point of prevention is to strengthen perinatal health care, actively carry out prenatal and postnatal care, and virus infection during pregnancy. Threatened abortion, asphyxia at birth, and cesarean section all have an effect on young children. Viral infection during pregnancy, especially in the first 3 months of pregnancy, can lead to abnormal brain development and childhood autism, such as rubella virus, herpes simplex virus. Influenza virus, cytomegalovirus, etc. can damage the central nervous system of children and cause disease. Therefore, pregnant women should pay attention not to get infected with the virus during pregnancy, especially in the early stage of pregnancy. In case of dystocia during childbirth, infants and young children should be avoided as much as possible to avoid suffocation. Cause brain damage, also pay attention to avoid high fever convulsions in early babies, and multiple high fever convulsions can also cause brain damage.

Babies should be breast-fed as much as possible, because breast milk is rich in alkaline minerals, which is good for children's intellectual development. Larger children should eat less sugar, eat more vegetables, fruits, miscellaneous grains and other "alkaline foods", pay attention to The "acid-base balance" of the diet is beneficial to the relative stability of the PH value in the body, so that various metabolic functions are coordinated, thereby maintaining a good state of mind and body.

Comprehensive measures should be taken to prevent and treat children's autism. Children should be allowed to participate in various exercises and participate in group activities. Do not let children have a "closed" life for a long time, so as to avoid a lonely personality and a child's life. If you have a child-like autism, you should consult a doctor in time, properly manage it, and conduct induction training.

When you understand your child's tendency to do this, the sooner parents discover that the sooner they are treated, the better they will be, because if they do not receive special education in a timely manner, they will become lifelong disability if they can With reasonable education and training, most children will have different degrees of improvement. Some children may have the ability to live independently, study and work.

Autism complications Complications autism

(1) Hyperactivity and distraction behavior are more common in most autistic children and are often misdiagnosed as children with ADHD. In addition, temper tantrums, attacks, self-injury, etc. are more likely to be seen in children with autism. Such behavior may be related to the use of snoring or punishment in parental education. There may also be mental retardation, in addition to epilepsy, tuberous sclerosis, phenylketonuria fragile X syndrome, Rett syndrome with autism is also more common.

(2) If the IQ of children with autism is below 60, the language communication is still poor at the age of 5, and the prognosis is poor, which may lead to permanent disability.

(3) About 1/5 of children with autism have seizures until puberty.

(4) Children with autism generally have a longer course of disease, and the treatment time is longer. Parents should pay attention to the side effects of drugs such as extrapyramidal reaction, liver function and cardiovascular and blood abnormalities.

Symptoms of autism common symptoms children's behavioral language developmental retardation self-harmful behavior memory impairment

The onset age of this disease is mostly 2-3 years old. Infants with autism usually show up in the first year after birth, no later than 3 years old, and there are also those who are born and sick. The main clinical manifestations are as follows:

1. Illness attachment to certain special items

Children with autism often have special interests in certain items, such as building blocks, radios, balls, etc., to the extent of attachment. They love these things and can feel satisfied in their play. If you take these items away, they will cause crying and panic. Children rarely participate in other children's games, and one person is happy to play, often enjoying themselves.

2. Stereoscopic repetitive action

Children often insist on repeated stereotypes of game patterns and lifestyle patterns, resisting change, lack of change and imagination, such as repeatedly queuing toys; sitting position can not be changed; places where things can not be changed; the order of life content must remain the same . Being stubbornly intact remains one of the most important symptoms of autism.

3. Interpersonal barriers

Children often feel particularly lonely, lack of communication with people, lack of emotional connections, such as the newborn is not close to the mother when picked up; 7-8 months when the relatives or other people pick up the reaction is no difference; Parents' return and departure are indifferent and unattached; they are not afraid of their loved ones, like their living beings, when they are with strangers. This type of child lacks gaze to the human eye, often avoids confrontation with people, and lacks emotional communication with people around.

4. Language development disorder

One of the most prominent manifestations of this disease. After the child is sick, the general language is gradually reduced, and in severe cases, it is completely lacking. Children's ability to understand language is low, and there are often some abnormal language such as stereotypes, repetitions, imitations, and pronouns (especially when you refer to yourself with "you" instead of "I"). Children lack abstract concepts, and the thinking process tends to be compulsive, limited, and poor, lacking in fantasy and imagination. Children do not use facial expressions, body movements, postures, and tones to interact with others.

5. Perceptual disturbance

The child's response to hearing and visual stimuli is slow, as if he had "turned a blind eye" or "not listening." It seems that people or other people appearing in the surrounding environment do not seem to see it, and they ignore their speech.

6. Intelligent barriers

Children with autism have no obvious sluggish appearance, but their social adaptability is obviously backward. They can't take care of themselves in daily life. Most of them have mental retardation and severe depression. Very few children with autism can show special abilities in the field of music, computer and mechanical memory in some respects. Very few children may have island-like precocity or specific functions, the so-called "idiot scholars". Some children have seizures.

7. Other symptoms

About 20%-40% of children will have epilepsy before puberty. Some patients are accompanied by schizophrenia syndrome during puberty or early adulthood, such as delusions, hallucinations, and the like.

Autism check

1. Childhood Autism Rating Scale (CARS)

It is used by professionals to evaluate children. The scale has a total of 15 items. Each item is divided into seven levels of 1-4 every 0.5, 1 is normal, 4 is the most serious, and the total is calculated. The total score of CARS is 29.5, and the total score of CARS is 30-36.5 for mild-to-moderate autism; the total score of CARS is 37 for severe autism.

2. EEG or brain topography

The abnormal rate of EEG examination is between 10% and 83%. Because the interpretation standard of the general EEG is different from that of the selected samples, there is a big difference. In general, the more leads, the higher the abnormal rate. Those with abnormal EEG are generally those with lower IQ, and the more obvious the impairment of IQ, the higher the probability of EEG abnormalities and epilepsy. However, about 20%-40% of children have epilepsy before puberty, and there may be no abnormalities in EEG.

3.CT and MRI

The results of MRI showed that the total brainstem area and total pons area of children with partial autism were smaller than those of children of the same age. The median sagittal area of cerebellum VI and VII sacral leaves was 19% smaller than that of the normal control group. It suggests that cerebellar dysplasia is possible with some autism.

4. SPECT single photon emission computed tomography

SPECT can detect cerebral blood flow. SPECT examination of children with autism found that cerebral blood perfusion was abnormal, with a positive rate of 75%. Mainly in the cerebral cortex, cerebellum and subcortical structures, concentrated in the cortex, temporal lobe, the left frontal lobe is most common. At the same time, the hippocampus returned to local blood perfusion.

Brainstem auditory evoked potential

The brainstem auditory evoked potentials of children with autism are abnormal. There are abnormal reports from I---V waves, and the abnormal rate is as high as 20%--60%. It shows that children with autism have hearing defects and brainstem conduction time prolonged, suggesting that brain stem function changes may be one of the causes of autism symptoms. Disorders of brainstem function can lead to damage to the pathways transmitted to the brain, which may be one of the reasons for the abnormal development of cognitive, social and linguistic abilities in children with autism.

6. Other inspections

Choose to do chromosome analysis, intelligence tests, etc. as needed.

Diagnosis of autism

Autism needs to be differentiated from other generalized developmental disorders as well as other common neuropsychiatric disorders in children.

1. Identification with mental retardation

Mental retardation is characterized by mental retardation and adaptive disability. Generally, they are kind, amiable, and have no serious social interaction barriers such as loneliness. Children with severe mental retardation often have characteristics such as sluggish appearance, which can be distinguished from autism; some children with mental retardation can show autism-like symptoms, and most children with autism also show mental retardation. It can be identified according to the social disorder, behavioral characteristics and some special cognitive abilities of children with autism.

2. Identification with childhood schizophrenia

The child is generally normal, with normal intelligence, and has signs of schizophrenia such as emotions, thinking disorders or hallucinations. Autistic children do not have delusions and hallucinations. Identification is not difficult.

3. Identification of children with attention deficit hyperactivity syndrome

The main cause of this disease is hyperactivity and attentional disability. The intelligence is normal or basically normal, and it is difficult for people to communicate.

4. Identification with Asperger syndrome

Asperger's syndrome is a type of generalized developmental disorder in which children have social communication disorders and repetitive stereotypes, but develop well in terms of language and cognitive ability, and most children may be in some aspects of cognition. The performance is extraordinary, especially for words, maps, statistical tables and other aspects of memory; awkward movement is a feature of the disease, it is difficult to establish friendship with students in school, usually only found in school age. It is easier to be confused with high-function autism. The key point is that children with high-function autism have language development retardation, while children with Asperger syndrome have no obvious language development.

5. Identification with children with disintegrating mental disorders

Also known as infant dementia or Heller syndrome, the child develops normally before at least two years of age. Afterwards, there were obvious and rapid language, social, game and adaptability retreat, incontinence, etc. It is quite difficult to identify the early onset and autism.

6. Identification with Rett syndrome

Rett syndrome is only seen in girls. The child develops normally at an early stage and begins to develop in about 6-24 months. The disease usually progresses through four stages, the early onset stagnation stage (6-18 months), and the rapid retreat stage (1). -4 years old), pseudo-stagnation stage (pre-school-early school age) and late stage motor decline stage (5-15 years old). Autism-like manifestations occur in the first and second phases, including loss of language function, characteristic hand-skinned "handwashing" movements, significant mental retrogression, and hyperventilation. However, in the third and fourth stages, the patient showed more obvious neurological symptoms and signs, such as decreased muscle tone, tonic ataxia and disuse, scoliosis and kyphosis, and severe cases of severe cases. Most cases With seizures. According to this, it can be distinguished from autism.

7. Extensive developmental disorders

PDD-NOS can be used to diagnose those with mild or atypical autism.

8. Other diseases that need to be differentiated from autism include attention deficit hyperactivity disorder, severe learning disabilities, selective mutism, and dysfunctional language development disorders.

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