Children are withdrawn

Introduction Children are so isolated, afraid to see people, always unhappy, indifferent to everything, or lose their temper when they are not moving, do not concentrate on doing things, and insist on poor performance, we must pay attention. For such a situation, many parents think that it is a child's personality characteristics, do not care. In fact, these children have got "high-rise autism", which is a new kind of mental illness for children.

Cause

At present, the cause is unknown, and the etiology and pathogenesis of autism cannot be elucidated, but at least it is regarded as a wide range of developmental disorders caused by various biological causes.

Kanner first proposed the diagnosis of autism in 1943, and also suggested that the cause of autism is caused by the apathy and over-formalization of parents in terms of emotions. After decades of extensive research, autism has been confirmed. Parental parenting has nothing to do with it, and the so-called indifference and parental formalization of some autistic parents actually indicate that parents may have similar obstacles of lightness. Although the cause of autism is still unclear, scholars have conducted extensive research on the etiology of autism, and more and more evidence indicates that biological factors (mainly genetic factors) and fetal intrauterine environmental factors in autism It plays an important role in the pathogenesis and has become a hot spot in the current cause research. Other factors include immune factors, nutritional factors, etc., comprehensive research, it is currently believed that autism is caused by external environmental factors (infection, intrauterine or perinatal injury, etc.) on individuals with autism genetic susceptibility caused by nervous system developmental disorders Sexual disease.

Genetic factor

In 1991, Folstein and Piven reported that the incidence of single-female twins in autism was 82%, and the incidence of twin twins was 10%. Epidemiological investigations also confirmed that the prevalence of autistic siblings was 3%, much higher than In the general group, there is a phenomenon of family aggregation. Even if there are no patients in the family, similar cognitive deficits, such as language development retardation, mental retardation, learning disabilities, mental disorders and significant introversion, can be found, indicating that there is a genetic basis for the onset of autism. . Further studies have found that symptoms of hereditary diseases such as fragile X syndrome, tuberous sclerosis, phenylketonuria, and Rett syndrome are associated with autism.

However, most children with autism do not have the above-mentioned hereditary diseases. Therefore, in recent years, a large number of related studies have focused on finding other abnormalities related to chromosomes and genes, from the mother's long chromosomes of chromosome 15, the X chromosome, and the long arm region of chromosome 7. It is thought to be related to autism, in which the long arm of chromosome 15 is considered to be related to dyslexia, and dyslexia is also one of the manifestations of autism, which is taken seriously. Using molecular biology techniques, we have also discovered a number of so-called candidate genes (CandidateGenes) that may be associated with autism, such as Serotonin transporter gene and c-Harvey-rasoncogene. It is worth noting that the results of studies on chromosome and genetic abnormalities in children with autism Not consistent. Most scholars believe that autism is probably not a single-gene hereditary disease, and polygenic inheritance is more likely.

2. Infection and immune factors

Some scholars have studied the role of immune and infectious factors in the etiology of autism. In terms of infection, congenital rubella virus infection and cytomegalovirus infection are thought to be related to the onset of autism. Twin studies have found that autistic twins The incidence of congenital minor abnormalities is higher than that of non-autistic twins, and these abnormalities are associated with congenital infections. 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.

an examination

Related inspection

Neurological examination EEG examination

(1) Being alone and out of the group will not establish normal contact with people.

That is, the lack of interaction with people. The tendency of communication, some children have expressed this characteristic since the baby's time. If they are not close to their parents from a young age, they don't like to hold people. When people want to pick him up, they don't reach out and express their desire to pick up. I don't take the initiative to find children to play. When others find him to play, they do not respond. They don't respond to the call. They always like to play alone and play by themselves. Although some children do not refuse others, they will not interact with children, that is, they lack social communication skills. For example, when they are looking for children, they are not suddenly taking pictures. They are swearing or suddenly swearing, and then they leave. It seems that people and people are not just looking for people to contact but just an action, or there is only one form of contact, and the content and purpose of the person without contact.

Their loneliness is also manifested in the fact that they dont care about the things around them. They seem to listen to them, turn a blind eye, do what they want to do, have no scruples, no one else, what seems to happen around him, its hard to arouse his interest and Note that the eyes often change and it is not easy to stay on the things that others ask him to pay attention to. They seem to live in their own little world. In addition, their eyes don't look at each other and even avoid the other's gaze. When they are active, their eyes are also erratic. People often squint, squint or linger, etc. They rarely smile and rarely smile, and never greet people.

(2) Speech disorder is very prominent.

Most children have very few words, and serious cases are almost non-verbal for a lifetime. They say that they have limited vocabulary, and even if some children say it, they often don't want to talk and prefer gestures instead. Some can talk, but the voice is very small, very low or repeating some monotonous words. Some children will only imitate what others have said and will not talk in their own language. Many children do not ask questions or answer questions, just repeat the questions of others. Language communication is often manifested in the confusion of the use of pronouns, such as the common "you" and "he" to replace himself. There are also many children with autism who often scream, which can last up to 5 to 6 years or older.

(3) The interest is narrow, the behavior is rigid, and the environment is strongly required to remain unchanged.

Children with autism often focus on one or several games or activities over a long period of time, such as being fascinated by rotating the lid, monotonously placing blocks, and keen to watch TV commercials and weather forecasts, in the face of what children usually like. Cartoons, children's TV, and movies are of no interest. Some children have to eat the same food every day. They have to go the same way when they go out. The bowel movement requires the same toilet. If there is a change, they will cry and make an obvious anxiety reaction. Ken will change his original habits and behaviors, and it is difficult to adapt to the new environment. Most children also show no purpose activities, excessive activities, monotonous and repeated jumping, clapping, waving, running and rotating, and some even self-injury, such as self-injury, such as Repeat the operation of picking up the nostrils, pouting, biting lips, sucking and so on.

(4) Most of the intellectual development is backward and uneven.

Most of the mental development is slower than that of the same age, and a small number of children have normal or near normal intelligence. However, it is surprisingly good in some aspect of intellectual activity. It is incredible. Many children have strong mechanical memory, especially the ability to remember words and symbols. If a child of 3 or 4 years old especially likes to read a word, he will take the initiative to ask what he wants, and only remember it once, so that he can read the children's story book fluently and effortlessly, indicating that he has a lot of mastery. Vocabulary, but when he wants to use words to express his own meaning, there are obvious difficulties, indicating that they have damages in understanding language and using language skills.

Differential diagnosis

Differential diagnosis of children's behavioral isolation:

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

1. Asperger Syndrome (AS)

Asperger's syndrome is a type of extensive developmental disorder in which children have social communication disorders and repetitive stereotypes, but develop well in terms of language and cognitive ability, and most AS children may be in some aspects of cognition. It is supernormal, especially in terms of memory of words, maps, statistical tables and train schedules. Although the language ability is normal, it can still be found that the oral language of AS children is abnormal, giving people the feeling that language is pedantic and too formal and looks like selling words. The clumsy movement is a feature of AS. It is difficult to establish friendship with students in school, usually only It was discovered only during school age. It is easier to be confused with high-function autism. The key point is that children with high-functioning autism have language development retardation, while AS children have no obvious language development.

2. Extensive developmental disorders

This diagnosis is usually used to diagnose those with mild or atypical autism.

3. 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.

4. Children with disintegrative mental disorders

Disintegrative mental disorder, also known as infant dementia or Heller syndrome, develops normally until 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.

5. Children's mental retardation (MR)

Some children with MR can show symptoms of autism, 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.

6. Childhood schizophrenia

Some behaviors of autistic children are similar to schizophrenia, but children with autism do not have delusions and hallucinations. Identification is not difficult.

7. 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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