Autism, causes and early warning signs. Daniel’s story moves the web
“My son on his 15th birthday expressed two wishes: to drive the car and to have friends. Help me. “A British daddy’s SOS of an autistic boy went viral on Twitter and even moved Hollywood stars, from Russell Crowe to Star Wars actor Mark Hamill, who sent their birthday wishes. And with them, symbolically, another 122 thousand users from all over the world have done so. It is incredible “, the comment of Daniel’s father, surprised by so much virtual solidarity. Faced with this global response, Daniel went mad with joy “, his father told the BBC
Daniela Chieffo – Head of Clinical Psychology UOS, “A. Gemelli” University Hospital Foundation and Lecturer at the Catholic University of the Sacred Heart – explained to Benedetta de Mattei what autism is, how important relationships are, what are the causes and how to recognize it early.
What is autism and how many people suffer from it
Autism, or better referred to as “autism spectrum disorders”, is a neurodevelopmental disorder that mainly involves language and communication, social interactions, narrow, stereotyped interests and repetitive behaviors. It is estimated that 1 in 160 children develop autism. This estimate represents an average figure, and the estimate varies substantially from study to study. Some studies, however, have reported higher recent rates, i.e. 1 case in 88 births. In Italy it is estimated that one in 77 children between 7 and 9 years has an autism spectrum disorder, with a prevalence among males (about 4.4 more than females).
How do we arrive at the diagnosis
The diagnosis of autism is “clinical”, that is based exclusively on the observation of the child and a specific assessment, it is therefore advisable to rely on specialized health structures and a multidisciplinary team, using appropriate tools. However, the neuropsychiatrist in the team always suggests a genetic investigation to overcome more complex frameworks within which a “link” profile can manifest itself as in Autism. There diagnosis is made with reference to the international classification of mental disorders through the DSM, which is currently in its fifth version, and there are criteria that must be met. There must be a persistent deficit in communication in social interaction in different contexts, which should not be interpreted in the context of a general delay in development and the coexistence of other comorbidities. Criteria have recently been revised and validated that a more precise diagnosis and allow to correctly distinguish autism spectrum disorders from other intellectual disabilities with similar characteristics.
The diagnosis of autism is generally possible at the age of 3 but already around the age of 2 it is possible to define a neurodevelopmental disorder, directing parents towards a possible autism spectrum disorder. An early diagnosis is essential and for this reason it is useful to know and pay attention to what are described first signs in the different age groups.
“Spectrum” to underline the heterogeneity of the disorder and indicate a continuum in which each individual presents his own specificities
What are the symptoms to watch out for?
First, it must be remembered that autism varies in severity based on the level of impairment that limits autonomy in daily life.
The first symptoms are often already recognizable from 18 months and are mainly:
– Lack of word production but also difficulties in non-verbal communication
– Deficit in communicative gestures
– Discontinuous or absent eye contact
– Difficulty sharing the game and building a game relationship
– Difficulty interacting and a tendency to escape from the social relationship failing to establish a relationship with his peers but not even with his parents.
– Stereotyped behaviors such as an excessive interest in some objects or parts of objects, an excessive attachment to routine behaviors, the presence of always the same and repeated gestures of the hands and body.
– Selectivity in food
In addition to these communication difficulties it is good that these basic children, however, possess extraordinary cognitive abilities, and it is possible to find unusually developed skills in other areas, that go immediately as they then become the resources through which rehabilitation protocols for communication and social relations are stabilized.
What are the causes of autism?
The causes are still unknown, even if researchers agree in affirming that it disturbs the autism spectrum, acquired neurobiological and psychological causes in the games at stake.
Some babies show signs from birth. Others seem to develop normally at first, only to suddenly slip into symptoms when they are between the ages of 36 months, by which time the child becomes part of his or her social world.
In the world, national and international community, a great work on raising awareness of symptom recognition since there are studies that show that already in the moment of breastfeeding, where the first exchanges of contact with the reference figure take place, there are mechanisms that do not occur in children with autism spectrum disorders.
In most cases these disorders are part of a genetic alteration and therefore parents must be lifted from the blame they give themselves unjustifiably.
Why is it important to intervene early?
It is essential to intervene early and with a specific approach because we see the results. Some children change their developmental trajectory, working with them seeks to intercept their resources and will make an otherwise resistant neurobehavioral process plastic. The development of the child can somehow be reorganized and it is right that the child is favored and supported by rehabilitation.
What cure?
It is not possible to identify an exclusive and specific treatment for all people with autism due to the variability and complexity of the symptoms. The intervention that must be started immediately is 360 degrees, therefore multi-system and with different dimensions, following a rehabilitation approach aimed at a specific protocol; in addition to the child it is important that the school and the parents are taken care of since the child with autism needs to have around him a context that uses the same communication channel, a “code” of synchronous two-way relationship; it is important that a “re-tuning” is created also with the parents, the latter paralyzed by the diagnosis. For this reason, we clinicians suggest to undertake a path of parent training or therapy mediated by the parents to favor the elaboration of the diagnosis and a correct way of interacting with the child. We must also be careful not to overcrowd the rehabilitation child, because it does not need different requests or approaches but a balanced guide, a multidisciplinary team that knows the benefits of an integrated approach.
How important are social relationships?
Social relations they are one of the most important ingredients, we see a big difference between the child with autism who lives within his or her society, with its meaningful relationships such as school versus the child who does not have this opportunity. The child who has the opportunity to live and share his difficulties but also his resources and qualities with his peers will certainly have enormous benefits; however, it is also good to underline that sometimes the social world itself fails to involve these children and their families because they do not know why they are afraid of failing.
Benedetta De Mattei