Expert opinion: what you need to know about autism

Expert opinion: what you need to know about autism

What is autism? Are there different types of autism?

Elisha Osin, a practicing child psychiatrist. “Autism is a developmental disorder in which a person’s ability to interact with the social environment, that is, with people around him, is reduced or somehow distorted. This leads to the fact that a person can not learn through the social environment and receive from it a lot of important information that all other children of the same age can do.

Ordinary small children literally immersed in the social environment – they primarily pay attention to other people, constantly monitor their reactions, try to interact with them, and with autism, these skills are violated. This leads to various consequences for mental development, one of the most striking examples of such consequences is speech disturbances when the child does not understand how speech can be used to interact with other people. All people with autistic disorders have this or that kind of violation of verbal communication. This is especially noticeable in young children – the process of mastering speech is slowed down, it occurs at a much slower rate.

The classification adopted generally includes several diagnoses that relate to autism spectrum disorders (RAS) – children’s autism, atypical autism, Asperger’s syndrome. The criteria for these categories are rather blurred.

Atypical autism and Asperger’s syndrome can be very similar, and two different doctors can put two different diagnoses on the same person. In addition, throughout life, the diagnosis can change, for example, the first two years of life, clinical manifestations can correspond to atypical autism, the next five years – to children’s autism, and then – to Asperger’s syndrome. Because a person develops, it changes, and the symptoms can also change.

The American Psychiatric Association now generally refused such a division, in the US there is only one diagnosis – an autism spectrum disorder (RAS), which includes all forms of autism. ”

Is autism an illness?

Elena Grigorenko, Doctor of Psychology, Professor at Yale and Houston Universities, Head of Laboratory for Interdisciplinary Early Childhood Studies of St. Petersburg State University, Head of the Expert Council of the Vykhod Foundation.  “Autism spectrum disorders are part of a large diagnostic group, which we call” developmental disorders. ” They manifest themselves at some stage of the life path and then change over a lifetime, so this category is not static, it can not enter, be in a state of disease, and then recover.

The analogy with the flu or angina is inappropriate here. In this state, a person is throughout life, and since life itself is by definition dynamic, this state also changes. Thus, autism is not a disease, but a developmental disorder.

Ekaterina Pomerantseva, geneticist, a candidate of biological sciences, head of the laboratory Genetics.  “Autism is such a” cunning “diagnosis, in fact, it is a group of different conditions, that is, this is the so-called umbrella diagnosis. Within this group, there are forms that are associated with one or another mutation in the genes. These are the so-called genetic forms of autism, and there are quite a few of them.

In general, about 70% of cases are associated with genetics in one way or another. However, not all of this 70 % is some kind of syndromic forms associated with a specific mutation, there may be some hereditary predispositions, there may be cases that depend on a combination of genes and the environment. Modern methods of genetic testing can identify the cause of autism in about 25% of children.

Also, many factors of the external environment that affect the risk of autism are already known. Even more, such factors are being studied right now, for example, activation of the maternal immune system during pregnancy. Most likely, there are factors that no one has ever thought about, but eventually, they will also be found. Therefore, the situation here is developing quite dynamically. Some time ago, for example, someone else thought it possible to discuss the risks associated with vaccination, and now it’s even funny to say that vaccination does not cause autism, it’s already clear. ”

How many people with autism are now in the world? Can we talk about an epidemic of autism?

Professor Mourin Durkin, Ph.D. in epidemiology and professor of public health and pediatrics at the University of Wisconsin.  “At the moment, we do not have data on the prevalence of autism in most countries of the world. However, this does not mean that there are fewer cases of autism in these countries. In general, we have data on the prevalence of autism in Western Europe, the United States and several countries in Asia. So, in the USA, according to the Center for Disease Control and Prevention, 1 out of 68 children have autism.

Yes, you can talk about an epidemic of autism. The epidemic means that the frequency of any disease or other condition in the population is higher than expected, or higher than normal, and is increasing. Last twenty years it was true for autism. ”

Are all people with autism the same?

Donna Williams is an autistic woman, writer, artist, and counselor on autism. In her autobiographical book “No one anywhere” was published. “ There are not two people with autism with the same personality or with what constitutes their” autism. ” Autism is a “fruit salad”, and the combination of the ingredients of this salad can be very different depending on the individual. They are all so different, and each has its own strengths. It is important to remember that people with autism are still just people, and children with autism are still just children. ”

Are people with autism dangerous? Are they capable of sympathy?

Emily Willingham, a mother of a child with autism, is a doctor of biology, a researcher and popularizer of science.  “Planned, social violence is uncharacteristic of autism. Moreover, autistic people are more likely to become victims of violence than to be abused by others. Autistic people find it difficult to automatically place themselves in the place of another person in a particular situation and intuitively understand what the other person is feeling now.

However, if the emotion is expressed explicitly and directly, then nothing prevents them from understanding what another person feels. My experience shows that as soon as an autistic person understands other people’s emotions, he experiences unlimited empathy. Usually, their emotions are very intense. ”

Do people with RAS need friends, fellowship?

Dr. Elizabeth Logeson, clinical psychologist, author of numerous studies on socialization in autism and the developer of one of the approaches to the development of social skills in adolescents with autism.

“In our social skills training program, we learned that although young people with autism do not always express a need for friends in words, the vast majority of them need friendship and communication. The only problem is that they do not know how to achieve this. In fact, numerous studies have shown that people with autism are very much affected by simply incredible loneliness. Because of social exclusion, they develop depression and anxiety disorders very often. ”

Is it possible to outgrow autism?

Dina Gassner is the mother of an adult son with autism, a public figure and a social worker who specializes in supporting adolescents and adults with autism and other developmental disorders. Gassner himself was diagnosed with Asperger’s syndrome – a form of autism without disturbances in intelligence and speech. 

 “There is a myth that autistic people in some magical way will outgrow their autism. It seems to me very important that society understands that autism can not grow! About myself, I usually say: I did not outgrow autism, I grew into it. I grew up and began to better understand myself as a person with autism, I learned how to solve problems associated with it. My success is in this, not that I’m trying to be someone I can not be. ”

Is there an effective treatment for autism?

Dr. Brian King, Professor of the Department of Psychiatry and Behavioral Sciences at the University of Washington, Director of the Children’s Center for Autism in Seattle, is one of the world’s leading experts in the field of autism and other developmental disorders. “Yes, and in recent years, we are getting more and more evidence of the effectiveness of therapy. First of all, these are lessons with the child based on techniques based on applied behavior analysis. Starting to help a child with autism follows them unequivocally.

In general, parents can be recommended not to think about autism as a whole, but about a specific unique child, about the specific difficulties that he has at this particular moment. What skills he lacks in comparison with peers. For example, many children with autism do not use a speech at all. With such a child, it is first of all necessary to work on the development of communication. There are effective behavioral techniques that are aimed specifically at the development of speech.

A child who already speaks well of such methods will not do. It is worth working with him to develop more complex social skills. Each child or adult with autism has its own unique needs. So the goal of the family is not autism as such, but the answer to the question: “What problems need to be focused on in the first place?”

Is it possible to treat autism with any medications or procedures?

 Dr. Danica Natalie Weder, child and adolescent psychiatrist, an expert non-profit organization for children’s mental health «Child Mind Institute». “In the first place, interventions for autism are behavioral. So far, there are no approved drugs or procedures that directly affect the symptoms of autism. The role of drug treatment for autism, to put it mildly, is modest. To drugs with autism should be resorted only when other methods failed. In this case, drugs do not affect autism itself, but reduce a specific symptom, for example, increased irritability or hyperactivity. ”

Is it possible to cure autism completely? What future awaits a child with autism?

Laura Dilli, the expert on diagnosis and early care for children with autism, psychologist, member of the Board of Directors of the Psychological Association of Georgia, specialist of the Center for Autism of Marcus (USA). “Parents often ask me about this. And I have to answer: “I do not know. I would like to answer, but I do not know. ” We know for sure that 5-10% of children who received an early diagnosis and early psychological and pedagogical help no longer meet the diagnostic criteria of autism when they become adults.

Of course, they still may have some peculiarities or difficulties associated with the spectrum of autism, but they are relatively insignificant. A lot depends on early diagnosis and help. First and foremost, such assistance should be directed to the so-called functional communication – the ability to communicate their desires and needs to other people, as well as self-service and other skills for independent living. ”

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