Autistic spectrum disorder (ASD), what is and how it manifests

In general, generalized developmental disorders are usually associated with some degree of cognitive deficit. They are characterized by a serious and generalized disturbance of various areas of development: social interaction skills, communication, existence of stereotyped behaviors and activities.

Content

• What is autistic spectrum disorder (ASD)
  • Prevalence
  • Associated disorders
• Home and TEA course
  • • What behaviors indicate the need for a doctor to evaluate a child for autism?
• Differential Diagnosis of TEA
• TEA treatment
  • 1. Intervention in the social area
    • Characteristics of the intervention in this area
    • Some specific intervention objectives in this area
  • 2. Intervention in the area of ​​communication
  • 3. Intervention against behavior problems
  • 4. Family intervention
  • Bibliographic references

What is autistic spectrum disorder (ASD)

He Autism is a complex biological disorder of development that generally lasts a lifetime. Is characterized by the presence of a Very abnormal or poor development of social interaction and communication. A remarkable affectation of nonverbal behaviors (ocular contact, facial expression, postures and body gestures can be observed). Disinterests is also shown to establish relationships with other children of their age or lack the necessary understanding to comply with social conventions.

It is also called the disability of development because it begins before three years of age, during the development period, and causes delays or problems with many of the different ways in which the person develops or grows.

In many cases, autism causes problems with:

• Communication, both verbal (spoken) and non-verbal (not spoken).
• Social interactions with other people, both physical (such as hugging or grabbing) and verbal (such as maintaining a conversation).
• Repetitive routines or behaviors, such as repeating words or actions again and again, following their routines or schedule for their activities obsessively, or having very specific ways to fix their belongings.

The symptoms of disorder disconnect people with autism from the world around them. It is possible that children with autism do not want their mothers to hold them. It is possible that adults with autism do not look at others in the eye. Some people with autism never learn to speak. These behaviors not only make life difficult for individuals with autism but also make their families difficult, health professionals who care for them, their teachers and anyone who gets contact with them.

The subjects who suffer the disorder do not participate in group games, preferring lonely activities And if they participate in games with other people, they use them as objects to serve in the game.

The Communication alterations They can vary from a total absence of language, to a lack of ability to maintain a conversation with another, through ecolalic repetitions, stereotyped use of phrases or words, or the use of tones that are not consistent with verbal content, ((( eg.: Talk with interrogative intonation or song form).

Behavior usually shows stereotyped mannerisms, continuously doing the same act for hours (eg.: Play with plasticine around the nose). They also usually accuse the change of order in the actions they perform and prefer a Very structured atmosphere. When changes are produced in this environment, even if they are small, they show exaggerated reactions (pamphs, self -supports and even heteroagresivity).

Another characteristic of its behavior includes the lack of adaptation of their reactions to stimuli, showing sometimes absence of reaction to intense stimuli and in others, an extreme reaction to insignificant stimuli.

Prevalence

Autism is a syndrome that statistically affects 4 out of 1.000 children approximately.

Currently the figures show that autism occurs in all racial, ethnic and social groups. These statistics also demonstrate that boys have three to four times more likely to be affected by autism than girls.

In addition, if a family has a child with autism, there is between 5 and 10 percent of possibility that the family has another child with autism. On the contrary, if a family does not have a child with autism there is only 0.1 to 0.2 percent possibility that the family has a child with autism.

Associated disorders

As previously stated, in most cases, specifically 75%, there is a cognitive deficit associated.

Sometimes there are irregular cognitive profiles, that is, a child with superior intellectual functioning and autistic disorder, presents a level of receptive language well below its intellectual level.

M -Chat questionnaire for the early detection of autism in young children

Home and TEA course

Autism is not a disease that one can "take" the same way that one gives a flu or a cold. Rather, scientists think that autism has its beginnings before
that the person is born. No one knows the exact cause or causes of autism.

By definition, The disorder begins before 3 years.

The course is continuous, although its manifestations varies over the years, emerging evolutionary progress in some areas. On other occasions, deterioration appear during adolescence. Only a small percentage of autistic subjects come to live autonomously in their adult life. A third of cases achieve partial personal independence.

What behaviors indicate the need for a doctor to evaluate a child for autism?

A doctor should evaluate a child to see if he has a autistic spectrum disorder, Yeah:

• Do not babble or canturrea at 12 months old
• Does not gestures (he points, greets, grabs, etc.) At 12 months of birth
• He does not say a single word at 16 months of birth
• He does not say phrases of two words alone (instead of just repeating what someone tells him) at 24 months of birth
• Suffers any loss of any ability to language or social at any age
• Does not respond to your name.
• You can't explain what you want.
• Has delay in language or speech skills.
• It does not follow instructions.
• Sometimes it seems deaf.
• It seems to listen sometimes, but sometimes not.
• He does not point or know how to say goodbye with his hand.
• I knew how to say some words or blushed but now it doesn't.
• It has intense or violent licks.
• Has rare patterns of movement.
• It is hyperactive, little cooperative or gives a lot of opposition.
• He doesn't know how to entertain with toys.
• Does not return the smiles.
• It has difficulty making visual contact.
• He stays "locked" in certain things, performing them again and again, without being able to continue to other tasks.
• It seems that you prefer to play alone.
• Bring things just for him.
• It is very independent for your age.
• He does things "first" than other children.
• It seems to be in his "own world".
• It seems that it is disconnected from others.
• He is not interested in other children.
• Walk at the tip of the feet.
• It shows an exaggerated attachment to toys, objects or schedules (for example, you are always holding a rope or you have to put the stockings before the
  pants).
• Spend a lot of time aligning things or putting them
  In a certain order.

Differential Diagnosis of TEA

It is distinguished from the RETT disorder that the latter has only been diagnosed in women and shows a slowdown in cranial growth, and loss of previously acquired skills.

From the infant disintegrative disorder it differs in this one, after two years of normal development, an evolutionary regression appears.

In Asperger's syndrome there is no delay in language development.

The differential diagnosis with schizophrenia is carried out because it occurs after several years of normal development, and with selective mutism because children suffering from the latter have preserved their communication skills and social interaction, except in relation to the expressive verbal aspect, And they don't show strange behavior patterns.

Asperger syndrome, main features and treatment

TEA treatment

Till the date, There is no cure for autism. However, there are a number of treatments that can help people with autism and their families to bring more normal lives.

Intense individualized interventions, which begin as early as possible, give people with autism the best opportunity to progress. Doctors suggest that these treatments begin before the child turns 2 or 3 years to obtain the best results and the longest. In some cases, treatment can help people with autism to function at normal or almost normal levels.

Many families of children and adults with autism are finding New hopes in a variety of treatments. The list below does not include all possible autism treatments. If you have a question about treatments, you must talk to a health professional specialized in the care of people with autism. Some treatments include:

• The Individualized educational programs (IEP) are an effective way to prevent behavioral problems typically associated with autism. IEP involve a variety of interventions, including some of those mentioned below, and are designed to help the child or adult with autism to overcome their specific problems. Children with autism seem to respond very well to IEPs that have been properly designed and systematically put into practice.
• The Comprehensive treatment programs They include a number of different theories about the treatment of autism. These programs cover from specific learning methods to the analysis of applied behavior, until certain development goals. In general, children need to be in this type of program of about 15 to 40 hours per week, for two or more years, to change their behavior and avoid problems.

Applied behavior analysis (ABA) is generally. Recently ABA programs have expanded their scope to include what should be done before or between problem behavior incidents, in addition to what should be done during or after these episodes. When children or adults are taught with autism to handle situations such as a change in the schedule, furniture that has moved or familiar with new people, ABA deactivates these situations so that they do not cause problematic behavior.

Interventions and support for positive behavior (PBS) constitute an approach that tries to increase positive behaviors, reduce problematic behavior, and improve person's lifestyle with autism. The PBS method looks at the interactions between people with autism, their environment, their behavior and their learning processes to develop the best lifestyle for them.

Medications can also be effective in improving a person's behavior or skills. In general, these medications are called "psychoactive" because drugs affect the brain of the person with autism. The medicine is often used to treat specific behavior, as well as to reduce the behavior of harming himself, which would allow the person with autism to concentrate on other things, such as learning.

Shy and Autistic Spectrum Disorder like to play with dinosaurs

The type of intervention established according to the different areas is as follows:

1. Intervention in the social area

The development in the social knowledge of autistic children is not achieved by the means in which others achieve it. The student with autism is not that he does not want to learn social knowledge (or that he learns it but refuses to manifest it), he does not know, he cannot learn it through natural means. Therefore, it is necessary to program the express teaching of that knowledge.

Characteristics of the intervention in this area

The intervention objectives are not given beforehand, but they arise individualized for each person, from the observation of that person, in different contexts, of certain social categories (Olley, 1986). This process to establish individualized objectives consists of four phases:

1. Assessment of social skills;
2. Interview with parents to determine their point of view on the child's social skills and their priorities for change (search for objectives agreed with families);
3. establish priorities and express them in the form of written objectives;
4. Based on these objectives to make an individualized design for social skills training.

Intervention in the social area must have as a starting point a structured environment, predictable and with a high degree of coherence. An intrusive style is necessary, which implies "forcing" the child to the contexts and situations of interaction that are designed for him, not forgetting to favor the social competences that he already has. It is necessary to design the environment with concrete and simple keys that help the child structure space and time (P.and., Giving information in advance -Feedforward- through posters with pictograms of the activity that will be carried out below, in addition to expressing it verbally). In another place we have raised specific environmental structuring systems for autistic children's classrooms (Tamarit et al., 1990) and we have emphasized that as in other alterations, such as motor, the elimination of architectural barriers, in the case of autism and serious and deep mental retardation, is proposed to propose and project the elimination of cognitive barriers, that is, to modify the complex keys that exist everywhere, changing them for others more consistent with the level and characteristics of these students.

Some specific intervention objectives in this area

• Teaching basic rules of behavior: P.and. Do not undress in public, keep the appropriate distance in an interaction, etc.
• Teaching social routines: greetings, farewells; Strategies for contact initiation, contact termination strategies, etc.
• Socio -emotional key training: through the video show emotions; use of lotos of emotional expressions; adaptation strategies of emotional expression to context, etc.
• Response strategies to the unforeseen: teaching of social "crushes" to "get out of the way", etc.
• Training of social cooperation strategies: make a construction having half of the pieces one student and the other half, or the teacher.
• Game teaching: teaching of rules games, simple table games, etc.
• Promote the help to classmates: teach specific tasks of assistants of the students of students of another classroom or level; favor this help taking advantage of external activities, such as excursions, visits, etc.
• Design tasks of distinction between appearance and reality: for example, filling someone with rags: "It seems fat but is actually thin".
• Teaching access roads to knowledge: Design tasks for the teaching of verbal routines about the knowledge of the type "I know because I have seen it" "I do not know why I have not seen it".
• Adopt the perceptual point of view of another person: for example, discriminate what a partner is seeing even when he does not see it, etc.

In students with less level of development, the use of simple instrumental strategies will be encouraged, in which the instrument is physical or social. Likewise, the perception of contingency between its - actions and the reactions of the environment will be encouraged (in this sense the contract - imitation by the adult of what the child does - can be, among others, a good way to achieve it).

2. Intervention in the area of ​​communication

The intervention is addressed more to favor communicative competences that linguistic competences, And therefore there is a close relationship between the intervention in the social area and the intervention in the communicative area. However, the latter is characterized by trying to promote expressive, functional and generalizable communication strategies, using as a vehicle of that communication the most appropriate support to the child's level (either the word, signs, pictograms, simple acts, unlikely actions, etc.). The so -called alternative communication systems have meant a huge advance in the intervention. In the specific case of autism, the total communication program (Schaeffer et al, 1980) has perhaps been the most used and the one that has offered the best results. This program emphasizes spontaneity and expressive language and is structured through learning the linguistic functions of: expression of desires, reference, concepts of person, request for information, and abstraction, symbolic game and conversation.

3. Intervention against behavior problems

Among those that are normally considered relevant criteria for the determination of a behavior as a problem are:

1. who produces damage to the individual or others;
2. that those behaviors interfere with the educational plans that this child requires for their development;
3. The fact that these behaviors magazine an important physical or psychological risk for the person or for others;
4. the one that the presence of these behaviors makes that person imply their passage to less restrictive environments.

Currently it is considered that a behavior rather than being a problem (which would indicate a kind of "guilt" in whom it performs) is said to be challenging behavior (as it challenges the environment, services and professionals, to plan and redesign those environments so that the person who performs these behaviors has a place and so that the most appropriate response to the modification of these behaviors can be offered within them).

4. Family intervention

There must be one close relationship of professionals who offer an educational response to these children with their families. One of the objectives that have to be pursued with this relationship is to carry out the same education guidelines in the house and at school, teaching parents the most appropriate ways of action before their child's actions. But another objective should be to give psychological support to these families, in which having a member with autism puts them in a situation of vulnerability and risk.

Many people with autism have other treatable conditions, in addition to their autism. It is common that people with autism also have sleep disorders, seizures, allergies and digestive problems, but these problems can often be treated with medications. The treatment for these conditions may not heal autism, but can improve the quality of life of people with autism and that of their families.

Bibliographic references

• Canal-Kedia, r., García-Primo, p., Martín-Cilleros, m. V., Santos-Borbujo, J., Guisuraga-Fernández, Z., Herráez-García, l.,… & Posada-de la Paz, M. (2012). Clinical practice guide on autistic spectrum disorders. Ministry of Health, Social Services and Equality, Health Technology Evaluation Agency in the Basque Country.
• Martos-Pérez, J. (2015). Asperger syndrome and autistic spectrum disorders: diagnosis and treatment. Neurology Magazine, 60 (Suppl. 1), S31-S37.
• Moya-Albiol, l., & Rodríguez-Scotal, J. F. (2015). Asperger syndrome and other autistic spectrum disorders. Journal of Psychopathology and Clinical Psychology, 20 (1), 1-12.
• Prior, m., & Roberts, J. M. (2012). Autistic spectrum disorders. AEPAP: Primary Care, 44 (5), 221-235.
• Vázquez-Santamaría, m. TO., García-Polo, p., & Fernández-Fernández, C. (2014). Interventions in autistic spectrum disorder. Journal of Psychopathology and Clinical Psychology, 19 (1), 35-52.