SORDER AND AUBISM IS CONFUSED? Alerts at diagnosis time

Both in the field of health and education, we find more and more boys and girls with symptoms coinciding with autistic spectrum disorders. According to recent studies, one in 160 boys or girls has ASD, which is why,
As professionals, it is appropriate to give us a moment to Evaluate this diagnosis.

In the case of the population with hearing impairment, the diagnostic doubt regarding autism is evident.

Hearing loss vs. autism

For the DSM V these symptoms are considered within the so -called neurodevelopment disorders that are normally manifested early and are characterized by a development deficit that produces deficiencies of the
Personal, social, academic or occupational functioning.

Investigating the subject I have encountered more than once, with references from recognized authors who put in relation to the diagnostic issue of autism and deafness. The thing is Hearing loss is a pathology that leaves the isolated subject of the others. It is a job for the deaf person to build links, develop their social, personal, academic and even occupational functions, because oral communication is difficult.

For example, Alicia Hartmann in her book "In search of the child in the structure”, Raises in relation to the Roberto case:“ It is striking that it does not look in the eye, and that is repeated by several sessions. It seems deaf, with a certain autistic shell, Although there are words, in their self -absorption it only directs them to toys ”(Hartmann, 2009, p. 240). For his part, Jerusalinsky, in "Autism psychoanalysis"He says that in 1943 Leo Kanner applies the term" autism "in children with a tendency to withdrawal, and states that" most of these children were treated with the assumption that they were intensely mental weak or with the question about a possible auditory decrease”(Jerusalinsky, 1988, P. 25) Later, in reference to another author, Furneaux says “A blind or deaf child has autistic characteristics, that is, it presents behaviors found in the creatures called autistic…” (Jerusalinsky, 1988, P. 26).

It is very interesting that professionals with experience, with clinical experience and especially with years dedicated to autism research, raise that similarity between such pathology and deafness. And this was the reason that led us to realize the Research published in our recent book "Differential Diagnosis. Deafness - Autism " of Spanish Academic Editorial.

In it we work the theme from a clinical case, the Andy case. And we propose a diagnostic approach, from Lacan's proposal, clinical structures and subjective positions. Andy, beyond his features, that from the DSM we could define as autistic, he was a child who evidenced connection and registration of the other. It is worth clarifying that for this manual the autistic spectrum disorder is characterized by a deficit in communication and social interaction including nonverbal communicative behaviors.

In the case of deaf boys and girls, including nonverbal communication brings confusion. It is common for a deaf child, born in a listening family, without a correct auditory rehabilitation (which is more common than is believed) and without a formal sign language, appeal to nonverbal communication, for gestures, mimicry or Homemade signs. As well as the presence of restricted or repetitive behaviors or interests, It is located at the agenda in the behavior of these children who, due to lack of a common language with their interlocutors, dedicate infinite hours to their particular games or interests, in solitude.

Finding deaf children with difficulties to link, with communicative problems and with repetitive or limited games cannot be sufficient to make an autism diagnosis, but all or the vast majority would be.

This conviction supported the published research and there we ask ourselves if, to these children who do not have language (at least Andy did not have a formal one), and their form of communication is almost nil, we will not diagnose them with ASD (which would offer us a treatment plan), so how do we help them? What is what happens to them?

Thus, psychoanalytic theory came to our aid, contributing its conceptualizations from a look at subjectivity. Subjectivity, particularity, case by case, involve for the analyst, a subject of the subject in the coordinates of his history, in his framework to link and, in the case of children, familiar, familiar.

M -chaat questionnaire for the early detection of autistic spectrum disorder (TEA) in young children

Andy's case

Andy, was a deaf child, with a listening family who did not speak signs language. He attends a special school in CABA (Argentina) and still, his teacher observes something in him that differentiates him from the other children. Evaluate these features such as
"Not expected" and suggests a consultation.

In those Andy coordinates he arrives at my office. In the mentioned book they can read how their treatment was carried out. In this article we are interested in resuming the idea of ​​differential diagnosis since we do not want to have the majority of deaf children, behaviors similar to the considered symptoms of ASD, said disorder would not be weighted at the time of the evaluation.

The behavior of deaf boys or girls without a formal language, accustomed to belonging to the social media of listeners, where orality is the protagonist and where both the child, as well as their needs -professional deafness, but that are not exhausted in it, and that are not resolved with repairing or rehabilitating interventions- are not taken into account, thus losing the look of their others of importance and being reduced to, as a mother said, "an ear that does not listen", can be striking for their teachers or intervening professionals (phonoaudiology, early stimulation, vocal reeducation, psychopedagogy, etc.). And this can lead to interconsultation with psychology, neurology and/or psychiatry.

When, as professionals, we find these patients, it is essential to be trained with respect to the particularities that deaf people are going through in their path of access to the language, for Do not fall into a rapid phenomenological diagnosis.

However, this does not mean that no deaf child has tea. Both pathologies, deafness and autism can coexist in a child, which does not mean that the second is explained by the presence of the first.

There are deaf children who phenomenologically have autism features, and autistic deaf children.

And that is because of that dividing line that we proposed to address the case of Andy. Because we understand that indeed Deafness, many times, brings linked, symbolic and behavioral alterationsS, which we do not consider enough to diagnose an autism, or to name them as "autistic features", but not for that reason, it does not deserve to be evaluated from mental health.

Conclusions

These are usual difficulties, which respond to organic pathology and the way in which it is inserted in the child of the child, that is why We find it right to accommodate them from analytical discourse.

With the Andy case you can access the beginnings of a treatment with a deaf child, to preliminary interviews. Clinical work begins from a school derivation that comes to tell us that there is something in Andy that does not go. Something that the family cannot see, and that now, thanks to clinical work, we can call Your symptom (In the analytical sense of the term).

Do not miss the new book by Marisol Flores:

Differential diagnosis: Deafness - Autism