Autism: Parents and the environment remain locked out.
The girl doesn’t like to sit in the sandbox with other kids. Instead, she prefers to spend a lot of time alone with a toy. She doesn’t react to other people’s smiles and avoids direct eye contact. Such and similar abnormalities can indicate autism.
Autistic children have adaptation difficulties because their perception differs from that of other people. Like an invisible and impenetrable wall, autism seems to separate them from their environment. It is a variant of human existence which, like all others, has its advantages in addition to difficulties: While autistic people may find “simple” things difficult, they may find “heavy” things easy. Many autistic people would therefore not want to do without their peculiarity and regard it as one of many ways of perceiving the world and people.
Definition of Autism
Autism is a neurological developmental disorder that is associated with difficulties in social interaction, social communication (verbal and non-verbal) and social understanding. However, there is disagreement as to whether it should be classified as a disease or rather as a special variant of human information processing. The restrictions in everyday life also include special perception processing, ways of thinking and problem-solving approaches.
These peculiarities, however, often represent a handicap in everyday life and in dealing with fellow human beings. People with autism find it difficult to assess the emotional signals of their fellow human beings and have difficulties in sending them out. People with autism also show repetitive, stereotypical behaviors.
What is the autism spectrum?
Autism is not expressed in a single characteristic, and the transitions between what is defined as autistic and non-autistic are fluid. Autism is a spectrum. This means that while all autistic people share certain characteristics, none is like the other. Some people are therefore “a bit autistic” and others are very autistic. Autism is therefore only spoken of when there are enough “symptoms” to suggest it.
Perceiving Autism as a Special Feature with the Pressure of Sorrow
One in a hundred children suffer from autism, British researchers have found, and boys are affected four times more often than girls. And one must indeed speak of “suffering”, is the opinion of Inge Kamp-Becker from the University of Marburg. “Even though the Internet in particular often propagates a view that describes autism as a new form of existence and reformulates the symptoms of autistic disorders into positive ones, there are usually strong difficulties in participating in society and integrating.
Especially when there is no cognitive impairment, the children perceive their ‘otherness’ and suffer from it, most clinicians and scientists agree,” explains the head of the Marburg Special Outpatient Clinic for Autism Spectrum Disorders.
Test best by the specialist
Often it’s the little things that stand out at some point: The child does not react to a smile, does not laugh itself and prefers to play alone than with other children. If such early signs of an autistic disorder occur, many parents are insecure. But not every delay in development must immediately indicate autism. In addition, autistic disorders vary in severity from child to child.
“The symptoms are very varied and require a differentiated and detailed diagnostic examination. For this purpose, standardised methods are used that take into account the entire range of symptoms, which requires specialist expertise and experience,” explains Kamp-Becker. People with autism often have problems eating and sleeping as babies and develop self-stimulating behaviours.
Test for Autism
There are online tests for children and adults. However, these do not distinguish between different forms of autism. The result should only be seen as an initial assessment. There may also be overlap between autistic and non-autistic results. But even when a psychiatrist makes a diagnosis, a certain arbitrariness cannot be ruled out, which is marked as autism and which is not.
Symptoms of autism
Despite all the diversity, there are also very typical core symptoms of autism that parents can watch out for. “We noticed that something was wrong when one of our sons was sitting in the sandbox with a neighbour boy”, the chairman of the regional association Autism Göttingen reports from her own experiences.
“Whether someone was sitting there or not was completely irrelevant to our son. Autistic children often seem unapproachable. They avoid eye contacts and touches and their interests usually refer to a few areas where they can then develop into true experts.
Behaviour of autistic persons
Each autistic is individual, but there are some symptoms that usually occur:
- Difficulties in building and maintaining relationships
- difficulties in communicating with other people, for example through language
- Stereotypical behaviors that repeat themselves
This is reflected in various behaviours: Autistic people tend to isolate themselves from their environment. Autistic children usually prefer to play alone. This retreat into “their own world” makes them seem unapproachable to some fellow human beings. They usually avoid contact with them by looking or touching them. Some do not want to shake hands or let themselves be embraced. Since autistic people sometimes do not notice that people are around them, they do not greet or say goodbye to them either.
Especially children with early childhood autism (Kanner syndrome) have a limited way of speaking, e.g. start speaking only at the beginning of puberty or hardly speak even as adults. They hardly include facial expressions and gestures in their communication and speak with an unusually accentuated, deep tone of voice, which is why they often seem peculiar and cool to their counterparts.
For example, they emphasize a statement like a question. Even if they speak to someone from the outside, this is usually more of a monologue than a dialogue, because they find it difficult to respond to the other person. It can also happen that autistic people do not react when they are called, even though they have a healthy hearing. Their body language is also often clumsy.
Autistic people never tire of taking an interest in a particular area, such as sorting things like cuddly toys. Most autistic children are more interested in one aspect of an object than in the whole object, for example the wheels of the toy car rather than the car itself.
Autistic people repeat certain behaviors or movements, such as rocking the body back and forth or grinding their teeth. On the one hand, this can have a calming effect if external stimuli are perceived as overstraining, on the other hand it has a stimulating effect if external stimuli are too weak to penetrate to the autistic person.
Autistic people are very sensitive to change, so it is good for their well-being if things go according to fixed structures. For example, if your favorite shoes are in a different place, or the morning way to school is a detour, you may react anxiously or angrily to this irritation. Anxiety and sleep disorders are not uncommon in autistic people.
Different forms of autistic disorders
The best known form of autistic disorder is early childhood autism, also known as Kanner syndrome. Early autism can already be noticeable in infancy. Corresponding signs should be taken immediately as an opportunity to initiate a specific diagnosis in order to be able to provide support as early as possible.
These children are often below average intelligent and usually need lifelong help and support. The intelligence of a person, however, is independent of the strength of autism. The cognitive abilities of autistic people range from diminished intelligence to average intelligence to giftedness. Children with Asperger’s syndrome or so-called atypical autism, both milder forms, have good chances of independent living.
Asperger’s syndrome and atypical autism
The current ICD-10 still distinguishes between early childhood autism, i.e. Kanner syndrome, Asperger syndrome and atypical autism as forms. DSM-5, on the other hand, the dominant psychiatric classification system in the USA, no longer distinguishes subtypes and only speaks of a general autism spectrum disorder.
Children with Asperger’s syndrome or atypical autism are therefore not noticed until kindergarten age at the earliest, and often not until primary school. They only make very limited contact with other people and have an isolated effect. Some are very intelligent, know their way around certain areas perfectly, but still have problems learning.
They often seem precocious and very serious, often talk to themselves and talk with a conspicuous speech melody. It is difficult for them to respond to the other person and what he or she says. Anger outbursts and an awkward body language are also typical for these forms. In addition to increased anxiety, sleep disorders and tics can also occur.
Each individual case requires an individual therapy.
Not least because of the variety of symptoms and different forms of autism, it is difficult to make an accurate diagnosis. “First of all, a differentiated diagnostic examination is necessary, which should be followed by a detailed and intensive consultation with the parents,” explains Inge Kamp-Becker.
“The aim is to obtain an accurate picture of the child’s strengths and weaknesses and to draw up an individual treatment plan, in which behavioural therapy measures have proven to be particularly helpful”. One often works here with a behavioural training called Applied Behavioural Analysis (ABA) which, to put it simply, is based on the reward principle. Sometimes it also makes sense to include physiotherapy and speech therapy in the treatment plan. However, autism is not completely curable according to current knowledge.