Autism

"The possibility of accessing educational, pedagogical and support services has a beneficial effect, since even children with more severe autism have the capacity to learn some adaptive skills".

DR. ROCÍO SÁNCHEZ-CARPINTERO ABAD
DIRECTOR. NEUROPEDIATRICS UNIT

Autism is one of the so-called pervasive developmental disorders.

In these disorders, not only is there a developmental delay, but also an atypical development, with extensive alteration of functions.

Most children with Pervasive Developmental Disorders are also mentally retarded (IQ less than 70).

Within children with autism, there is a wide spectrum of severity, with some symptoms being more severe and others being milder.

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What are the symptoms of autism?

Deficits in social interaction are probably the most characteristic and specific of children with autism. From an early age, children do not respond to the gestures and looks of the people around them, they do not seek contact with other people, they prefer to play alone.

Serious problems in the verbal and non verbal communicative language, frequently they do not have an intelligible language or they repeat the words that they hear (echolalia), they alter the order of the words or they use them with particular meanings for them.

Repetitive or stereotyped behaviors: they are only interested in one thing in an excessive and inflexible way (car wheels, red books...), they perform repeated rituals or routines without any function or stereotyped movements (such as hand flapping).

The most common symptoms are:

  • Lack of contact with the environment.
  • Stereotyped body movements.
  • Abnormalities in the emission, form and content of language.
  • Marked abnormality in non-verbal communication.
  • Irrational insistence on following routines.

Do you have any of these symptoms?

Your child may have an autistic disorder

What are the causes of autism?

The cause of autism is not known, although it is known to be a genetic disorder, since it is more frequent in siblings of children with autism (frequency of 4.5% in siblings of patients).

Autism could be the result of the interruption of normal brain development at an early stage of fetal development, caused by defects in the genes that control brain growth and regulate the way in which neurons communicate with each other.

Up to 80% of children with autism are mentally retarded, and up to 35-40% suffer from epilepsy in the first 20 years of their lives.

About 5% have Fragile X syndrome and others have suffered infections, such as meningitis, or have been affected by congenital rubella, phenylketonuria or tuberous sclerosis.

Through brain imaging studies, such as magnetic resonance imaging and axial tomography (CT scan), alterations in brain morphology, enlargement of the areas of the brain containing the cerebrospinal fluid (the brain ventricles), and alterations in the cerebellum and the front of the brain are found.

What is the prognosis of autism?

Children with autism often get worse when they have medical illnesses or there is environmental stress. The possibility of accessing educational, pedagogical and support services has a beneficial effect, since even children with more severe autism have the capacity to learn some adaptive skills.

Some predictors of good response include near-normal IQ, good language skills (especially if the child can communicate verbally before age 5), increased social skills, and later onset of symptoms.

Depending on the severity of the disorder, 2-15% of children with autism reach an intellectual level and 33% are able to function independently by the time they reach adulthood.

How is autism diagnosed?

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The behavioral observation of a child with autism for diagnostic purposes is a complex task that must be performed, therefore, by expert professionals (neurologists, psychiatrists or psychologists).

A complete physical and neurological examination, including vision and hearing tests, should be performed.

During this phase, it is advisable to be able to observe the relationship with the mother (or the person who is preferably attending the child), since this usually provides very significant data for the differential diagnosis. 

To make the diagnosis of autism, severe deficits must be detected in three main areas:

  1. Qualitative alteration of social interaction.
  2. Qualitative alteration of communication.
  3. Patterns of behavior, interests and restricted, repetitive and stereotyped activities.

How is autism treated?

Those patients who have early access to multimodal treatment improve significantly. The environment should be highly structured and include special education teachers, speech and language therapy, vocational treatment, and adaptive skills training.

Behavioral treatment reduces unwanted behaviors, promotes language and social interaction, and increases skills that promote independence.

It is critical for parents to work with their child to find the necessary services available in their area.

There are associations of parents of children with autism that are very helpful in organizing and distributing resources.

Educational programs should be based on structured principles and include behavioral learning systems, speech therapy, and occupational therapy. Psychotherapy is indicated in high functioning autism and Asperger's disorder, all aimed at improving social skills or expression of feelings.

Medication is sometimes necessary to treat psychiatric symptoms that may arise, such as antidepressants to reduce repetitive behaviors; and antipsychotics to improve social interaction.

Where do we treat it?

IN NAVARRE AND MADRID

OUR MEDICAL TEAM

Specialists of the Neuropediatric Unit

The Unit is part of the Department of Pediatrics and works closely with specialists from other departments to provide integrated care for children and adolescents with risk factors or diseases affecting the central nervous system and neuromuscular system.

It is made up of a team of neuropediatric specialists and psychopedagogues.

Diseases we treat

  • Early development and its deviations.
  • Motor control disorders.
  • Global developmental disorders. Autism.
  • Epilepsy in children. Dravet syndrome.
  • Sleep disorders.
  • Attention deficit and hyperactivity disorders. ADHD.
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Why at the Clinica?

  • Teamwork to offer a valuation in 24 hours.
  • Most experienced nationally in Dravet Syndrome.

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