了解自闭症

Five-year-old Eli is quiet and serious. Bright lights and loud noises can overwhelm him, but he loves color and expresses himself through vivid drawings. He tends to play on his own, focusing intently on the intricate patterns he creates with his toy blocks.

At eight, Leah is non-verbal but has a strong sense of her surroundings. Using an assistive communication device, she selects images to convey her feelings and needs. She thrives on routines, finding comfort in predictability, and often rocks back and forth when trying to soothe herself.

Ten-year-old Shmueli finds comfort in routines. Transitions, especially unexpected ones, are unsettling for him. He asks lots of questions, seeking clarity and stability. He thrives on clear expectations and needs gentle reassurance throughout the day. He rarely initiates conversations but listens intently, often repeating phrases or sounds he finds intriguing. 

All three of these children have autism spectrum disorder (ASD, or autism in short). 

What exactly is autism?

Autism is a complex neurological disorder. At its core, autism is a neurodevelopmental disability shaped by various brain differences, and it impacts how the brain processes information, interprets experiences, and engages with the world.

According to the Centers for Disease Control, ASD affects approximately 1 in 36 children in the United States today. It’s four times as common among boys as girls. 

Understanding the types and levels of autism

ASD has been termed a spectrum disorder because there’s a vast range of experiences and abilities among individuals with autism. There are different types of autism, including Asperger’s syndrome, pervasive developmental disorder-not otherwise specified (PDD-NOS), and classic autistic disorder. Each type presents unique challenges and strengths.

Additionally, autism is often categorized into different levels of autism severity, based on how much support an individual requires. Level 1 (requiring support), Level 2 (requiring substantial support), and Level 3 (requiring very substantial support) reflect the range of experiences and abilities among individuals with autism.

Some individuals face challenges primarily in social interactions, while others may have heightened sensitivities to sensory stimuli. Conversely, many show remarkable talents in areas like art, music, mathematics, or memory.

The biological basis of autism

These varying talents and challenges can often align with specific types of autism or different levels of autism. Every individual with autism experiences the world uniquely, and behind each of these experiences lies a rich tapestry of thoughts, feelings, and potential.

The neurological underpinnings of autism are multifaceted. Variances in brain structure and function contribute to the unique challenges and strengths of those with ASD. Imagine the brain as a complex highway system; in autism, the “routes” for social cues, sensory input, and other skills might be mapped differently.

These alternative pathways can lead to sensory sensitivities and often coexist with medical or mental health conditions like gastrointestinal disorders, seizures, or anxiety, which can vary based on the different levels of autism severity.

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Identifying the first signs of autism

Signs of ASD can manifest early on in a child’s life. While signs of autism in newborns aren’t pronounced, they become more apparent at 24 months or later. 

Early diagnosis offers the benefit of timely intervention, increasing the potential for a positive long-term impact. However, it’s essential to note that even if a diagnosis was made later, there’s still great potential for growth and progress. 

Keeping an eye on a child’s developmental progress is essential. Signs of autism in newborns to look out for during the first year of life include things like limited eye contact, not responding to their names, or a lack of bodily communication like pointing or waving by 12 months. These symptoms can indicate various types of autism.

As they grow into toddlers, between the ages of 1 and 3, you might notice more pronounced symptoms such as delayed speech, repetitive behaviors, or inconsistent reactions to sensory stimuli.

When children reach preschool age, from 3 to 5 years, their social interactions offer more cues. They may show difficulty in understanding how to play with toys appropriately, exhibit distress at even minor changes in routine, and may struggle with understanding and expressing emotions. 

However, you should understand that occasional signs don’t confirm autism; it’s their persistence and intensity that matter. Consult a health care professional for an evaluation and possible early interventions if you’re concerned.

Diagnosis: How screening works

Identifying autism is a multi-step process that integrates observations, screenings, and comprehensive assessments. 

Pediatricians often serve as the first line of identification through routine well-child checkups, at which they monitor growth, behavior, and learning. These regular visits can help detect potential developmental delays and serve as a foundation for further evaluation.

Additionally, a specific screening tool, the Modified Checklist for Autism in Toddlers (M-CHAT), is used for children aged 16-30 months to help parents and professionals identify early signs of autism.  If preliminary screenings raise flags, the next step involves a more comprehensive diagnostic evaluation by a team of specialists. 

Comprehensive diagnostic evaluation

These evaluations help identify the specific types of autism and determine the appropriate levels of autism severity, informing targeted intervention and support plans. 

Specialists involved typically include developmental pediatricians (who specialize in child development and behavior), child neurologists (who rule out other neurological disorders), child psychologists or psychiatrists (who conduct detailed behavioral assessments), and speech and language pathologists focusing on common speech and language challenges.

The guidelines for diagnosing autism come from the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). There isn’t a specific medical test to diagnose autism, but a combination of structured observations and tests covering social interactions, communication skills, and behavior to assess whether an individual meets these criteria. 

Additional specialists may be included in the diagnostic process, and some cases, genetic testing may be recommended to identify conditions like Rett syndrome or Fragile X syndrome.

The results of these formal evaluations are crucial for determining whether an individual meets the criteria for an autism spectrum disorder, which now encompasses types of autism previously diagnosed separately, like autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome.

What help is available? 

Navigating the realm of autism treatments and medication options can be overwhelming. With the vast array of choices available, it’s important to ensure that interventions are an appropriate fit with the person’s unique needs. These are some of the interventions that you might find helpful in assisting your child with autism.

1. Behavioral and communication therapies

Behavioral and communication therapies play a significant role in supporting individuals with autism across various types of autism and levels of autism. These therapies aim to address specific challenges in behavior, communication, and everyday skills.

Applied Behavior Analysis (ABA)

Applied Behavior Analysis (ABA) is a widely recognized therapy used to address challenges related to autism. ABA involves understanding behaviors and modifying them through positive reinforcement. It helps individuals across all levels of autism to improve a range of skills and reduce undesired behaviors.

Speech Therapy

Speech therapy directly addresses common communication difficulties found across different types of autism. It supports individuals in enhancing their verbal, non-verbal, and social communication skills, helping them better express themselves and interact with others.

Occupational Therapy

Occupational therapy is customized to support individuals in overcoming daily life challenges. It particularly benefits people with varying levels of autism by targeting essential areas such as daily living skills, motor coordination, and sensory processing.

Educational Therapies

Children with autism greatly benefit from personalized educational programs and specialized teaching strategies designed according to their unique types of autism severity.

• Individualized education plans (IEPs): Customized learning plans designed specifically for the student's unique educational and developmental needs.
• Structured teaching and autism visual supports: Utilizing visual aids, this approach helps organize the learning environment to match an individual's learning style, benefiting learners across various autism profiles.

These educational therapies can greatly enhance academic and social success for individuals with autism.

2. Family therapies and support

Family involvement is critical in autism support. Family therapies and autism support groups empower family members by providing strategies and emotional support, beneficial across all types of autism.

• Equip families with practical strategies to better understand and support their loved ones.
• Provide counseling services to address the emotional and physical challenges faced by families.

Family therapies foster stronger bonds and create more supportive home environments, vital for individuals with autism.

3. Medication options

While no medication can cure autism, certain drugs can manage symptoms associated with specific types of autism. Medication should always be considered alongside behavioral and educational interventions.

• Attention challenges: Medication like Methylphenidate can improve focus in some individuals.
• Anxiety and depression: 选择性血清素再摄取抑制剂（SSRI）可能会有所帮助。
• 行为问题： 利培酮或阿立哌唑可以控制烦躁和攻击性。
• 睡眠障碍： 褪黑素补充剂或处方助眠剂可能有助于更好的休息。

药物可以显著提高生活质量，但需要医疗保健专业人员的仔细监测。

4。替代疗法和补充疗法

许多家庭都在探索替代疗法和疗法，以补充传统的自闭症干预措施。这些方法通常支持特定的感官需求和情感表达，不同类型的自闭症会有所不同。

• 基于感官的疗法： 利用 感官整合 秋千或蹦床等工具。
• 饮食方法： 尽管科学证据各不相同，但无麸质或无酪蛋白饮食可能会带来好处。
• 音乐或艺术疗法： 创造性活动可以缓解情绪，带来治疗益处，并为自我表达提供宝贵的渠道。

替代疗法提供了根据个人需求量身定制的额外支持和充实途径。

归根结底，自闭症的治疗和管理需要高度个性化的方法。与医疗保健和治疗专业人员密切合作，了解个人的特定自闭症类型和相关的自闭症水平，并建立强大的支持系统，为成功和幸福奠定了最坚实的基础。

总结

如果你是这段旅程中的家长，请知道我们对自闭症的理解在不断演变，随时了解情况非常重要。我们提供支持，既有专业指导，也有自闭症家长支持小组，即与你走在同一条道路上的父母和看护人组成的社区。寻求和接受这种支持将使一切变得不同。

立即联系 Hamaspik 并了解我们的专业资源、专家指导和富有同情心的护理如何帮助您的家庭蓬勃发展。

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