Childhood autism has entered the common vocabulary and is often misused to define children with behaviors judged to be abnormal, such as a tendency to isolate themselves or difficulty interacting with the world around them. They can also be signs of autism but often have nothing to do with it. The child neuropsychiatrist Leonardo Zoccante sheds light on this disorder
Autism is a condition inscribed in what is now called the “autism spectrum”, which also includes Asperger’s syndrome and selective mutism, according to the new, fifth, edition of the Diagnostic and statistical manual of mental disorders (Dsm V), the reference manual for all disorders concerning the sphere of mental health.
Here is what it is useful to know in order not to come to hasty conclusions when the child assumes attitudes that can be judged anomalous or, on the contrary, not to neglect signals that could, instead, be alarm bells that should be heard as soon as possible.
Nostrofiglio.it has resolved the doubts about autism and children with Leonardo Zoccante, child neuropsychiatrist of the integrated university hospital of Verona and professor at the University of Verona, who also collaborates with the Children and Autism Onlus Foundation.
In this article
1) More than autism, it is better to talk about autism spectrum disorders
In the past it was considered the infantile stage of psychosis, while today it is known that autism is a so-called “neurobiological disorder”, with its own characteristics and a stable trend, which in some cases can tend to improve over time.
Since autism can express itself at various levels of severity, it is considered more correct to speak of the “autism spectrum”, according to the new, fifth, edition of the Diagnostic and Statistical Manual of Mental Disorders (Dsm V), the reference manual for all disorders. concerning the sphere of mental health.
The definition ‘autism spectrum’ implies precisely the possibility that there are more or less severe forms.
2) Possible symptoms of autism
Autism is characterized by the inability to interact with the outside world. It manifests itself with closure towards others, lack of learning of language (50% of cases) or, inappropriate use of verbal communication.
There is a tendency to isolate oneself, repetition of particular behaviors (for example, rocking with the body), inability to understand the expressions and attitudes that characterize normal social and emotional life (for example, hugs and smiles).
Symptoms are not the same for everyone and also vary according to the severity of the disorder.
3) Autism is not on the rise but there are more diagnoses
In recent years, the notion that autism is on the rise has emerged among ordinary people. In reality, it is not sure if this is the case: it is possible, in fact, that the number of registered cases, higher than in the past, is due to a greater knowledge of the disease from which more chances of diagnosing it arise. Autism spectrum disorder is currently estimated to affect 4-6 children in every thousand births. The prevalence is in males, in a 4 to 1 ratio. There are no precise data referring to the past.
4) The first diagnosis can be made between two and three years of life
It is around two to two and a half years of age that autism can be diagnosed with certainty, even if some signs can be picked up early (see next point). Certainly the disorder cannot appear suddenly after three years of age, if there has been no sign of it before this time.
The diagnosis belongs to the infantile neuropsychhatra, to which the parents are usually referred by the primary care pediatrician, who is usually the first to detect the existence of a problem, also thanks to what the mother tells.
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5) It is useless to hazard a do-it-yourself diagnosis. Better to go to a specialist (and then ask for a second opinion)
At six to eight months of life, the first signs of autism may appear, even if to venture a hypothesis as well as wait for the child to grow older, you need extreme caution and, above all, the indispensable support of a specialist.
Here are the signs that may suggest the problem: the child does not stretch his hands towards the mother to be taken in her arms; does not show particular reactions when the mother appears; reacts poorly to sounds; has a cry that is difficult to interpret; is very irritable.
However, it is possible that up to 8-16 months of life (approximately) the child has almost normal behaviors and that the disorder begins to manifest itself conspicuously after this period: in a similar eventuality we speak of “loss of skills”.
6) The possible signs of indifference towards the mother and some games
Between 12 and 24 months he is completely indifferent towards his mother: he doesn’t cry when she walks away, he doesn’t smile at her when she approaches.
He does not show interest in games such as “hide and seek” (“bau – seven), he does not appear amused if you sing songs to him.
When he looks at an object to grasp it, he does not look for the collaboration of his mother to succeed in his intent.
He also doesn’t try to involve her in games or when looking at pictures in a book.
It may not pronounce any monosyllable (“ma”; “ba”; “pa”). It does not understand the prohibitions (“Don’t do this!”); does not obey simple orders (“Get the ball!”); does not react to praise; does not express emotions appropriate to specific circumstances.
7) The closure of the communication channel
From 24 months onwards it becomes absolutely unequivocal that all communication systems, verbal and otherwise, are altered: we speak of “closing the communication channel”. In particular, the child does not interact in any way with the people around him (he does not smile, does not look into the eyes, does not show joy, surprise, curiosity).
It tends not to understand even one of the simplest communication codes; is intolerant of physical contact; it never has any affectionate movement; is not attracted to the company of other children; may have unjustified fits of fear; he is more comfortable when alone. He may not have acquired any form of language or he may use only a few words repetitively or …