Where does the term "autism" come from?
The term autism comes from the Greek (autos = self) and describes the social retreat and a way back into one's own thought world
The autistic syndrome referred to above has three special features:
- Qualitative impairment of social interaction
- Qualitative impairment of communication and
- Restricted interests, stereotyped behaviour patterns, special talents and peculiarities in the attention functions
What are the characteristics of everyday life?
1. Qualitative impairment of social interaction
Affected persons have problems recognising the emotions of others and putting themselves in the emotional state of the other person, lack of "cognitive empathy".
2. Qualitative impairment of communication
Affected persons have problems in non-verbal communication, for example understanding or correctly interpreting the facial expressions and gestures of the person opposite, so that misunderstandings often occur. Proverbs are understood literally, for example "hit the ceiling", two-way communication is difficult, "small talk" is not possible, "reading between the lines" does not work.
3. Restricted interests, stereotyped behaviour patterns, special talents
Affected people live according to their own rigid and repetitive daily routine, often with routines (e.g. always eating the same thing at a fixed time before going to bed, everything must always be laid out exactly the same way on the desk).
Example for special talent or special interest: one of our patients, who attends a grammar school, rides the tram for several hours a day and knows every line, every single tram and also every tram driver in the city.
4. Other characteristics that are typical:
Lack of spontaneous eye contact (often trained to look between the eyes of the other person), rapid sensory overload (acoustic, tactile, visual) Difficulties in fine motor skills and coordination of movements, e.g. noticeable in group games,
detail-oriented e.g. in visual perception, anger attacks, motor stereotypies such as rocking, running in circles.
The 3 different forms of autism
- Early Childhood autism
- Asperger syndrome
- Atypical autism
Early Childhood autism
Here, abnormalities occur from birth. Significant delays in language development and motor development are noticeable. Prelingual social contact of the toddlers, for example in the form of eye contact or social smiles, is also often disturbed. It is not uncommon for there to be a general delay in development and a reduction in intelligence. In distinction to Asperger's syndrome, these abnormalities are already visible before the age of 3.
Asperger syndrome
Asperger's syndrome was described by Hans Asperger in 1944, but research only intensified in the early 1990s.
It differs from early childhood autism in that until the age of 3, development and especially language development still progresses in line with age. People with Asperger syndrome often have an inconspicuous intelligence, sometimes even above average. As a result, difficulties in social perception and communication can often be hidden or compensated for, so that the diagnosis is only made very late in adulthood.
Atypical autism
This subtype is often composed of patients who cannot be clearly assigned, who, for example, did not show any abnormalities until the age of three, but then develop a plethora of symptoms that go beyond classic Asperger's autism.
In the future, however, classification will only be carried out in severity
In the new classification (according to DSM-V and ICD 10), this is now called autism spectrum disorder. This includes all forms of autism. Instead, a distinction is to be made between different degrees of severity.
Autism often does not occur alone – frequent concomitant diseases (comorbidities)
- AD (h) s (Attention deficit/hyperactivity disorder, concentration problems that arise due to easy distractibility by external stimuli or own thoughts and can be coupled with impulsivity and hyperactivity).
- Tourette syndrome
- Depression, phobias, post-traumatic stress disorder, obsessive compulsive disorder, eating disorders, insomnia, stuttering, etc.
- Epilepsy - especially in the case of an existing mental disability
Causes of autism disorders
Genetic factors
Hereditary factors are considered to be one of the main causes of autistic disorders. However, there is no such thing as an autism gene; instead, it is assumed that there is an interplay of different genes that are passed on by the hereditary carrier or have only changed in early intrauterine development (spontaneous mutations). If one parent is affected by autism spectrum disorder, the risk of also having a child with autism spectrum disorder is greatly increased. Identical twins usually both develop autism spectrum disorder. Presumably, a complex interaction of different genes and environmental factors is responsible for the disorder.
Parental age at birth of child
The influence of older age of fathers on increased rates of autism spectrum disorders could be confirmed. Other studies found effects for both higher maternal and paternal age.
Risk factors in pregnancy and childbirth
Certain infectious diseases of the mother during pregnancy, such as rubella infection, are proven risk factors for autism spectrum disorders. A Danish study found an increased risk after severe viral infections in the first trimester and severe bacterial infections in the second trimester. Several population-based studies were also able to show that a (strong) alcohol consumption and a strong psychosocial burden on the mother could be excluded as pregnancy-associated risk factors.
The diagnosis of "autism" is increasingly hitting children. Especially among Asperger's syndrome many suffer
Children with autism usually find it difficult to make friends, prefer to be alone, are more interested in technical things than in people: Autistic people unfortunately suffer from a disorder of social interaction and communication as well as rigid behaviour. More and more often, children are being diagnosed with a specific form of the disease, Asperger's autism. What is the reason for this? And when is a child simply a loner, when is he autistic?
Other signs of autism include:
- Autistic avoid eye and body contact.
- Even slight deviations from everyday life can be brought out of the version.
- They always repeat the same movements and words.
- Autistic often do not listen to their own names and ignore human voices rather than sounds.
- When you play, you can't pretend to be – that is, you do yourself with role playing hard.
- Even as toddlers, they do not show things and do not try to direct the gaze of an accompanying person at the same time.
- They cannot be infected by the feelings of others – for example, when everyone is happy for them on their birthday.
Ever more children affected?
Until the 1970s, only early childhood autism was known as a clinical picture. At that time, there were four to five autistic people for every 10,000 people. In the 1980s, Asperger's autism was discovered in the English-speaking world, which increased the number of cases. In addition, the diagnostic possibilities became better and better. In the meantime, the number of cases has risen to 1 to 1.5 percent. This is positive for those affected, as they are spared a long ordeal of misdiagnosis and appropriate therapies can be started earlier.
Diagnostic methods are constantly improved
Today, refined diagnostic tools make it possible to detect signs of the disorder earlier and earlier. However, it is often only conspicuities at school that lead to the diagnosis. The signs are then usually disturbed language development and problems in dealing with other children. Sometimes other possible Comorbidities (e.g. ADD/ADHD) are so prominent that they obscure the diagnosis of "autism spectrum disorder" and this only occurs much later.
Therapeutic approaches
Exercising everyday situations with behavioral therapy
There is no medication for autism, only for some accompanying disorders such as ADD/ADHD or epilepsy. Otherwise, behavioural therapy helps: In special exercises, those affected train, for example, how best to make contact with other people and communicate with them, how they should behave in groups and what is socially appropriate.
Various organisations or special outpatient clinics, usually at university hospitals, offer courses for parents of autistic children. One example is the autism therapy centres of Autismus Deutschland e.V. However, health insurance companies do not usually pay for the courses.
Some useful addresses
Autismus.de
Autism Therapy Institute Long
University Freiburg