Early childhood autism

from Wikipedia, the free encyclopedia
Classification according to ICD-10
F84 Profound developmental disorders
F84.0 Early childhood autism
ICD-10 online (WHO version 2019)

The early childhood autism (also: Kanner's autism , autistic disorder or infantile autism ) is a form of autism . According to the ICD-10 (classification system of the World Health Organization ), it begins before the age of three and is counted among the profound developmental disorders. This form occurs with a frequency of 1: 1000, with the ratio of boys to girls being 3: 1.

Early childhood autism was first described by Leo Kanner (hence Kanner autism ). In 1943, Kanner diagnosed eleven children with an "autistic disorder of affective contact" (see psychopathology of affect ), which later became known as "early childhood autism".

Symptoms and ailments

The early childhood autism leads to a diverse type of problems, especially in the area of development, social behavior , of perception and communication . In some cases the children develop abnormally in the first few months of life. In other cases, early childhood development is (apparently) normal at first, abnormalities sometimes only become visible in the second or third year of life. Furthermore, there is a trend that after an initially (apparently) normal development in the second or third year of life, there is a loss of the social and communication skills already acquired.

If one summarizes the two internationally recognized classification systems ICD-10 and DSM-IV, one recognizes the following matching features:

The ICD-10 also lists “unspecific problems such as fears, phobias , sleeping and eating disorders , outbursts of anger , aggression , self-harm ” as a feature .

One of the characteristics of early childhood autism is the isolation from other people. The attention to the primary person, which is typical for this age, shows clear disturbances. The affect is indifferent, the ability to vibrate emotionally is reduced. Reduced eye contact can be determined in direct contact . For some autistic people, it is difficult to develop relationships with people. It often seems as if they enjoy working with objects more than in personal contact with people of the same age. Others show interest in social contact, but then often suffer from being offended and marginalized in other people due to their social behavior problems .

Fear of change : Autistic people sometimes react with states of fear and panic if something changes only slightly in the regular daily routine or if expectations (e.g. the place where the furniture is) are not met.

Kanner people with autism usually have severe language problems . Approximately 30% of Kanner's autistic people can not spoken language to express. Those who can speak often have language abnormalities (for example, monotonous speech melody; verbatim understanding of language ). In general, articulation and grammar are less affected, the semantics are often a little more affected and often the correct use of the language is very much affected, as this is often the most difficult.

Retarded language development is noticeable in children. Typical symptoms are echolalia , neologisms , iterations, and pronominal reversals. The latter means that the child refers to themselves as you and addresses the communication partner as I.

To train the sensory perception, drawing or painting can be used as a therapeutic tool. Writing can serve as supportive communication . Fears are reduced when those affected learn to express themselves in writing on the computer or calculator or practice their language with tape recordings and the subsequent playback.

Diagnostic criteria

In the DSM-IV , early childhood autism is assigned to the profound developmental disorders and is described by the following diagnostic criteria:

A. A total of at least six criteria from 1., 2. and 3. must apply, with at least two points from 1. and one point each from 2. and 3.:

  1. qualitative impairment of social interaction in at least two of the following areas:
    • pronounced impairment in the use of a variety of non-verbal behaviors such as eye contact, facial expression, posture and gestures to control social interactions,
    • Inability to develop developmental relationships with peers,
    • Lack of spontaneous aspirations to share joy, interests or successes with others (for example, a lack of showing, bringing or pointing out objects of interest),
    • Lack of social or emotional reciprocity;
  2. qualitative impairment of communication in at least one of the following areas:
    • Delayed onset or complete absence of the development of spoken language (without attempting to compensate for the impairment through alternative forms of communication such as gestures or facial expressions),
    • in people with sufficient language skills, significant impairment of the ability to start or continue a conversation,
    • stereotypical or repetitive use of language or idiosyncratic language,
    • Lack of developmentally varied, spontaneous role-play or social imitation games;
  3. Limited repetitive and stereotypical behavior, interest and activity patterns in at least one of the following areas:
    • extensive in-depth employment within one or more stereotypical and limited interest patterns, with either the focus or intensity of employment being abnormal,
    • noticeably inflexible adherence to certain non-functional habits or rituals,
    • stereotypical and repetitive motor mannerisms (e.g. twisting, bending or flapping the hands or fingers, or complex movements of the whole body),
    • persistent in-depth preoccupation with parts of objects.

B. Delays or abnormal functioning in at least one of the following areas beginning before the age of three:

  • social interaction,
  • Language as a means of social communication or
  • symbolic or fantasy game.

C. The disorder cannot be better explained by Rett or Heller syndrome .

In addition, ICD-10 names unspecific problems such as fears, phobias , sleep disorders , eating disorders , outbursts of anger , aggression and self-harming behavior (automutilation).

causes

There is a great deal of evidence that genetic influences play a role. Brain damage, brain dysfunction, biochemical peculiarities, a disruption of cognitive processes, language development and emotional processes are also associated with the development of early childhood autism. However, there is broad consensus that autism is not - as was still believed in the 1960s - caused by maternal misconduct (see: Fridge Mother ).

Consequences and complications

Early childhood autism has a significant impact on the lives of those affected and makes it difficult to lead an independent life. Because of the language and communication difficulties , a changed perception and especially the resulting isolation from the environment, it is difficult for the people affected to adapt to the social environment, to make friends or to fit into the framework of a school or family . The education of an autistic child, the parents with major difficulties and often with a lot of stress connected. Even slightly autistic people run the risk of offending people around them, for example because they do not know the social rules or cannot apply them. Many Kanner autistic people are dependent on intensive and lifelong care (see also under Autism ).

supporting documents

  1. ↑ Hans-Michael Strasbourg, Winfried Dacheneder, Wolfram Kreß: Developmental disorders in children. 2nd Edition. Urban & Fischer, Munich / Jena 2003, ISBN 3-437-22221-X , p. 132 f.
  2. ↑ a b Stefan Brunnhuber, Klaus Lieb: Psychiatry, Psychotherapy, Psychosomatics - short textbook . 4th edition. Urban & Fischer Verlag, Munich / Jena 2000, ISBN 3-437-42130-1 , p. 234.
  3. ↑ Helmut Remschmidt: Autism: manifestations, causes, help . In: Beck's series . 5th edition. tape 2147 . CH Beck, 2012, ISBN 978-3-406-64347-7 , pp. 27 ff .

literature

Web links