Autism is a serious mental disorder that requires immediate treatment because it prevents a person from functioning normally in society. As a rule, autistic disorders manifest themselves in childhood. The reasons for the development of this disease are not yet fully understood, which complicates the process of diagnosing and treating patients with autism.

When diagnosing a disorder, it is customary to use the following criteria:

1. Qualitative Interaction Disorders autistic child with the outside world. They manifest themselves in the absence of emotional reactions to what is happening, in the unwillingness to make contact with both peers and adults.
2. Qualitative violations in the communication sphere. Manifested in problems with oral and written speech: spontaneous speech is practically absent, the child speaks in repetitive, stereotypical phrases.
3. Limited, stereotyped behavior. The interests of the child are limited, he is attached to certain actions and rituals.

The first symptoms of autism usually appear in early childhood. The diagnosis of autism can be suspected if the child has delays in psychomotor and speech development. In case of any compliance of the child's behavior with any of the criteria, you should immediately consult a doctor.

In a psychiatric clinic, a comprehensive autism diagnosis, allowing to exclude other mental disorders or, on the contrary, to establish the presence of concomitant diseases. In the process of diagnosing autism, the following methods are used:

Special questionnaires and questionnaires

Questioning patients who are suspected of having autism allows you to determine their personality traits and identify deviations from the norm. When diagnosing, they usually use:

• scales for assessing language functions, which help to find out how well the child understands and uses speech.
• diagnostic interview, which allows you to identify social and communication disorders in the patient's behavior.

At the moment, questionnaires are the main method for diagnosing autism, since patients with this disorder almost always have impaired language function and problems with social interaction.

Genetic analysis

It involves the study of the genetic material of an autistic patient, as well as the medical history of the entire family. Recently, this method has become increasingly popular, as science is actively developing a hypothesis about the genetic origin of autism spectrum diseases. In the near future, perhaps, genetic analysis will take the leading place among the methods of diagnosing autism.

Neuroimaging

The use of various devices for the diagnosis of autism (MRI, PET, spectroscopy), which allow detecting neuroanatomical signs of autism: an increase in brain volume, a change in the ratio of gray and white matter, etc. In addition, instrumental diagnostic methods make it possible to exclude the presence of organic brain lesions and other mental illnesses in a patient.

The results are also taken into account when diagnosing. electroencephalogram (EEG), which can be used to fix various types of brain dysfunction, however, they are characteristic only for some forms of autistic disorder.

Thus, complex diagnostics makes it possible to more accurately diagnose and determine the degree of development of the disease, while excluding the presence of other disorders in the patient.

At the Mental Health Clinic, we carry out a comprehensive diagnosis of the disease using scales and questionnaires, as well as instrumental methods (MRI, EEG). Our clinic employs qualified specialists - child psychiatrists and neurologists - who will make an accurate diagnosis for your child and prescribe the necessary treatment.

Did your child show signs of autism? We will help you and your child!

The function of effective support for a family raising an autistic child has now been taken over by public organizations in Ukraine.

What survey methods can be offered by specialists working in such organizations?

In addition to questionnaires and questionnaires that carry only additional information, highly qualified correctional teachers and special psychologists can organize a diagnosis of the child's holistic development.

The experience of our organization (“SONIACHNE KOLO”) proves that there are several ways to carry out such a complete diagnosis.

1. Examination according to the special Diagnostic Card of Child Development developed by K.S. Lebedinskaya and O.S. Nikolskaya (1989), which serves as an addition to the traditional clinical history and aims not only to clarify the diagnosis, but also to help in the individualization of psychological correctional work with the child.

The map gives a detailed list of the developmental features of a child with pronounced features of autistic dysontogenesis and allows you to detect signs of the formation of its most severe variants. The great advantage of the map is that in order to reveal the state of formation of various structural components of the child's psyche - the vegetative-instinctive, affective spheres, the sphere of attraction, communication, and others - the authors have collected a large number of signs and those guidelines that are important for determining the state of development of the child. However, the redundancy and unstructuredness of indicators within each sphere, the presence of disparate characteristics make it difficult to clarify a clear picture of the characteristics of the child's mental organization and, accordingly, the further construction of an individual program of his education.

2. Examination with the help of the internationally recognized (primarily in the diagnosis of autistics) "Psychoeducational profile PEP-R". This methodology provides a reference point for two scales: the “Development Scale” (imitation, perception, general and fine motor skills, cognitive functions, etc.) and the “Behavior Scale” (emotional reactions, play and interest in objects, reaction to stimuli, language).

An important advantage of the test is its flexibility, the optional observance of a certain sequence of tasks in the implementation of diagnostics, which corresponds to the mental characteristics of children with a spectrum of autistic disorders. Diagnostic indicators are recorded during the child's performance of tasks (often in a playful way), as well as during his peculiar behavior. The result is the creation of a profile that allows you to determine what biological age corresponds to the state of formation of a particular mental function in each individual child. The main drawback of the test is its volume: it consists of 174 diagnostic tasks. It should also be added that this most interesting test has not yet been published in either Russian or Ukrainian. And those specialists who use it also translate the test tasks themselves (we have information about the translation by some specialists from Moscow of the Psychoeducational Profile from English, but we use instructions and developments that were translated from the Polish version, just like our Lviv colleagues from the Open Heart organization).

3. Diagnosis using neuropsychological techniques.
Specially trained professionals may offer neuropsychological diagnostics. For some people, this method is associated exclusively with hardware. However, it is not. Based on deep knowledge about ontogenesis (morpho- and functional genesis) of various forms of mental activity and the mechanisms of their functioning in normal and pathological conditions, as well as certain skills in this area, a psychologist / neuropsychologist can competently carry out a systematic analysis of disorders (deficiency) of higher mental functions (HMF). ). At the same time, the focus of his attention is the definition of the primary defect and its systemic impact on other mental functions.

Neuropsychological diagnostics is mainly modified (transformed) versions of the battery of tests by A.R. Luria. Known methods developed by E. G. Simernitskaya, 1991, 1995; Yu. V. Mikadze, 1994; T. V. Akhutina, 1996; N. K. Korsakova, 1997; L. S. Tsvetkova, 1998, 2001; A. V. Semenovich, 2002. For example, using the technique of A. V. Semenovich, such hierarchical levels of the psyche are diagnosed as neurobiological prerequisites for perception; interhemispheric interaction; homeostatic rhythm of the body; metric, structural-topological and projection representations, etc. The main meaning of the results of such diagnostics is the development and application of a system of methods of correctional and developmental education that are adequate to the structure of a mental defect (in the context of the implementation of the “replacing ontogeny” method).

4. P diagnostic procedures developed by scientists on the basis of fundamental theories, which allow you to optimally reveal the fullest possible picture of the characteristics of the mental development of the child and become the basis for the development of an effective development program.

For us, such a tool was the “Integral Assessment of Child Development”, developed by us on the basis of the theory of the mental triad by L.M. Wekker and the theory of coordination levels by N.A. Bernshtein. The advantage of our approach is that the picture of the development of the child is revealed in the context of the relationship: from the functioning of the sense organs and basic mental processes to higher mental phenomena. At the same time, we consider the revealed picture of the development of the child in such a context of an integral mental system as the formation of psychomotor, emotional and general intelligence.

In our organization, the examination of the child takes place in a playful, relaxed form, although the result of contact with the child and his family is a fairly complete picture of both the mental development of the child and the characteristics of the interaction of parents with him.

At the beginning, we can ask the mother to play with the child (using the didactic and game material previously grouped by us in different parts of the diagnostic room). Thanks to this, the child adapts faster in a new room and among strangers, and we have the opportunity to observe the strengths and certain flaws in the process of interaction between mother and child. The following is significant here: how much the mother knows how to play with the child, in what ways she attracts his attention, how she supports him, how she communicates with the child (intonation, their diversity, timbre, tempo, voice power, etc.), what style of interaction she uses ( dominates, cooperates or adjusts), which sense organs are included in the contact (visual, auditory, tactile, motor), etc. Then the psychologist begins to interact with the child, revealing the features of his manifestations at different levels.

The results of the diagnostic process are structured records of a specialist, where the features of functioning are noted:

1) regulatory functions in a child (tonus, balance, motor activity, coordination of movements, visual-motor coordination, manifestations of general and fine motor skills, motor imitation, stereotypes, exhaustion, etc.);

2) his emotional and social processes (communication, interoperability, reaction to obstacles, emotional contagion, emotional spectrum, etc.) and

3) the cognitive sphere (the functioning of various analyzers, the features of the formation of mental processes, the spectrum of interests, etc.).

A comprehensive description of the state of development of the child allows us to draw a conclusion about his psychological diagnosis, note the resources for the development of the child, outline priority tasks and develop an individual program for his further effective education.

Thus, at the current stage, it can be stated that each organization whose activities are aimed at helping in the development, education and socialization of children with autism, at its own discretion, develops, selects and masters those diagnostic methods that seem to its specialists to be informative for the organization of correctional and developmental classes. And here, of course, a lot depends on the qualifications of specialists who carry out such diagnostics, their talent and experience.

The study of children with an autism spectrum disorder is ongoing. Improved, optimized and methods of examination of them. Consistency between researchers and practitioners in this direction will make it possible to develop and make available for use such diagnostic tools that will most effectively help in working with such children.

Early Childhood Autism Syndrome is a disorder of the child's mental development, the main manifestation of which is the lack of social interaction and the difficulty of contacts with other people. Autistic patients have pronounced difficulties in understanding the emotions of others, specific features of verbal and cognitive development.

The main symptoms of the disease appear between the ages of 0 and 3 years. These can be violations of the emotional-volitional sphere, specific features of motor functions (motor stereotypes, irregular movements), as well as a delay in cognitive and speech development.

Pathogenic mechanisms of RDA still remain insufficiently studied. In some cases, the disorders are combined and can be caused by certain medical disorders, such as tuberous sclerosis, congenital rubella, infantile spasms, etc.

The basis for the diagnosis should be the presence of characterizing factors, regardless of the presence or absence of the above abnormalities. However, each of these conditions must be determined separately, as well as the presence of mental retardation in the pathogenesis.

Diagnosis of early childhood autism (Kanner's syndrome)

To detect classic autism, a number of methods are used, developed and tested mainly in foreign countries and used in scientific and experimental studies.

Diagnostic methods:

1. ADOS, Observation Scale for Diagnosis;
2. ABC Behavioral Questionnaire;
3. ADI-R, an adapted version of the diagnostic survey;
4. RDA CARS rating scale.
5. The ADOS-G observation scale is a general variant.

When making a diagnosis, in this case, anamnesis data, the results of dynamic monitoring of the child, the correspondence of the manifestations of the disease to the main diagnostic signs are used:

1. Qualitative pathologies of social interaction are the inability to establish social relations with others, the inability to model behavior in accordance with the social situation.
2. Qualitative communicative anomalies - difficulties in establishing emotional contact and lack of spontaneous speech, inability to engage in dialogue and maintain a conversation, difficulties in differentiating living objects and inanimate objects.
3. Repetitive behavior, stereotypes - the child is absorbed in monotonous interests and hobbies, is committed to specific rituals in behavior.

The classic syndrome of this disease is characterized by the manifestation of the clinical picture of pathology at an early age - up to 3 years. With age, additional symptoms appear:

• psychopathological phenomena - like fears and phobias, sometimes inexplicable and illogical;
• pronounced aggression and auto-aggression;
• disturbances in the process of sleep and eating;
• excessive excitability.

Diagnosis of Autistic Personality Disorder (Asperger Syndrome)

To identify signs of the disease in question in adults, you can use the method of observation. The manifestation of the following symptoms may indicate a possible diagnosis:

• avoidance of eye contact, absence or weak, inexpressive facial expressions and gestures;
• monotonous, inexpressive speech, limited vocabulary;
• poor development of communication skills;
• inability to recognize the emotional states of people around;
• inability to express one's own emotions and feelings, difficulty in expressing and understanding abstract concepts;
• misunderstanding or ignoring the elementary rules of communication;
• lack of initiative in conversation, inability to conduct a dialogue;
• adherence to stereotypes, the same type of monotonous actions and rituals, often without a specific meaning;
• an acute reaction to the slightest change in life or immediate environment.

It is also relevant to use a test called "Reading the Mind in the Eyes", the purpose of which is to detect a decrease in understanding in an adult with a normal level of intelligence.

The technique determines the level of the subject's ability to put himself in the opponent's place and tune in to his mental state. The test consists of 36 photographs of pairs of eyes representing different emotions. Having a limited amount of data (sight and area around the eyes), the subject must give information about the internal state of the owner of the eyes.

When diagnosing, the accuracy of the diagnosis is of great importance, since the syndrome of childhood autism in some of its manifestations is similar to other mental development disorders: a number of genetic diseases, cerebral palsy, childhood schizophrenia, etc.

To make a final diagnosis, a decision is required by a council of doctors, which includes a child psychiatrist, a neurologist, a psychotherapist, a speech pathologist, a pediatrician, a psychologist and other experts whose activities are aimed at studying children with special needs.

The tests discussed in this article can only be used to confirm suspicions, and not to make a definitive diagnosis.

The definition of the disease involves a survey of the parents and relatives of the child, the organization of observations of the subject in various everyday situations is relevant. Examination of the child and observation of him should be carried out in the conditions familiar to him, otherwise the diagnostic picture may be distorted due to excessive stress.

To date, a way to completely overcome this complex disorder has not yet been discovered, but timely complex treatment, correction and rehabilitation work can help the child partially reduce negative symptoms and achieve acceptable social adaptation in some cases.

Due to the peculiarities of emotional, motor, speech development, an autistic child perceives the world around him a little differently than ordinary children. Specialists who have observed autistic children note that they prefer "special" toys, books, visual aids, at a time when other items for play and learning go unnoticed. They are active, restless, others are silent, withdrawn, more assiduous.

In order to identify the level of development, the capabilities of the child, the degree of preservation of mental functions, readiness for learning, it is recommended to conduct testing. The situation that developed during testing is not a reason to talk about intellectual decline, most likely, this can be explained by the emotional immaturity of the child, his increased anxiety, and the unformed voluntary control over behavior.

There are several testing methods. All of them are aimed at identifying the same problems, but differ in the form of implementation. For young children, testing is carried out in a playful way, which helps to maintain the child's interest throughout the time and avoid negative reactions. For older children, testing is carried out in conditions close to real. The degree of success of the child's answers depends on the teacher's ability to conduct testing; during testing, the teacher finds out the level of development, the child's readiness for learning. He appreciates:

the state of general motor skills (coordination of movements, the state of fine motor skills, which hand the child prefers to work with);

level of orientation in time, space;

development of the emotional-volitional sphere;

the degree of formation of oral speech;

the ability to think logically, mastering the skills of reading, writing, counting.

When testing, there are a few things to keep in mind:

The time allotted for testing should not exceed 15–20 minutes for children aged 5–6 and 30–40 minutes for older children;

The number and sequence of tasks may vary depending on the age of the child.

N.B. Lavrentieva offers the following pedagogical diagnostics of children with autism.

Pedagogical diagnostics of children with autism

Based on the test results, the activity of an autistic child is evaluated, a pedagogical conclusion is given, recommendations to parents, and a correction program is outlined.

It is worth talking about the child's readiness for learning in cases where:

1. Sits independently at the study table for 5–10 minutes;

2. Independently or together with adults is engaged in any type of activity (drawing, designing, etc.);

3. Easy to interact with adults (answers his questions, carries out his instructions);

4. Feels comfortable at the study table during the task (does not cry, does not hide under the table).

If a child performs all of the above tasks without much difficulty, then he is more prepared for learning.

If the child is naughty, refuses to sit at the study table, scatters manuals or does not pay attention to them, it is difficult to organize him, and he constantly demands something, then it is too early to talk about readiness for learning. Without special training, it will be difficult for such a child to acquire the skills necessary for learning. Parents of such children are given recommendations on how to practice these skills in everyday life.

Sometimes parents, without knowing it, form a negative attitude towards learning. In order to avoid a negative attitude of the child to learning, several rules should be considered:

1. You should not teach your child at a too fast pace.

2. You should adhere to a single training program.

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Early signs of autism

signs autism can be detected already in the first year of life. However, this applies only to early childhood autism, which occurs in children under 3 years of age. As for the rest of the autism spectrum disorders, their signs can also be observed in early childhood, but closer to 2-3 years.

Symptoms of autism in children under 1 year old

Symptoms of autism in children under one year old are among the criteria for early diagnosis. As a rule, the mother notices these signs first. Parents react especially quickly if the family already has one child. Compared to a healthy older sibling, an autistic child looks "weird".

Symptoms of autism in children under one year old are (frequency of occurrence):

• violation or complete absence of eye contact - 80 percent;
• the phenomenon of identity - 79 percent;
• violation of the revitalization complex - 50 percent;
• pathological attitude towards close relatives - 41 percent;
• a pathological reaction to a new person, 21 percent;
• pathological attitude to verbal treatment - 21 percent;
• pathological attitude to physical contact - 19 percent.

Loss or loss of eye contact
This symptom manifests itself in the absence of fixation of the gaze in the child or in its active avoidance. Parents notice that when trying to attract a child and make eye contact with him, the baby actively resists this. Sometimes it is still possible to establish eye contact, but at the same time the child seems to be looking past (“look through”). The gaze can also be fixed or frozen.

Identity Phenomenon
This symptom appears when parents begin to introduce complementary foods into the child's diet, that is, after 6 months. It manifests itself in the difficulties of introducing complementary foods - in response to new food, the child shows aggression. Difficulties appear not only in nutrition, but also in changing the environment of the place. The kid reacts violently to the new arrangement of furniture and his toys, resists new clothes. At the same time, a certain rituality appears - he eats food in a certain order, his toys laid out according to a certain pattern. Autistic children react negatively to new premises - a hospital, a nursery, a kindergarten.

Violation of the recovery complex
Violation of the animation complex occurs in every second autistic child at the age of one. The symptom manifests itself in a weak reaction (and in a severe case - in its complete absence) to external stimuli - light, the sound of a rattle, surrounding voices. The child reacts weakly to the mother's voice, does not respond when she calls her. It also reacts sluggishly to a smile, does not become infected in response to an adult's smile (usually children smile in response to a smile). Children with autism also have a poorly developed motor component - they do not begin to actively jump like other children, they do not go towards their mother.

Pathological attitude towards close relatives
This symptom is also most noticeable in children under one year old. It is expressed in a delay or in the absence of recognition of the mother - the child does not meet her halfway, does not reach out to her, does not go into her arms. Also, the baby reacts poorly to his mother's caresses, does not show the need for care. Sometimes this attitude can manifest itself in relation to other family members, while the child experiences strong attachment to the mother. On the whole, ambivalence (duality) is observed in the relationship of the child with adults. Strong affection can be replaced by coldness and hostility.

Pathological reaction to a new person
Every fifth autistic child shows a pathological reaction to a new person. This reaction is expressed in anxiety, fear, excitement in response to the appearance of a new person. Sometimes it can be replaced by over-sociality, in which the child shows an increased interest in a new person.

Pathological attitude to verbal treatment
The symptom manifests itself in the absence of a response to verbal appeal and often imitates deafness in a child. That is why often parents first of all turn to an otorhinolaryngologist. Also, autistic children do not use gestures of affirmation or denial - they do not nod their heads; do not use gestures of greeting or farewell.

Pathological attitude towards physical contact
This symptom is expressed in dislike for physical contact - caresses, "hugs". When you try to stroke a child or hug him, he dodges. Autistic children tolerate only small doses of physical contact and are quite selective about who shows them. Some children may prefer only tossing or spinning.

Symptoms of autism in children under 3 years of age
As the child grows and develops, the attention of parents is attracted by his speech, manner of play, type of communication with other children.

Symptoms of autism in children under 3 years of age are (frequency of occurrence):

• violation of communication with children - 70 percent;
• attachment to inanimate objects - 21 percent;
• fears - 80 percent;
• violation of the sense of self-preservation - 21 percent;
• speech pathology - 69 percent;
• stereotypes - 69 percent;
• features of intelligence - 72 percent;
• game features - 30 percent.

Disruption of communication with children
Autistic children often avoid the company of their peers. Ignoring communication can be either passive - the child is simply isolated from other children, or active - aggressive, impulsive behavior appears. Sometimes the circle of friends can be limited to one friend who is a couple of years older, or a relative (brother or sister). In the general team - in a manger, on the street, at a birthday party, an autistic person does not stay long, since he often prefers solitude to the company.

Attachment to inanimate objects
Another feature of behavior is attachment to inanimate objects. The attention of autistic children is most often attracted by an ornament of a carpet, some particular detail of clothing, a pattern on the wallpaper.

fears
Autistic children also have unusual fears. As a rule, they are not afraid of heights or darkness, but of everyday noises, bright lights, a certain shape of an object. Fears are explained by hypersensitivity (hyperesthesia) of autistic children.

The fears of autistic children are:

• noises - the noise of an electric razor, a vacuum cleaner, a hair dryer, water pressure, the sound of an elevator;
• bright, harsh or shiny colors in clothes;
• atmospheric precipitation - drops of water, snowflakes.

In the aggressive course of the disease, there is a fixation of fears with the formation of delusional ideas. This may be a fear of everything round - while the child will avoid all objects of a rounded shape. It can also be an inexplicable fear of the mother, fear of one's own shadow, fear of hatches, and so on.

Violation of the sense of self-preservation
The absence of a sense of fear is shown by every fifth child with autism. This symptom can manifest itself since childhood, when the child hangs dangerously over the side of the stroller or playpen. Older children can run out onto the carriageway, jump from a great height. Characteristic is the lack of consolidation of the negative experience of cuts, bruises, burns. So, an ordinary child, having accidentally burned himself, avoids this object in the future. However, autistic children can "step on the same rake" many times.

Speech pathology
Features of speech development are observed in 7 out of 10 children suffering from an autism spectrum disorder. Even in the early childhood period, this is manifested in the absence of a reaction to speech - the child reacts poorly to appeals. Further, parents can note that their child prefers quiet and whispered speech. There is a lag in the development of speech - the first words appear later, the child does not coo, does not babble.
The child's speech is characterized by the phenomenon of echolalia, which is expressed in the repetition of words. The child may repeat the question several times to the question addressed to him. For example, to the question “how old are you?” the child answers "years, years, years." There is also a tendency to declare, to monologues, to very expressive speech. The attention of parents is attracted by the fact that the child begins to talk about himself in the third person (the pronoun "I" is not typical).

Most cases of autism are characterized by the initial development of speech with subsequent regression. So, parents note that the child, who was originally talking, suddenly falls silent. Vocabulary, previously consisting of a dozen words, is now limited to two or three words. Speech regression can occur at any stage. More often it is noted at the age of one and a half years, but it can also be detected later already at the level of phrasal speech.

stereotypes
Stereotypes are stable repetitions of movements, phrases. In autism spectrum disorder, stereotypic behavior is considered a type of self-stimulating behavior. It should be noted that healthy people also sometimes show stereotypes. For example, this is expressed in winding hair around a finger, in tapping a pencil on a table, in passing sand through fingers. "Healthy stereotypes" differ from pathological ones in the degree of intensity. In autism, stereotyping is observed in movement, speech, and play.

Stereotypes in autism are:

• stereotypical movements- rhythmic swaying or rocking of the body, bending the fingers, jumping, turning the head;
• stereotyped visual perceptions- pouring mosaics, turning on and off the light;
• stereotypical sound perceptions- rustling of packages, crushing and tearing of paper, swinging of doors or windows;
• tactile stereotypes- pouring cereals, peas and other bulk products, pouring water;
• olfactory stereotypes- constant sniffing of the same objects.

Features of intelligence
A lag in intellectual development is observed in every third child with autism. Intellectual passivity, lack of purposefulness and productive activity, inability to fix attention on anything are noted.

At the same time, the acceleration of intellectual development is observed in 30 percent of cases. It is expressed in the rapid development of speech, fantasies, associations, as well as in the accumulation of knowledge in some abstract areas. In the choice of sciences, autistic children are very selective - there is an increased interest in numbers, countries, and structures. Hearing memory is highly developed. The decay of intellectual function is observed in 10 percent of cases. It is expressed in the disintegration of behavioral skills, cognitive activity and previously formed speech.

Game Features
This symptom manifests itself either in the complete absence of play, or in the predominance of play alone. In the first case, the child ignores toys - does not look at them or examines them without interest. Often the game is limited to elementary manipulations - rolling a bead or a pea, spinning a button on a thread. Solo play predominates, usually in a specific location that does not change. The child folds his toys according to a certain principle, usually by color or shape (but not by functionality). Very often in his game the child uses completely non-play items.

Autism Diagnosis

Diagnosis of autism includes complaints from parents, anamnesis of the disease and examination of the child. At the appointment with the child psychiatrist, the parents first explain the reason for their visit. This may be the lack of speech in a child or its regression, aggressive behavior, fears, stereotypes. Most often, parents complain that the child does not speak and does not use communication as a means of communication.

Common complaints from parents are:

• the baby does not respond to treatment, creates the impression of a deaf child;
• the child does not look into the eyes;

• the first words, phrases, addressed speech are missing;
• regression of speech development (when the baby was already talking, but suddenly fell silent);
• slapping one's cheeks, biting oneself;
• repeats the same words, movements;
• avoids other children, does not play with them;
• prefers solitude;
• does not like change and reacts aggressively to them.

Next, the doctor asks questions about the development of the child. How he was born, whether there were birth injuries, how he grew and developed. Of great diagnostic importance is heredity in psychiatric terms. Differential diagnosis is carried out with delayed psychoverbal development (ZPR), mental retardation and childhood schizophrenia.

Examination of a child with suspected autism consists of talking with him and observing him. Children with autism, when entering the doctor's office, often rush to the window first. Small children can hide behind a chair, table and other furniture. Almost always, any visit to the doctor is accompanied by negative behavior, crying, tantrums. Such a child rarely enters into a dialogue, often repeating the question asked after the doctor. The baby does not react to the appeal to him, does not turn his head. Children do not show interest in toys and the offer to play, they are passive. Sometimes they may be interested in a puzzle or constructor.

Autism Tests

Tests for identifying autistic inclinations are based on observing a child's behavior in everyday life, his interaction with peers and parents, and his attitude to toys. There are many programs for self-diagnosis of autism, but none of them gives accurate results. The results of any test are only an assumption, which only a doctor can confirm or refute.

simple test
This test is the simplest of all, but its results are rather vague. Experts recommend conducting this type of test in conjunction with other testing methods.
The test consists of two parts, the first of which involves observing the child, the second is the joint performance of some actions.

The questions for the first part of the test are:

• whether the baby likes to sit on the lap of adults;
• Does the child like parental hugs?
• whether he is fond of children's games;
• whether the child is in contact with his peers;
• whether it imitates certain actions or sounds when playing;
• whether he uses his index finger as a pointer in order to draw the attention of others to an object;
• whether the baby brings toys or other items to draw parental attention to them.

The next part of this program requires the involvement of parents.

The tasks of the second part of the test are:

• Point your finger at an object, while carefully observing his reaction. The child's gaze should rush to the pointed object, and not stop at the parent's finger.
• When playing together, observe how often the baby looks into your eyes.
• Invite your child to prepare tea or other food in a toy bowl. Will this offer be of interest to him?
• Give the kid blocks and ask him to build a tower. Will he accept this offer?

The susceptibility to autism is considered sufficiently high if the majority of responses to this test were negative.

CARS (Early Childhood Autism Rating Scale)
This type of testing is the primary tool for screening children whose behavior is suggestive of autism.
CARS includes 15 blocks, each of which affects a separate part of children's behavior in certain situations. For each item, 4 main answers are offered - normal - 1 point, slightly abnormal - 2 points, moderately abnormal - 3 points, significantly abnormal - 4 points. There are also three intermediate options between each of the main answers, which are valued at 1.5 points, 2.5 points and 3.5 points, respectively. Intermediate options are needed for cases where the parent cannot accurately determine, for example, the reaction or behavior of the baby in the situation indicated in the test is slightly abnormal or moderately abnormal.

CARS test parameters

Parameter	Interpretation
Social interaction (environment)	Fine. Absence of obvious difficulties or deviations from the norm in communication with peers and adults. There may be mild shyness or anxiety. A little abnormal. There may be an unwillingness to make eye contact, nervousness when trying to attract children's attention, excessive shyness. The child avoids adult society or does not react at the moments when he is addressed. Moderately abnormal. At times, the child is indifferent to the environment, thus creating the impression that he does not notice adults. To attract children's attention, in most cases, coercive measures are necessary. On an independent initiative, the baby makes contact in exceptional cases. Significantly abnormal. To attract the attention of a child, many and persistent attempts are needed. Of his own accord, he never initiates contact and does not respond to attempts to speak to him.
Imitation	Fine. Imitation of sounds, words and actions is age appropriate. A little abnormal. In some cases, simulation is carried out with a delay. You may have difficulty repeating more complex words or movements. Moderately abnormal. In most cases, imitation is carried out with a delay and only at the suggestion of adults. Significantly abnormal. Even after prompting from the parents, the child does not imitate movements or speech skills.
Emotional reaction	Fine. Facial expressions and other expressions of emotion are appropriate for the situation and age. A little abnormal. Sometimes the response may not be appropriate for the circumstances. Moderately abnormal. Feelings may be delayed or not appropriate for the situation ( the child laughs, grimaces or cries for no apparent reason). Significantly abnormal. Children's emotions are extremely rarely true. The baby can be in a certain mood for a long time, which is difficult to change. Also, a child can suddenly visit different feelings without objective reasons.
Body possession	Fine. Movements are carried out without difficulty, coordination corresponds to age. A little abnormal. There may be sluggishness, in some cases - strange movements. Moderately abnormal. Parents may observe unusual finger movements, body swaying, tiptoeing for no reason. Sometimes a child may show unmotivated aggression towards himself. Significantly abnormal. Regardless of the comments from adults, the child constantly performs body movements unusual for children.
Use of toys	Fine. The child shows interest in toys and uses them for their intended purpose. A little abnormal. Behavior may include non-standard use of toys. Moderately abnormal. Weak interest in toys, difficulty in understanding how to use them. Significantly abnormal. Marked difficulty in using toys or complete lack of interest in them.
Reaction to change	Fine. The child easily experiences changes, notes and comments on them. A little abnormal. If parents try to distract the child from certain activities, he may continue to engage in them. Moderately abnormal. Active resistance to any change. When parents try to stop a child's game or other activity, the child becomes angry. Significantly abnormal. Adaptation to change is manifested by aggression.
visual response	Fine. Together with other senses, vision is used to get to know the world and new objects. A little abnormal. Sometimes a child may look into space for no reason, avoid eye contact. Moderately abnormal. The child rarely controls his actions with his eyes. He can also view objects or people from an unusual angle. Significantly abnormal. Does not look at objects and people around him or does it with pronounced oddities.
auditory response	Fine. Reacts to sounds according to age and uses hearing. A little abnormal. Sometimes hypersensitivity to certain sounds may be present, and the auditory response may be delayed. Moderately abnormal. Some sounds are ignored, others receive an unusual reaction - crying, fear, closing the ears. Significantly abnormal. Hypersensitivity or its complete absence to certain types of sounds.
Taste, smell, touch	Fine. Smell, touch and taste are equally involved in the study of the world around us. Experiencing pain, the baby reacts accordingly. A little abnormal. An inappropriate reaction to discomfort may be detected - too strong or weak. Some sense organs are not used for their intended purpose. Moderately abnormal. The child sometimes touches, smells, or tastes strangers or other objects. Reacts to pain weakly or too strongly. Significantly abnormal. The child experiences pronounced difficulties with the correct use of the senses of taste, smell and touch. Responds too sharply to minor pain sensations or completely ignores the pain.
Feelings of fear, nervousness	Fine. Behavioral pattern appropriate to age and circumstances. A little abnormal. In comparison with other children, in some situations, fear or nervousness may be exaggerated or, conversely, weakly expressed. Moderately abnormal. Periodically, the reaction of the child to traumatic circumstances is not true. Significantly abnormal. The child does not attach importance to danger or overreacts to it, even after he has been proven otherwise.
Communication skills	Fine. The level of development of verbal skills corresponds to age. A little abnormal. The formation of speech occurs with a delay, some parts of speech may be used for other purposes. Moderately abnormal. Meaningful speech is manifested by excessive enthusiasm for a specific topic, numerous questions that are not relevant to the situation. Strange sounds are also used, incorrect words, or there may be a complete lack of speech. Significantly abnormal. Verbal skills are manifested by animal sounds, imitation of natural sounds, complex noises. There may be correct words or phrases that are used inappropriately.
Non-verbal communication	Fine. Gestures are used according to the circumstances. A little abnormal. In some cases, there are difficulties with the correct gestures. Moderately abnormal. The child cannot communicate his needs with gestures and also has difficulty understanding other people's movements. Significantly abnormal. The gestures or movements used do not make sense. Facial expressions of other people and other signs of non-verbal communication are not perceived.
Degree of activity	Fine. The behavior of the child is appropriate for the age and circumstances. A little abnormal. Sometimes the baby may show excessive activity or slowness. Moderately abnormal. The child is difficult to control, in the evenings it is difficult for him to fall asleep. Sometimes, on the contrary, participation from parents is necessary to make it move. Significantly abnormal. Manifested by extreme states of active or passive behavior, which can sometimes replace each other for no apparent reason.
Intelligence	Fine. The intellectual level does not differ from peers. A little abnormal. Some skills may not be as pronounced. Moderately abnormal. The child lags behind children of his age in development. However, there may be significant progress in one or more specific areas. Significantly abnormal. There is a pronounced lag, but in some areas the child shows himself much better than his peers.
General impression	Fine. In children's behavior there are no oddities. A little abnormal. In a number of situations, traits or inclinations that are atypical for the age of the child and the situation may appear. Moderately abnormal. Expressed demonstration of non-standard behavior. Significantly abnormal. The child shows many of the symptoms of autism.

If the total score on this test is between 15 and 30, the child is normal. With a score of 30 to 37, there is a possibility of mild or moderate autism. If it was scored from 37 to 60 points, there is suspicion of a severe form of autism.

Classification of autism according to ICD-10

There are several options for classifying autism, which take into account the onset, manifestations and course of the disease. According to the International Classification of Diseases (ICD), there are 6 variants of autism.

Classification of autism according to the ICD

species name	Disease code	Characteristic
Childhood autism		It is manifested by developmental anomalies in children under 3 years old, deviations in the following areas - social interaction, communication and behavior. The child's behavior is stereotyped, limited and monotonous. The clinical picture is complemented by sleep disorders, eating disorders, aggression, multiple fears.
atypical autism		The clinical picture of atypical autism is characterized by the absence of one of the criteria from the classic triad of autism ( impaired social interaction, communication, and behavior). As a rule, it is accompanied by a deep mental retardation.
Rett syndrome		This variant of autism occurs only in girls. Psychomotor development is characterized by partial or complete loss of speech, hand skills, growth retardation. All these violations are detected at the age of 7 to 24 months. Despite the fact that social development is suspended, interest in communication remains. Also, this syndrome is accompanied by severe mental retardation.
Other disintegrative disorder of childhood		Before the first signs of the disorder appear, psychomotor development is normal. However, soon after the onset of the disease, there is a loss of all acquired skills. At the same time, interest in the world around is lost, behavior becomes stereotypical and monotonous. Disorders are noted in the field of social interaction, communication, intellectual development.
Hyperactive disorder with mental retardation and stereotyped movements.		It occurs in children whose intelligence is below 50 IQ. They exhibit hyperactive and stereotyped behavior, reduced understanding of the speech addressed to them. Children with hyperactive disorder and stereotyped movements do not respond well to drug therapy.
Asperger's Syndrome		As with the previous disorder, the causes of Asperger's syndrome are unknown. The syndrome is not characterized by a stop in psychoverbal development ( what happens in childhood autism). Pathology is characterized by clumsiness, stereotyping in occupations, interests. Psychotic episodes may occur at an early age.

In addition to the generally accepted classification, there is also a classification proposed by the psychologist Nikolskaya in 1985. This classification takes into account the main characteristics of autism and divides it into four groups.

Classification of autism according to Nikolskaya

Group	Characteristic
First group (8 percent)with a predominance of detachment from the outside world.	Already in the first year of life, children are sensitive to a change in the situation of the place, to new people. They are often in passive contemplation of some objects. In the second year of life, there is a loss of all the skills acquired in the first year - speech, reaction to appeal, visual contact.
Second group (62 percent)with a predominance of rejection of the environment.	There are multiple motor, speech, tactile stereotypes. The sense of self-preservation is disturbed, multiple fears and a pronounced “phenomenon of identity” are noted. This type of autism is often combined with schizophrenia, epilepsy and other pathologies of the central nervous system.
Third group (10 percent)with a predominance of overvalued interests and fantasies.	The interests and activities of the child are extremely abstract, there are also overvalued addictions. Attitude towards relatives and friends with elements of aggression, fears are delusional in nature.
Fourth group (21 percent)with extreme vulnerability and timidity.	Children from early childhood are very vulnerable, shy, they have a low mood background. At the slightest change in the environment, timidity increases. Children are often very inhibited, insecure, therefore they are characterized by increased attachment to their mother.

Autism Therapies

Today, there are no specific therapeutic methods to permanently get rid of autism. At the same time, according to medical statistics, it has been established that timely classes with specialists, which are supported by a special diet and pharmacotherapy, significantly increase the level of development of an autist. There are many therapies that are used individually or in combination for autism. Depending on the goals and methods used, all types of therapy are divided into several groups.

The groups into which autism correction methods are divided are:

• behavioral therapy;
• biomedicine;
• pharmacological therapy;
• controversial methods.

Behavioral Therapy for Autism

This group includes programs whose purpose is to correct defects in the autistic behavioral model that prevent him from adapting to life.

Behavior correction methods are:

• speech therapy;
• occupational therapy;
• social skills therapy;
• developmental therapy;
• alternative communication.

Speech therapy
Many children with autism do not use language, either partially or completely. Often the problems are not related to the fact that the child does not know how to pronounce words, but to the inability to use verbal skills to get to know people. Communication training is carried out according to an individual program that takes into account the level of speech skills and the individual characteristics of an autist.

Occupational therapy
This method of correcting autism is aimed at developing the child's skills that will help him in everyday life. Since such patients experience significant difficulties with self-care, occupational therapy plays a large role in this disease. In the course of classes, an autistic person acquires basic self-care skills - brushing his teeth, dressing, combing his hair. Physical activity performed during classes develops the child's fine motor skills and coordination. Gradually, the child's behavior becomes more conscious, he learns to concentrate on individual tasks and becomes more adapted to life.

Social Skills Therapy
In such sessions, therapists teach autistic people to meet new people, build dialogues and behave in accordance with the rules established in society. Social skills therapy helps children with autism to interact more easily with peers and others in their environment.

Developmental Therapy
A characteristic feature of such classes is that the emphasis is not on the development of specific skills, but on the overall development of the child. The work with the patient is carried out in a playful way, when the therapist joins the autistic person in the game, encouraging him to act and encouraging him to establish contact.

Alternative Communication
The goal of this type of therapy is to replace oral speech with more understandable images or symbols for the patient. In the classroom, patients are taught to express their desires, thoughts and needs using a special sign language, pictures or cards with words written on them. Electronic equipment can also be used that plays single words or entire phrases aloud when the keys are pressed. The optimal alternative communication program is selected individually. This method is most justified in cases with autistic people who do not speak well or do not speak at all.

One of the most common alternative communication programs is the PECS system. In the course of the lesson, the child is taught to choose and show the environment cards that depict the object he needs or the action that he wants to perform. Many experts recommend that parents of autistic children practice this type of therapy at home. The book Alternative Card Communication System (PECS) by Lori Frost and Andy Bondy will help with this.

Biomedicine in Autism

The key focus in this type of treatment is the physiological needs of the body. The biomedical approach involves dietary modification and is often used as an adjunct therapy. There are several theories about which foods increase or, conversely, weaken the manifestations of this disease. Based on these theories, the main biomedical areas of autism therapy are built.

The groups of most commonly used drugs include:

• Nootropics- substances that stimulate the nutrition of the brain and improve metabolism in it. Examples: pantogam, encephabol, cortexin.
• Antipsychotics- drugs that eliminate hyperactive behavior and arousal. Examples: risperidone, sonapax.
• thymoleptics- drugs that stabilize the emotional background. Examples: depakine, lithium preparations.

Drugs used in the treatment of autism symptoms

Name of the drug	Main Effects	How to use?
Pantogam	Improves metabolic processes in the nervous tissue, increasing the absorption of glucose and oxygen. Stimulates the development of cognitive processes, memory, attention.	The dose of the drug is selected individually depending on the body weight of the child.
Cortexin	Stimulates speech development, leads to an improvement in intellectual activity.	Children under 6 - 7 years old intramuscularly, 5 milligrams daily for 10 days. Injections are given in the morning. Children after 7 years, 10 milligrams deep into the muscle.
encephabol	Concentrates attention, improves memory and thinking. However, it can provoke excitability.	It is prescribed in the form of a suspension or in tablet form.
Phenibut	In addition to improving metabolic processes, it also has an anti-anxiety and calming effect.	250 milligrams twice daily for children over 10 years of age. Children of primary preschool age half a tablet ( 125 milligrams) twice a day.
Risperidone	Eliminates psychomotor agitation, restlessness, hyperexcitability.	The initial dose is 0.15 - 0.25 milligrams per day. Further, the dose is increased to 1 - 2 milligrams per day.
Depakine	Participates in balancing the emotional background, eliminates outbreaks of aggression.	It is calculated according to the scheme of 20 - 30 milligrams per kilogram of body weight. So, for a child weighing 20 kilograms, the dose would be 400 milligrams per day. The received dose is divided into 2-3 doses.

Other groups of drugs are also used in autism. For example, tranquilizers or anti-anxiety drugs are used in children with severe fears. Atarax and diazepam are rarely used today in the treatment of autism.

Studies have been conducted on the use of lithium in children with autism. According to these studies, lithium significantly reduces mood swings, being a good behavior corrector. However, the main problem in its use is the complexity of dosing. Treatment should always be accompanied by measurement of blood lithium levels.
If you have difficulty falling asleep, drugs with a hypnotic effect are often used. From the group of neuroleptics, in addition to risperidone, haloperidol (approved for use from 3 years old) and sonapax (approved for use from 4 years old) can be used.

Controversial therapies in autism therapy

In addition to the generally accepted methods for the correction of autism, which have proven their effectiveness, other methods of treating this disease are described in the medical literature. Their effectiveness has not been proven, and their use causes conflicting comments from experts.

Controversial therapies for autism include:

• aversion therapy;
• chiropractic (treatment by influencing the spine);
• cranial osteopathy (massage of the skull).

Aversion therapy
One controversial technique is aversion therapy. This method consists in using electric shock to correct the behavior of an autistic person. Punishments alternate with rewards, but, nevertheless, this technique is one of the most cruel and has a large number of opponents.

Chiropractic (treatment by influencing the spine)
According to this area of ​​alternative medicine, the cause of autism is a dislocation of one of the vertebrae. The therapy consists of using chiropractic techniques to reduce the dislocation. Tapping with a special tool is also used. This theory does not have scientific confirmation, but is quite common in some countries.

Cranial osteopathy (massage of the skull)
Manual manipulation of the skull bones is another controversial method used in the treatment of autism. The use of this method is based on the theory that a slight displacement of the sutures of the skull improves the circulation of cerebrospinal fluid and normalizes the patient's condition. Many patients with autism spectrum disorders become calmer after such procedures, their communication skills improve, and eye contact becomes longer.

Other ways to work with children with autism

There are other ways of working with autists that are used in conjunction with the main methods of therapy for this disease.

Additional therapeutic practices include:

• sensory integration;
• hypnosis;
• pet therapy (treatment involving animals).

Sensory integration
Sensory integration is a popular area in the fight against autism spectrum disorders. A healthy person is able to combine feelings with the sensations of his body to get a complete picture of the world around him. In autism, this ability is impaired, as people with this disease suffer from hypersensitivity or its deficiency. Therapists conducting sensory integration sessions aim to teach the patient to correctly perceive the information that they receive with the help of the senses. So, if an autistic person has problems with touch, in the classroom he is invited to get acquainted with various objects by touch.

Examples of sensory integration tasks are:

• passage of the tunnel- develops orientation in space;
• dancing to music- train the hearing system;
• rotation of the chair– trains coordination and vision;
• hangs on the crossbar- learn to feel the balance of the body.

Hypnosis
Hypnosis is most effective in the treatment of late childhood autism. A significant advantage of this approach is that between the instructor and the patient there is a closer contact than with other types of therapy. Hypnosis is used in combination with other methods of correction, and its main goal is to increase the effectiveness of the main therapy.

Pet therapy (treatment involving animals)
There is scientific evidence that games and other forms of interaction with animals make a person less aggressive, improve sleep, and improve overall well-being. In the treatment of autism, dogs and horses are most often used, less often cats and dolphins.

Autism Programs

An autism program is a set of specific activities and exercises that a child performs jointly or under the supervision of adults (parent, therapist). The purpose of such programs is to improve the communication and adaptive abilities of the autistic person.

The most common autism programs are:

• ABA program;
• FLOOR Time - game time;
• other programs for autism.

ABA program in autism correction

ABA has been around for over 30 years and is based on the principle that every action has a consequence. If the patient likes these consequences, he will repeat this behavior. The purpose of the classes is to teach the autistic person the basic skills of self-care and interaction with other people. Also, in the process of ABA therapy, the patient is taught to think logically and figuratively, express his desires, and use speech correctly. First, classes are held under the usual circumstances for the child (at home, in the circle of relatives and friends). Then the acquired skills are generalized and repeated to consolidate in an unfamiliar environment.

The main principles of this program are:

• ABA is most beneficial to children who are under 5 years of age;
• the program is especially effective in teaching autistic speech skills;
• one-on-one sessions have the best results;
• exercises should be carried out regularly and often - from 20 to 40 hours a week, regardless of whether the child attends kindergarten or school;
• it is systematically necessary to be monitored by a specialist in order to monitor the effectiveness of classes and adjust them if necessary;
• all classes should be liked by the child - this is the most important condition for this program.

How are ABA sessions performed?
This program includes various classes on non-verbal and verbal communication, development of gross and fine motor skills, naming objects and actions. Sessions can be conducted by both a specialist and parents. For self-study, you must purchase a program guide (Robert Schramm's book "Children's Autism and ABA"). Also, the program can be downloaded from the Internet on specialized resources.

The principle of the classes is that all the skills that are difficult for the child (speech, look, contact with other people) are divided into small blocks that are learned. Then the learned actions are combined into one complex action. Moreover, each time the autistic person copes with the task, he receives a reward. The study of any action takes place in 4 stages.

Stages of the ABA program
First step called understanding. An adult gives the child a task, for example, to stretch a hand forward. Then the parent or therapist gives a hint - helps the autistic person complete the exercise and rewards him for this with candy, praise, or another method that affects the child. Having performed several joint actions, the facilitator provides the child with the opportunity to lend a hand. If a small patient does not complete the task on his own, he is again assisted. The exercise is considered completed when, at the request to lend a hand, the child performs the action on his own without prompts and delays. Then the mastering of the second movement begins, which should be similar to the previous one (raise your hand up, nod your head). This exercise is worked out by analogy with the first task.

Second stage is a complication. It is started after the child in 90 percent of cases begins to complete both tasks of the first stage without any hitches and prompts. At the second level, the exercises begin to alternate among themselves in any random order. Then, returning to the first stage, a new action is introduced - take a certain object in your hand, stretch out your hand to an adult. After mastering 3 exercises, they again return to complication, starting to alternate all learned tasks.

Third stage - generalization. It is started when enough learned monosyllabic movements accumulate in the child's arsenal in order to combine them into one action. For example, take an apple in your hand and treat your mother to them. At the same time, exercises are carried out in a new place for the baby. You can start from another room, then try to spend it on the street, in a store. Then they begin to change the people taking part in the process. It can be relatives, neighbors, other children.

fourth stage is the way out into the world. When the baby begins to independently use the acquired skill in order to satisfy his needs, you can move on to mastering other skills.

Features of ABA therapy
Before starting the practice, it is necessary to prepare training materials. Many of the activities in this program require the use of educational games, picture cards, drawing boards, and other similar items.
In addition to the financial costs of acquiring game materials, the correct use of the ABA program involves a significant amount of time. Many parents are not able to devote 5 to 6 hours a day to classes. Therefore, it is recommended, if possible, to carry out ABA therapy in specialized institutions. You can also combine classes at home and with a therapist.

FLOOR TIME - game time

The author of this technique suggests that every healthy child goes through 6 stages of development - interest in the world, attachment, two-way communication, self-awareness, emotional ideas, emotional thinking. With autism, children do not go through all the levels, stopping at one of them. The purpose of this program is to help the child go through all stages of development through play.

During the game, the therapist begins to repeat all his actions after the child, creating certain obstacles for him or asking questions in order for the autistic person to make contact. The adult does not impose new ideas for the game on the baby, but develops those that the child offers. At the same time, even the most unusual and pathological actions are supported - sniffing objects, rubbing glass. The therapist pretends not to understand what is happening, encouraging the child to give explanations, which develops his thinking and communication skills. The author of the program does not recommend interrupting the game even when the child begins to show aggression. Because in this way he learns to cope with his emotions and manage them.

The program can be carried out by both the therapist and parents at home. To practice this technique on your own, it is recommended to get advice from a FLOOR TIME practitioner.

Other autism correction programs

One of the different programs for autism is the TEACH system. Its developers believe that the fight against autism should not consist in changing the child, but in creating special conditions to improve the quality of his life. TEACH does not provide the patient with a high level of adaptation to the outside world, but allows him to independently satisfy his needs in conditions specially created for him. Most often, the main habitat is the home of an autistic person, so this program involves significant work with parents and relatives.

Other autism programs are:

• MBA therapy– motivation of an autist through encouragement;
• early birds- help the patient through his parents;
• RDI– development of partnerships;
• Son Rise– integration of adults into the world of an autistic child.

The quality of life in autism can be markedly improved if the environment takes an active part in the adaptation of the patient to his surrounding circumstances. The primary role in this is assigned to the parents of an autistic person, who should devote time not only to the child, but also to their own awareness of this disease and its features.

In raising an autistic child will help:

• autism schools;
• centers for autism;
• autism books.

autism schools

School attendance is mandatory for a child diagnosed with autism. In this institution, he not only receives the required knowledge, but also acquires the skills of interaction with peers. Children with autistic inclinations can study in a regular school, provided that profile specialists and parents additionally work with them. Professional help is especially important in secondary school, as at this age children begin to recognize differences, and cases of ridicule at autists are not uncommon.

The best option is to visit specialized schools or separate classes for autistic people. In such institutions, children are taught not only standard school subjects, but also other skills that help them adapt to life outside the school walls. Classes are held on a flexible schedule, teaching methods are used both traditional and non-standard. Autistic schools can be public or private (fee-based).

autism centers

Rehabilitation centers are a viable alternative when it is not possible to attend a special school. Such organizations may be municipal or private.
Rehabilitation centers carry out correctional and educational work with children. The purpose of the classes is to overcome or reduce the influence of deficiencies in mental and physical development. In such institutions, modern methods of autism therapy are used, the appointment of which is carried out in accordance with the individual characteristics of the child.

Examples of classes that are held in autism centers are:

• neurocorrective (motor and breathing exercises)- aimed at improving fine and gross motor skills, increasing efficiency and reducing fatigue;
• art therapy (music, drawing, modeling, theatrical performances)- helps children express their feelings and develop communication skills;
• holding therapy (cuddling therapy)- the purpose of the classes is to bring the child into the arms of the mother and establish long-term physical and visual contact.

In addition to classes with children in rehabilitation centers, recommendations are provided to parents. Specialists advise adults on how to raise such children, what to pay attention to and what literature to use.

Books on autism

Special books will help to create a harmonious atmosphere that improves the quality of life not only for an autistic child, but also for other family members. The information presented in such publications will help to understand the features of this disease and provide the baby with competent assistance in various areas of his life.

Useful books on autism are:

• Development of basic skills in children with autism (Tara Delaney). The book contains more than 100 games aimed at improving children's sociability and raising the level of knowledge about the world around them.
• Autism. A practical guide for parents, family members and teachers. (Fred Volkmar and Lisa Weisner). The book presents data on the latest research and development in the field of autism. All information is presented in a clear and accessible language.
• Opening the doors of hope. My Experience with Autism (Temple Grandin). The author of the book suffers from autism, but the disease did not prevent her from getting an education, becoming a professor and reaching many heights in life. This book was also made into a feature film of the same name.
• Brain starved children (Jacqueline McCandless). The book focuses on the description of the disease from a physiological point of view. The spelling is dominated by many medical terms, so it is not easy to digest the information. The value of the work lies in the fact that the author's granddaughter suffered from this disorder, so the book provides a lot of practical advice on education and therapy.

Features in the behavior of an autistic require increased attention from parents to the child. Adults should be prudent during the baby's walks, rest and other activities. Using some recommendations and advice from experts, parents can make their child's life not only more comfortable, but also safer.

• a tag with the address and the parent's phone number should be attached to the child's clothes;
• if possible, data with one's own name and surname, as well as the address and telephone number of the parents should be memorized by the child;
• it is recommended to systematically (every 2-3 months) take fresh photos of the child and have them with you in case he gets lost;
• before visiting a new place, the child must be familiarized with the route;
• before going to the theater, cinema, circus, it is recommended to purchase tickets in advance to avoid a queue in which the child will be uncomfortable;
• when leaving the house with the baby for a long time, parents need to take with them a toy or other favorite thing of the child to help him cope with anxiety;
• if adults have decided to send the baby to a sports section or a creative circle, several individual lessons should be held;
• for too active children, it is worth choosing the least traumatic sports;
• before starting to do their own thing, parents should organize leisure time for the child so that he does not feel lonely.

Before use, you should consult with a specialist.