April 02, 2023
Autism is a disorder related to the development of the brain, which presents a series of characteristics that can be identified in early childhood; however, in most cases it is diagnosed late, hindering people’s quality of life.
No doubt, early childhood -from birth to 3 years of age- is a critical period for the development of every human being, since the necessary bases for subsequent learning processes are established, since growth and development brain, are a combination of genetic factors, stimuli and the experiences of the interactions that the child has with his environment, giving rise to a series of social, emotional, cognitive, sensory-perceptive and motor skills, vital to maximize his future well-being.
However, there may be certain alterations at the brain level that hinder the expected development, as is the case with autism, which is a multifactorial neurobiological condition that significantly affects the sensory, social and emotional level. As Pamela Muñoz, a pediatric neurologist at Clinica Ricardo Palma explained to El Comercio’s Bienestar, people with autism may have difficulties establishing social relationships and communicating effectively with others, as well as presenting repetitive or stereotyped behaviors and peculiar interests, which is why , if an early diagnosis and intervention is not carried out, it can have a negative impact on the child’s quality of life.
How to identify an infant with autism?
According to Muñoz, symptoms can occur from the first months or years of life, for example, children with autism are usually very serious, they do not even present that characteristic reciprocal smile that infants have with their parents.
“In general, they do not show an interest in socializing, as they prefer to play alone or adopt routine attitudes, such as going around in circles, lining up objects or arranging them in a group. They can also present echolalia, that is, they repeat what they hear many times, since there is no correct understanding of the language,” she says.
How is the diagnosis made?
The diagnosis can be established from 30 months, and as mentioned by the specialist, this is made based on the behavior patterns that the child presents during the interaction that he/she has with the trained professional, be it a pediatric neurologist or a child psychiatrist. Additionally, an interview is carried out with the parents to map the minor’s behavior in other typical social situations.
“Some evaluations can also be carried out, such as the so-called additional psychological tests that help to identify the degree of social interaction, communication, etc. or neurological exams, which allow for the ruling out of some other condition, such as determining if the child hears well,” she said.
What kind of therapies are performed?
Indeed, many children with autism have sensory difficulties, because they are hypersensitive, that is, they are bothered by noises or being touched, while in other cases they may be hyposensitive, which is why they seek to put everything in their mouths. For this reason, Muñoz stressed the importance of sensory therapy, which has the purpose of integrating the entire environment that surrounds the child so that he does not go into crisis and that he can really discriminate which stimulus is more important.
“Thanks to optimal brain development, if we are manipulating something and somebody call us, we automatically turn around, since human beings prioritize social contact. However, this does not happen in autistic children, since for them sensory search or rejection is more important, which is why they tend to have peculiar interests”.
On the other hand, the pediatric neurologist explained that behavioral therapy is essential, where behavior patterns are worked on, such as greeting, waiting for the turn, interaction, among others. Generally, two types of approaches are carried out: applied behavior analysis (ABA) and the Denver model. In addition, once these therapies have been carried out, the child can just begin to work on language, basically, with a series of techniques that range from repetitions to learning through images.
How early intervention programs can improve the prognosis of autism?
Indeed, it is important to consider that brain development is a pattern acquisition process that occurs from birth and; especially during the first years of life. For this reason, it is essential, first of all, to carry out an early diagnosis, because if a child is presenting interaction and language problems even before 30 months of age or it is observed that something is not going according to the typical pattern of development, they should be evaluated immediately by a specialist, Muñoz said.
“Unfortunately, many children with autism spectrum disorder are diagnosed late, even after the age of five, since in many cases denial or thinking that since there is a relative in the family who was late in speaking, then the child is also the same and he will acquire the ability naturally in time. According to several studies, the parents of seven out of ten children with autism always suspected this condition; therefore, they were diagnosed after the recommended age.
Definitely, early intervention programs allow the child to develop important skills, such as communication, social interaction, problem solving and the ability to play and learn. As stated by Valeria Rojas, Andrea Riversa and Nelson Nilo in the scientific article of the “Update on diagnosis and early intervention of de| autistic spectrum”, published in the Chilean Journal of Pediatrics, thanks to neuroplasticity, the various intervention methodologies can counteract, to a certain extent, the cascade of developmental alterations typical of this condition, thus mitigating the manifestation of symptoms in the great most cases.
Dr. Pamela Muñoz
Pediatric neurologist at Clinica Ricardo Palma