Diagnosis
The diagnosis is made only on the basis of the symptoms the child shows. There are no specific tests to detect autism because the children “live like in another world”. Therefore, tests that involve the children must be avoided.
The reason for this is that autism is often only diagnosed in kindergarten, even though it is already present at birth. The parent survey plays an important role. They know best how their child normally behaves and what abnormalities it shows.
However, the diagnosis of a possible high giftedness is more precisely defined. Since the symptoms of autism can be diverse and of varying degrees of severity or weakness, the diagnosis of autism is not easy to make. For this reason, doctors and specialists use special tests when autism is suspected.
Firstly, various intelligence tests are used. In most cases, autism is associated with mental retardation and speech disorders. Especially early childhood autism is associated with reduced intelligence.
These tests are specifically the Hamburger-Wechsler-Test for children and the Hannover-Wechsler-Test for the pre-school age for children from 2-6 years. Other tests are also used for language development. If these tests are abnormal, there are two more special tests for autism to confirm the suspicion.
The specialists use the Diagnostic Observation Scale for Autistic Disorders (ADOS) and the Diagnostic Interview for Autism (ADI-R). In the ADOS test, the social interaction, communication and play behaviour of the child and adult are observed and classified. There are different modules for this test, which can be used depending on age.
It is a test that is used by default when autism is suspected. In the ADI-R test, the parents or other key caregivers of the child or adult patient are interviewed. The persons are questioned in the absence of the child about abnormalities in communication, language development, social behaviour, development, interest and play behaviour.
The test can take up to 4 hours in total. In order to exclude a physical illness, the children or adults are also physically examined. This includes for example a hearing test, an eye test, EEG or MRT.
Therapy
Parent training is particularly important in therapy, which takes up a large part of the therapy. There is no curative therapy against the hereditary disease of autism. Psychiatric or psychosomatic care plays an important role.
Behavioural therapy is particularly important here. For the therapy of autism, the reward system is used. Desired behaviour is rewarded.
In the case of so-called auto-aggressive behaviour (e.g. banging one’s head against the wall) there may be a need for punishment. Punishment in this case means, for example, taking away your favourite toy. Such measures should only be applied in exceptional cases.
Autistic children need a very stable family structure and an environment that does not change. For example, the child’s excessive behaviour must be reacted to immediately and adequately. Depending on which areas are particularly underdeveloped, these require special support (motor learning in children with rather weak motor skills).
Psychotherapeutic drugs can be used, but only in cases of severe disease progression with, for example, self-injury. These drugs are normally used in schizophrenic patients. Sulpiride and risperidone, which lower the serotonin levels in the blood, should be mentioned here.
In some children this can improve their behaviour and mental abilities. Drugs specifically designed for autism are not yet available. Autism is not a curable disease, it can only be tried to reduce the symptoms.
