Kanner syndrome is early childhood autism. In this case, the interpersonal contact disorder is already apparent in babies.
What is Kanner syndrome?
Kanner syndrome is also known as Kanner autism, infantile autism or early childhood autism. It is a form of autism with onset before the age of three. The syndrome is considered a profound developmental disorder and is more common in boys than girls. Kanner syndrome was named after the Austrian-American child and adolescent psychiatrist Leo Kanner (1894-1981), who is considered the founder of child and adolescent psychiatry in the USA. In 1943, Kanner diagnosed autistic affective contact disorder in several children. Later, this disorder was given the name “early childhood autism.” Kanner syndrome belongs to the severe forms of autism. Thus, affected children are impaired in their behavior, speech, as well as in their social interactions. Already in infancy, they show a conspicuous differentness, avoid eye contact and show no reactions to facial expressions or gestures. Feelings are not understood or misinterpreted by them. Instead, objects are more important to them than people, and they prefer to play with their parents or alone rather than with other children.
Causes
The causes of Kanner syndrome are usually genetic. For example, studies found autism in both children in 70 to 90 percent of all identical twins studied. In contrast, the autism rate in fraternal twins was only about 23 percent. The exact cause of Kanner syndrome has not yet been adequately explained. It is assumed that, in addition to genetic factors, functional or structural brain changes also play a role. In about every third affected child, seizures occur in the course of the disease. Neurobiological abnormalities such as eating disorders or abnormal crying can also be observed. Studies of brain metabolism have revealed differences from the general population. For example, the brain volume of children with the disease is larger than that of their peers. In addition, brain growth is faster during pregnancy and in the first years of life. Furthermore, disturbances in emotional and cognitive development may be present.
Symptoms, complaints, and signs
The first symptoms of Kanner syndrome usually appear in the early months of life. Particularly noticeable is that affected children avoid or severely limit human contact, which also applies to parents and siblings. Instead, they are more interested in objects and only make contact with other people when their own needs are at stake. This emotional coldness of the children is especially hard on their parents. There is no sympathy, happiness or anger. Even eye contact with the mother is avoided. In addition, autistic children do not make friends and prefer to play alone. Feelings are not understood by children suffering from Kanner syndrome. They also do not express spontaneous emotions themselves. Often feelings are misinterpreted by them. Another typical symptom of Kanner autism is a disorder of language development. Thus, the affected persons are hardly able to articulate themselves and have only a limited vocabulary. Often a random sentence is constantly repeated or what is said is parroted meaninglessly. Since the speech sounds very monotonous, it reminds of a robot. When playing, the children follow a certain unimaginative pattern over and over again. If their play is interrupted by other people, they react restlessly or very anxiously. Approximately 70 percent of all children with Kanner syndrome have mental disabilities associated with reduced intelligence. Exceptional talents are very rare in Kanner autism. Sometimes the affected children giggle for no reason and underestimate everyday dangers such as traffic. In addition, eating disorders, sleep disturbances, and self-injury occur.
Diagnosis and course of the disease
Significant components of the diagnosis are the medical history (anamnesis) and a clinical observation of the child by the physician. In doing so, the physician resorts to scales that serve as aids. Differential diagnosis is also important.Thus, similar symptoms can also occur in Rett syndrome, Asperger syndrome, oligophrenia (giftedness) or schizophrenia. The course of Kanner syndrome is often negative. Thus, the disease cannot be cured. However, if there are no neurological abnormalities or epilepsy, a positive prognosis can still be achieved. The same applies if language develops relatively well by the age of six and the intelligence quotient is more than 80.
Complications
Kanner syndrome is typically associated with decreased intelligence. This can result in life complications if the affected person cannot live independently in adulthood. Some autistic individuals are dependent on support throughout their lives. Limitations in everyday life are also possible with Asperger syndrome – but on average they are less pronounced than with Kanner syndrome. In particular, weaker manifestations of autism do not have to affect the way people live their lives. In addition, various neurological disorders occur more frequently in individuals with Kanner autism. These disorders include epilepsy, for example. The seizures can result in further complications: Falls, unintentional self-harm, and airway obstruction are among them, as is the general stress placed on the body during an epileptic seizure. Even with treatment, various complications are possible. In particular, Applied Behavior Analysis (ABA) is coming under increasing criticism. The behavioral therapy method is based on operant conditioning and reinforces desired behavior while punishing undesired behavior. ABA is used primarily with children. Some forms of ABA employ aversive stimuli that are unpleasant to the autistic child, although they do not cause him physical harm. In this context, the literature now repeatedly reports traumatic consequences resulting from ABA. Conversely, however, ABA can also be beneficial. For this reason, careful application of the method is necessary.
When should one go to the doctor?
Kanner syndrome is usually noticeable in the first few years of life. Parents who notice coldness of feeling or other typical symptoms in their child should consult a pediatrician. The rare syndrome can be treated symptomatically if it is addressed early. Parents should see a general practitioner or a neurologist and work out a treatment together. Further visits to occupational therapists, internists and psychologists are indicated as part of the treatment. Children who show signs of depression should be seen by a therapist. If seizures or epileptic seizures occur, the emergency physician should be alerted. Affected children usually require support throughout their lives. Relatives must maintain close contact with various physicians and therapists and inform them regularly about the affected person’s constitution. Should unusual symptoms develop or even complications arise, this must be clarified immediately by a doctor. In case of doubt, the emergency medical service can be contacted first.
Treatment and therapy
A causal therapy for Kanner autism is not possible. Therefore, the symptoms of the affected person show throughout his life. However, over the years, they are somewhat alleviated. As part of the treatment, the patient’s communicative and social characteristics should be improved. The sooner the therapy begins, the greater the chances of success. The child’s social environment also plays a part in the treatment. The main areas of training for children with early autism include independence, social skills and communication, language skills through speech therapy, and self-control. Suitable supportive treatment measures include swimming with dolphins, equine therapy, or music therapy. Since Kanner syndrome is often associated with other disorders such as depression or epilepsy, the administration of medications such as serotonin reuptake inhibitors (SSRIs) can be useful. However, people who suffer from autism are often sensitive to medication, which increases the risk of side effects.
Outlook and prognosis
In order for parents to help with therapy as efficiently as possible, even in the home environment, the individual strengths and weaknesses of the affected child must first be determined, and a treatment plan must be developed together with physicians. The main focus must be never to make the child think that he or she is different from other children or that he or she is sick. The child should not grow up with the awareness that there is something wrong with him. It is better to emphasize the uniqueness of everyone and show that everyone has their strengths and weaknesses. Regular behavioral training helps the child learn how to behave better in certain situations and may help control any tics. However, this should in no way degenerate into dressage, where the child’s naturalness is changed by new rules. Rather, it is important to gently show the child ways to react and to approach problem solving step by step. Depending on the child’s stage of development and psychological maturity, additional physiotherapeutic measures and speech therapy can be started, some of which can also be integrated into everyday life at home. By contacting kindergartens and schools at an early stage, individual support can also be achieved there on site, depending on the institute.
Prevention
There is no way to effectively prevent Kanner syndrome. Thus, its exact causes are not yet known.
Follow-up
In most cases, patients with Kanner syndrome do not have any specific and direct options for aftercare, so the disease must be primarily investigated and treated by a physician. This is the only way to prevent further complications or further worsening of symptoms. Therefore, affected individuals should contact a physician at the first signs and symptoms of the disorder. In general, early diagnosis of Kanner syndrome has a very positive effect on the further course of the disease. As a rule, a complete cure is not possible, so that those affected by Kanner syndrome are dependent on the support and help of friends and their own family. Intensive care is necessary to increase social skills and prevent further symptoms. Likewise, intensive and loving conversations with the affected person are also necessary so that depression or other psychological upsets do not occur. Often, therapies with music or with dolphins are also very helpful to alleviate the symptoms of Kanner syndrome. Since the syndrome is treated in some cases by taking medication, care must be taken to take it regularly and also to follow the prescribed dosage.
Here’s what you can do yourself
Children suffering from Kanner syndrome require individualized therapy based on symptoms and conditions. Above all, regular behavioral training is important. The child should learn to integrate and control any tics. Here, it is primarily the parents who are called upon to deal with the child and the disorder and should work out an adequate therapy together with the doctor and the psychologist. The goal is to determine the child’s strengths and weaknesses and then to promote or treat them in a targeted manner. In some cases, physiotherapy and/or speech therapy can be included in the treatment. Which measures are appropriate depends entirely on the child’s stage of development and mental maturity. A therapist must assess whether a particular therapy is appropriate or whether further examinations are necessary. In principle, however, parents should not give the child the impression that he or she is different or even ill. It is better to accept a child with early childhood autism as he or she is and to address the problems gradually. For this purpose, it makes sense to contact schools and kindergartens and provide the child with individual support.
