What are the gender differences in autism
What is autism
In addition to autism (a term that can be translated with self-centeredness, isolation or withdrawal into one's own psychological world), other terms are also used: early childhood autism, autistic disorders, autistic syndrome, Asperger's syndrome, high-functioning autism and atypical autism. These are different varieties from the autistic spectrum (ASD - Autistic Spectrum Disorders), because we know today that autism can manifest itself in completely different degrees of severity and in combinations with other disabilities. There are autistic people who are mentally disabled at the same time (approx. 70%) or have another disease or disability (e.g. tuberous sclerosis, neurofibromatosis, phenylketonuria, fragile X syndrome and many others, cf. Baron-Cohen, Bolton 1993). Others with their discrete disabilities can attend a higher school, complete a qualified training and achieve a high degree of independence.
Kanner syndrome is a typical disability, and Asperger's syndrome is a lighter form. Syndrome means that several, here up to 60, individual abnormalities or symptoms can be observed, although they do not all have to occur at the same time. Atypical autism is usually found in severely disabled people who do not have all of the major symptoms. High-functioning-autism (autism with a high functional level) is a symptomatic, somewhat unclear term for people with Kanner syndrome who have outstanding skills in certain areas (e.g. music, calendar arithmetic, drawing, memory).
Since autistic people are particularly impaired in their ability to enter into close, emotional social contact with other people - including their own parents - and find it difficult to understand the motives for human action, most of them are dependent on help for life, regardless of their level of intelligence stay.
When was autism first described? How many people with autism are there?
The American psychiatrist Kanner is considered to be the first to describe “early childhood autism”. In 1943 he brought together a number of typical similarities for the professional world. At the time, he assumed that it was only a small group of affected children. Today we know that not only 4 or 5 (the so-called core group), but even 15 to 40 out of 10,000 children - predominantly boys (4: 1) - with a broader diagnostic key are affected by this disability (see BAG HfB 2000, ARRI 2002, 2003; Remschmidt 2000). For Germany this means that there are considerably more autistic than blind children. At least 41,000 people from the core group and up to 205,000 from the autistic spectrum (BAG HfB 2000) live among us.
At the same time, the Viennese Hans Asperger described a group with an “autistic personality disorder” in 1943, which has many abnormalities in common with the Kannersian type. But these children learn to speak earlier; They are often able to express themselves selectively, have at least average intellectual abilities and develop distinctive special interests (e.g. pirates, timetables, church bells) with which they deal long-term and often obsessively.
What leads to the diagnosis of “autism”?
During the first three years of life, several typical abnormalities must be observed at the same time, which are listed below. Some of these peculiarities are not exceptional in normal development.
First signs (up to 18 months):
- The children do not want to be fooled, they scream for long periods of time for no apparent reason, do not smile back when people they trust approach, and avoid eye contact. They are not interested in toys or the environment, pay no attention to adult pointing gestures or imitate them. They are deaf to noise, seem unable to understand speech, yell when you want to engage with them, and seem most comfortable when they are alone, often with repetitive, stereotyped movements, or always with the employ the same objects. The development of language ebbs away in monotonous sound formations, as they do not try to imitate what is spoken to them. Sleep disturbances and disturbances in eating can also be observed (see BAG HfB 2000).
- If these early signs condense into severe perception, relationship and communication disorders, this requires a precise diagnostic work-up by specialists (in child and adolescent psychiatry, in an outpatient clinic for autistic children or in a psychological counseling center).
Full image of the disability:
According to the international classification systems (ICD 10 and DSMIV), the full image is based on the following core symptoms:
- a qualitative impairment of interpersonal relationships
- severe impairment of communication and imagination
- clearly restricted interests and development of stereotypical behavioral patterns
- Begins during the first 36 months of life
An autism diagnosis is only justified if 1-3 relevant abnormalities can be observed in each of the areas at the same time. The most important are listed below (complete lists of symptoms can be found at the Federal Association Help for the Autistic Child - BV HAK - and BAG Help for Disabled 2000).
Language and communication
About half of all autistic children never learn to use spoken language; they are more likely to pull on the hand of adults when expressing their will. Others develop a language that is conspicuous in many ways (e.g. in the melody, choice of words, in grammar, in the speed of speech). You have not used personal pronouns (“I”) for a long time; they talk about themselves in the 3rd person or confuse you and me.
When speaking, eye contact is only made briefly, if at all. Speech-accompanying facial expressions and gestures are omitted. The children tend to talk to themselves, some to clichéd, bizarre language with new creations. Constant repetition of words or repetition of questions asked of them are typical. The children communicate in a mechanical way, and this gives the impression that they have not mastered the usual rules of communication. Even if your understanding of language appears to be better than your active ability to speak, it is more likely that you derive the meaning of the utterances or the information from the situation or from the everyday context. They have difficulty deciphering the meaning of gestures or of metaphorical, pictorial utterances (“he has his eye on you”, “I see black”? “I only understand train station”).
Perception, processing of sensory stimuli
The children prefer certain noises (high tones, knocking tones, music, noises from the vacuum cleaner or other household machines), but they do not pay attention to speech or very loud sounds. They may also be extremely sensitive to normal everyday sounds. They are fascinated by optical stimuli (carpet patterns, soap bubbles, cling film), which they also generate themselves (uniform movement of ribbons or threads in front of their eyes). They only take brief glances at people and things, see past you. They find it difficult to recognize the faces of people who should be familiar to them. Some tend to explore their surroundings by licking or sniffing and appear almost insensitive to cold, heat or pain.
The children often show repetitive, rhythmic hand, head or body movements - especially when they are aroused. They like to grimace, swing or hop. Sometimes they show deficiencies in the coordination of movements. They find it difficult to imitate even simple movements. Sometimes they tiptoe. They often take a long time to actually perform an action when prompted. Sometimes they stop moving.
The children show that they are unable to play rules or role-play. They tend to use toys (dolls, cars) to stimulate the senses. Popular activities (e.g. letting water or sand trickle through your hands) can fascinate you for hours. Everyday life is characterized by rituals that run the same way and that they often try to keep compulsively (e.g. arranging shoes, CDs, closing windows, giving preference to certain foods). If one tries to break these compulsions, they often react aggressively or with self-harm. They develop little motivation to deal with new things, often turn their attention to little things (e.g. ball, earring, wheel) and develop little imagination.
In addition, the people astonish us with their abilities (e.g. arithmetic, dismantling and assembling mechanical parts, saving melodies, poems or texts that they only briefly glanced at, making precise images, etc. ), which we can hardly explain and which stand in contrast to their behavioral problems.
What particularly affects people when dealing with other people, however, is the difficulty in extracting the meaning from the language, recognizing intentions in the actions of other people and emotional expressions (joy, anger, sadness ...) in facial expressions, gestures and To understand speech melody correctly. They also find it difficult to convey their own feelings in an understandable way through the use of facial expressions and gestures.
Living in a world that seems incomprehensible because one does not understand the underlying rules by which it works promotes withdrawal and uniform preoccupation with selected objects and with oneself.
Can autistic people never get in touch with other people?
Many people think that this withdrawal behavior, the refusal to make eye contact, the refusal to make contact and the lack of sympathy as typical signs of autism last for a lifetime and that these children feel most comfortable when they are left alone. In fact, as people get older, autistic people naturally learn to make contact with other people. They do it in the way they think possible.
If one follows the self-statements of expressive people who are affected by autism (cf. Sellin 1993, Zöllner 1988), it becomes obvious that one of the most painful feelings of those affected is to be regarded as disinterested in social contacts or to be described as cold-hearted . Of course they have feelings - they just don't always manage to express them in an understandable way. They also do not want to be left in peace, but need support in communication and help to better understand the intentions and actions of their fellow human beings.
How can the various behavioral problems be explained?
Changes in the environment are difficult for autistic children to endure. Therefore, they make sure to always restore an order that is appropriate to them. The compulsions that result from this are a great burden for the relatives. However, autistic children need this self-created order for a while so that they can feel safe.
Autistic children also differ from their peers in their play and preferred activities: They develop stereotypes (turning and spinning objects, moving their hands back and forth in front of their eyes, making knocking tones) or are only interested in certain objects (e.g. deck chairs , Detergent, drainage shafts ...). When they can speak, their attention is often focused on one-sided topics of conversation (flight plans, astronomy, geography ...) about which they acquire detailed knowledge. Excessive collecting passions, refusing to wear certain clothes or eating a certain dish, or repeating the same sentences over and over again - all of this is related not only to problems in understanding communicative rules and striving for safety, but also to elementary disturbances in the field of perception and perception processing.
Because it is difficult for autistic children to grasp complex relationships and to distinguish important from unimportant, they focus their attention on details (e.g. earring, ball) or on restricted subject areas. Due to their noticeable hypersensitivity or under-sensitivity to various sensory stimuli (smelling, tasting, feeling, hearing, seeing and stimulating balance; cf. Dalferth 1995) they react very sensitively to certain stimuli that are perceived as unpleasant. Certain noises, smells, crowds of people, babble of voices, etc. can also induce self-harm.
Even if these behavioral peculiarities weaken over time, these habits make dealing with autistic children considerably more difficult and require a lot of empathy and patience from the relatives. Since many children are also unable to correctly assess dangers, constant supervision and care are required.
Is it upbringing that children become autistic?
The assumption that it could be due to the parenting behavior of the parents if children develop an autistic syndrome is scientifically untenable and completely unjustified. Today it has been clearly proven that the parenting behavior of the parents can neither cause autism nor is responsible for the often bizarre behavior: the children are not badly brought up if they utter unpleasant things in public (tactlessness) or behave inappropriately (e.g. on a seat that is already occupied). All of this is an expression of their disturbance in the perception of the world and expresses their limited understanding of social situations.
Are Autistic Children Mentally Disabled?
The intellectual ability of autistic children can vary greatly. It ranges from the level of severe intellectual disability to average or above-average intelligence. Some have above-average computational, technical or musical skills. Their intelligence profile is more likely to be described as disharmonious, since people with severe disabilities can also have amazing performance islands. For example, a girl can trace complicated circuits out of her head and knows entire nutrient tables by heart - but she cannot remember her own telephone number or the price for a liter of milk.
Accordingly, it is not easy to clearly assign autistic children to a certain type of school. It is therefore best if the school adapts to the particularities of the respective child.
How does an autistic disability come about?
It is often said that nothing is known about the causes of this enigmatic handicap. In fact, there are a number of findings and theories (Dzikowski 1996) that make it clear that this disability is due to the interaction of several factors.
Ch. Gillberg aptly characterized autism as a biologically determined behavioral disorder. That is, a genetic disposition (physical readiness) to develop autism and unfavorable influences in the course of pregnancy and childbirth, i.e. the increased occurrence of very different pregnancy and childbirth complications (e.g. viral infections, oxygen deficiency) - which, however, are unspecific -, can damage the brain and lead to the development of autistic syndrome.
Family and twin examinations speak for the importance of genetic factors (cf. Dalferth 1990), since with identical twins mostly not only one but both are affected by autism. In addition, brain damage and brain dysfunction play a central role, which can be detected in 60% of children (cf. BV HAK 2001).
Autism also manifests itself in a number of neurobiological and biochemical peculiarities (cf. Remschmidt 2000), the occurrence of which has not yet been clarified in detail.
In any case, however, an autistic disability manifests itself in a disturbance in perception and processing. This means that autistic people with intact sensory organs can absorb the numerous stimuli from the environment, but cannot properly combine, classify and understand them. The sensory stimuli do not become understandable carriers of meaning and thus do not give those affected the opportunity to organize their behavior and experience appropriately and to adjust to the outside world.These disturbances in the processing of perception and the inability to properly empathize with the thoughts and feelings of other people mean that they have difficulty understanding the behavior of their fellow human beings and it is difficult for them to understand themselves to the outside world.
In addition, the body does not always obey the will of autistic people, i.e. they cannot act or express themselves as they want or should (cf. Zöller 1989, Sellin 1993). In this way one can also get the impression that the children are deaf or severely mentally handicapped. For example, an autistic boy who learned to communicate in writing said: "I cannot speak because my mouth cannot carry out the commands of the brain, but I can think."
Important contact address
Federal Association for Help for Autistic Children (BV HAK)
Association for the Promotion of Autistic People
Tel .: 040/5115604
- Autism Research Review International (ARRI) No. 3, 4, Vol 16, 2002, 1, Vol 17, 2003
- BAG Help for the Disabled (Ed.): Communication between partners. Early childhood autism (edited by St. Dzikowski). Kirchfeldstrasse 149, 40215 Düsseldorf
- Baron-Cohen, S .; Bolton, P. (1996): Autism. The facts. Oxford University Press, New York
- BV HAK (ed.): Memorandum on the situation of autistic people in the Federal Republic of Germany. Hamburg 2001 (contains the current basic knowledge about autism, important literature references and information on brochures on various topics and lists of symptoms that were published by the BV, as well as the addresses of all regional associations and outpatient clinics)
- BV HAK (ed.): Professional integration of autistic adults (edited by M. Dalferth). Hamburg 1996
- Dalferth M. (1990): On the importance of hereditary factors in early childhood autism 3, 207-217
- Dalferth, M. (1995): Disabled people with autism syndrome. Problems of perception and affectivity - a contribution to the understanding and genesis of the disability. Winter, Heidelberg
- Dzikowski, St .: The Causes of Autism: A Documentation. Beltz, Weinheim 1996
- Gillberg, C .; Coleman, M. (1992): The biology of autistic syndromes. MacKeth Press, London
- Remschmidt, H. (2000): Autism. Manifestations, causes, help. Beck, Munich
- Schopler, E .; Lansing, M .; Waters, L. (2000): Exercise Instructions for Supporting Autistic and Developmentally Disabled Children. vml., Dortmund
- Sellin, B. (1993): I don't want to be inside me anymore. Kiepenheuer and Witch, Cologne
- Zöller, D. (1989): If I could talk to you. Joke, Bern, Munich, Vienna
Further contributions by the author can be found here in our family handbook
Prof. Dr. phil. Matthias Dalferth (Member of the Scientific Advisory Board of BV Help for the Autistic Child)
Regensburg University of Applied Sciences
FB Social Affairs
P.O. Box 12 03 27
Tel .: 0941/9431087/81
Created on June 24th, 2003, last changed on March 31st, 2010
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