How should a doctor react to autism

Psychiatry, Psychosomatics & Psychotherapy

Diagnosing Autism Spectrum Disorders

There are children who are hardly or not at all interested in their environment. Others scream constantly and avoid any kind of touch as much as possible. These abnormalities can hide an autistic disorder, but also other diseases or an extreme variant of normal development. It is therefore Difficult to make a definite diagnosis of Autism Spectrum Disorder before the age of 18 months.

With the help of special questionnaires (for patients and relatives), the child and adolescent psychiatrist therefore questions the child's development and the signs that occur in great detail. Autism Spectrum Disorders are mainly characterized by the following three main features marked: disturbed social interaction; Impaired communication / language and repeated, stereotypical behaviors and interests. The exact classification of a developmental disorder with autistic features can often only be made after long observation.

The following behaviors can indicate an autism spectrum disorder:

  • Profound relationship and communication disorder, i.e. the child turns away from his environment and makes little or no social contact, not even with his own parents; it avoids both eye and body contact.
  • The affected person withdraws and lives in his own world to which others have little access.
  • The child develops stereotypes, i.e. they do the same, often meaningless things over and over in the same way.
  • The child is constantly making strange, abnormal movements.
  • The child sometimes develops aggressive behavior towards other people or towards itself.
  • The child does not give any answers to questions, but simply repeats them (echolalia) or shows clear deficits in language development.
  • When you call the child, it seems deaf. On the other hand, it reacts to other, often harmless and completely everyday noises with violent defensive reactions.
  • The person concerned rejects changes of any kind.
  • The child has various food intake disorders (e.g. chewing problems) and rigid preferences for certain foods.
  • Existing skills are receding.

By means of an extensive physical, psychiatric, neurological and laboratory medical examination, the child and adolescent psychiatrist differentiates between other clinical pictures such as epilepsy, ADHD, anxiety, obsessive-compulsive and tic disorders. In cooperation with other specialists, possible hearing and visual impairments must be ruled out.

A human genetic examination and advice to the family is also recommended after the diagnosis. In individual cases, a detailed child neurological examination must be carried out, accompanied by an EEG examination, brain imaging and the exclusion of metabolic, muscle or autoimmune diseases. These examinations can be arranged by the pediatrician or child and adolescent psychiatrist if there is a suspicion.

Technical support: Prof. Dr. med. Dipl. Theol. Christine M. Freitag, Frankfurt (DGKJP)