OfMaria Giovanna Faiella
In Italy, one child in 77, between 7 and 9 years old, has an autism spectrum disorder. 500 thousand families involved. Cognitive-behavioral therapies (recommended by Guidelines) are most often paid for by families. Experts at work (Ministerial Decree) for the Consensus Conference on ABA-based interventions
Difficulty in the communication (verbal and otherwise) e to interact with othersfor example a “lost” look, a tendency to isolate oneself, little interest in other children; stereotyped and repetitive behaviors such as continuous rocking or clapping or repetitive speaking); in some cases there may be aalteration of motor coordination (for example extravagant, awkward gait or other abnormal signs), in others a intellectual impairment.
These are some of the manifestations of autism spectrum disorderswhich can manifest themselves in different forms and severity.
April 2nd is World Autism Awareness Day, established in 2007 by the United Nations to shine a spotlight on this condition (it's not a disease) that in our country interest is estimated one child in 77, between 7 and 9 years, and approximately 500 thousand families.
Autism spectrum disorders: what they are, how to recognize them
Not all forms of autism are the same, which is why we talk about «autism spectrum disorders», a heterogeneous group of conditions characterized mainly by:
– compromise in the areas of communication and of thesocial interaction,
– repetitive and stereotyped patterns of behavior, interests and activities.
THE symptoms they can be extremely heterogeneous both in terms of complexity what about severity and then, vary over timeas well as manifest differently from person to person.
THE symptoms most common are:
• difficulty in verbal communication with language repetitive or not useful for communication or completely absent;
• difficulties in communication Not verbal, for example do It's hard to look the person in front of you in the eye and maintain eye contact, have no facial expressiveness or feel indifference towards the facial expressions of parents and other people;
• difficulty on a relational level with little (or no) ability to share interests, emotions or feelings and to interact with others, both peers and adults;
• stereotyped behaviours, with gestures that are always the same and repeated, such as rocking, clapping, snapping one's fingers;
• narrow interestssuch as a pathological attachment to particular objects;
• abnormal reactions to sensory or environmental stimuli (for example: sudden sounds, flashes of light).
Diagnosis, who to contact
The causes of autism spectrum disorders are not fully known. There diagnosis it can only be formulated through observation of behavior.
Elisa Fazzi, president of the Italian Society of Child and Adolescent Neuropsychiatry (SINPIA) and director of Child and Adolescent Neuropsychiatry at the ASST Spedali Civili and University of Brescia, explains: «The identification of signs of riskthe early diagnosis And timely intervention they are strategic actions for improving the prognosis and quality of life of children with autism spectrum disorders and their caregivers. It is important that child and adolescent neuropsychiatry services throughout the national territory have available all the necessary resources For implement early interventiona request that we have been making insistently for years and which to this day is not yet a consolidated reality.”
The Istituto Superiore di Sanità, on mandate from the Ministry of Health, has activated a permanent collaboration with all the Regions and autonomous Provinces for the mapping of regional and provincial services for diagnosis and management of people with autism spectrum disorders and other neurodevelopmental disorders, at all ages of life. On the website ofNational Autism Observatory can be found i services of accredited/agreeded public and private structures available on the territory.
Reports from schools
On the occasion of the world day, some child neuropsychiatrists, pedagogists and philosophers, who have signed the Autism Manifestothey put beware of «diagnostic excesses» to protect children from possible errors and confusion. In particular, the authors of the Manifesto underline: «Every child who presents some difficulty evolutionary, which may be transitory if addressed with appropriate interventions on the child himself and his family context, it comes immediately reported by schools, perhaps too involved in these practices, as suspected of autism and the family invitedsometimes with strong pressure, to contact specialized centres to initiate the necessary treatment. Treatments that do not always take into consideration the emotional-relational world of the child and his truest and deepest needs.”
Therapeutic interventions and life plans
Following the diagnosis of autism spectrum disorder, there are several therapeutic interventions proposed and they go calibrated to specific needs of the person at various stages of life. Among the most effective ones, according to Guide recommendations on the diagnosis and treatment of autism spectrum disorder in children and adolescentspublished by the Istituto Superiore di Sanità in October 2023, there are the therapies cognitive-behavioral, most of the time, however, at the expense of families.
They are also fundamental, but often still a mirage, i “tailor-made” individual life projects aimed atjob placement of adults with autism spectrum disorders that enhance their abilities, as established by the same Law no. 134/2015«Provisions regarding the diagnosis, treatment and qualification of people with autism spectrum disorders and assistance to families».
Ministry of Health, experts at work
Last February 20, the Ministry of Health, with the Decree of the Undersecretary Marcello Gemmato, he gave a job to a group of experts on autism spectrum disorders to define more fully, within three months (20 May ed), «some aspects relating to habilitative/rehabilitative therapeutic treatmentsbased on the principles of the science of behavior analysis, applied within the National Health Servicefor children with autism spectrum disorders aged between 0 and 7 years and, in particular, guarantee the appropriate management of specific and controversial clinical situations».
Specifically, the working group has the task of defining, through a Consensus conference:
– if thepersonalized behavioral intervention (intensive/focused), based on «ABA» principles (acronym for «Applied behavior analysis» or «Analysis applied of behavior”), both appropriate in the age group that goes from zero to seven yearsinside a overall therapeutic project;
– what is the minimum duration of hours for the intervention comprehensive based on ABA principles depending on the severity of the autism spectrum disorder diagnosed in the 0-7 age group.
More prejudices
«Unfortunately – says Roberto Speziale, president of Anfass-National Association of families and people with intellectual disabilities and neurodevelopmental disorderswhich takes care of around 4,000 people on the autism spectrum and their families throughout Italy – even today we are forced to point out the constant presence of stereotypes and preconceptions that they continue to cause discriminations: there are still many cultural legacies to counteract and dispel, starting with the correct use of words and language when talking about spectrum disorders, for avoid derogatory and denigrating terms. Another important theme is the taken charge: it's about having adequate assistance from diagnosis and throughout their lives, e not random interventions. From this perspective also the support for families is very important: they must not be left alone to make up for the shortcomings of a system that should instead work. Another sore point is the lack of resources and fundsa serious problem that has gone unanswered for too long.”
Initiatives and monuments that are tinged with blue
On the occasion of World Day, the awareness campaign and fundraising #sfidAutismo24 promoted by Italian Foundation for Autism (FIA) to finance research projects aimed at both identifying autism spectrum disorders early and promoting interventions based on scientific evidence.
Among the initiatives scheduled for April 2nd: the scientific conference «Life project in autism, from sport to work inclusion», in Rome at the CONI headquarters, organized by Aira-Italian Association for Autism Research in collaboration with the Child Neuropsychiatry Department of the University of Tor Vergata and the Bambino Gesù Hospital. Also at the CONI, during the charity-gala evening, there will be introduce yourself a scientific and popular story on autism, one show of works created by children followed by the Child Neuropsychiatry Operational Unit of the Tor Vergata Polyclinic and a fencing challenge between two teams made up of Italian Olympians and athletes with autism.
After sunset, then, i main Italian monuments will light up in blue – color symbol of autism – to shine a spotlight on this condition.
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