A Case From Medical Practice. Autistic Inevitably

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A Case From Medical Practice. Autistic Inevitably
A Case From Medical Practice. Autistic Inevitably

Video: A Case From Medical Practice. Autistic Inevitably

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Video: Autism Spectrum Disorder Moderate Severe Example, DSM 5 Symptoms Case 2023, January

A case from medical practice. Autistic inevitably

The father of his five-year-old son asked for advice on further tactics of management and correction of treatment. At the reception together. The main complaints are the delayed speech and psycho-emotional development of the child.

The father of his five-year-old son asked for advice on further tactics of management and correction of treatment. At the reception together. The main complaints are the delayed speech and psycho-emotional development of the child.

The boy has a proportional physique, physically developed by age. There were no clinically significant symptoms of the cranial nerves. The reflex-sensitive sphere is physiological. No movement disorders were found.

The child keeps close to the father, almost does not make eye contact, looks away. He enters into verbal contact with a great delay, speech is very quiet and illegible, without intelligible articulation, answers to questions are monosyllabic, practically indistinguishable in meaning without the help of the father. The gaze is directed mostly downward or at the father, looks sullenly.


According to the father, the mother's pregnancy and childbirth were uneventful. Childbirth is independent, on time. There is a second child in the family - an older sister of ten years old. In the family, the situation is on the verge of divorce, the father announced his intention to divorce, keep both children for himself due to adultery on the part of his wife. Father is a military man, an aviation technician by profession.

As a treatment, the child was prescribed nootropic, neurometabolic therapy, which, according to his father, did not have a significant effect. The boy attends a speech therapy group in a kindergarten.

- Tell us about your child in more detail, perhaps, besides the violation of speech development, is there anything else that bothers you?

- Yes, everything seemed normal. Until the age of four, we did not pay attention to the fact that he was so withdrawn and hardly spoke. This is probably wrong, but we tried to guess and fulfill any of his wishes. Perhaps that is why he is lazy to say something, to pronounce words. And so he is quick-witted, he understands everything very well. He quickly understands any, even complex toy, he mastered the phone in no time. He likes to listen to music through my headphones, and not just any music, but asks AC / DC to turn it up, most importantly, louder.

- Have you previously visited psychologists, psychotherapists? They showed the child, assessed his development, what did they tell you?

- Yes of course. We were told that he probably has autism or something like that, but I read about it, it seems to me that it is not so. He's not feeble-minded at all, I say, smart, but he just doesn't want to talk. And he doesn't make contact with strangers.

The boy calmly stood half-turned to the doctor's table, turned towards his father, and was looking at something on the floor in front of him.

- Tell me, how is it in your family, are there episodes with scandals, do you quarrel with each other, it happens that you break into a cry, you, mom - at each other or at the children?

- No, there is no such thing. Mom is not noisy at all, neither am I., no scenes, if you mean that, and even more so with regard to children. We have already figured out our relationship normally, this is not the first time on her part, I'm tired of it. She does not mind that the children stay with me, they will see her regularly, so everything is fine in this regard.


- Maybe you remember something that traumatizes the psyche of a child, any circumstances, events? I'm primarily interested in the sound trauma factor - screams, noise? Maybe during pregnancy, after childbirth?

- No, doctor, nothing special. Mom wore it calmly and treats the children exactly, and even more so in everything I please, maybe even too much.

- Where are you from?

- About a year ago they settled in Krasnodar, and before that they lived in Kamchatka.

- Children were born and raised there? Where and who did you work there, where did you live?

- Yes, their homeland is there. I told you, I myself am an aviation technician, I have now demobilized. He served at a military airfield, and lived practically next to it. Served military aviation flights.

- Did you live near the airfield?

- Yes, our officers' house was practically close.

- I can imagine: the noise of the engines during the purge, at the start, afterburner … Daily takeoffs, landings.

- Yes, with rare exceptions all the time, but you know, you get used to the noise, we did not notice it.

- And what about the children?

- Well, yes, probably, but we tried to close the windows. Although not always, you are right. But somehow I didn't connect at all …

- Probably no one asked you about this, I understand. The fact is that all children are different, and the morphology of the nervous system and the sensitivity of the sensory apparatus - visual, auditory - can also differ by orders of magnitude. In system-vector psychology, there is the concept of "sound vector". People with a sound vector have a supersensitive auditory analyzer. There is every reason to believe that your child has it. The child is endowed with this from birth, even during the period of intrauterine development, his nervous system develops under the influence of his given characteristics. Such children and adults are extremely sensitive to any sounds.

The primary auditory area in the cerebral cortex is responsible not only for the perception of sounds, but also for multisensory integration, as it were, a double-check, confirmation of information about the world around it that enters the brain through other analyzers. That at the level of physiology confirms the dominance of the sound vector.

The period of formation and formation of the auditory apparatus at the stage of embryogenesis is extremely important for sound children. No less important is the period of early development of such a child, in which it should be especially carefully protected from strong noise, loud sounds, and screams from the parents and especially the mother should not be allowed.


But here, from your words, I understand that everything should have been in order, but the noise of jet engines operating at full power is a very significant factor in sound trauma, precisely for this child, endowed by nature with a sound vector. Whereas your first daughter could develop quite adequately under the same conditions, since she, most likely, does not have a sound vector and, accordingly, all characteristic neurophysiology.

Please note that your child wants to listen to loud music, as far as I know, the creativity of this group lies far beyond what is called quiet melodies. In terms of the decibel level and the nature of the sound, hard rock is quite comparable to the sound of an airplane jet engine.

Unfortunately, now we can only make assumptions about the reasons that underlie the delay in the child's speech development. Correct articulation, pronunciation of words is impossible without a clear perception of speech. There are many examples of this. Children who are completely isolated and raised in a deaf and dumb family have certain difficulties in verbal communication. This also applies to children who grew up outside of society.

- Doctor, but we checked his hearing, the doctors said that everything is in order.

- Of course, everything is in order, you were rightly told. The audiogram will be perfect, maybe even more than perfect. This is the whole point. We are talking about increased sensitivity to sounds and, accordingly, about greater vulnerability. Do you understand what the threshold of perception is? What are transcendental stimuli, the phenomenon of transcendental inhibition? With a very low threshold of perception, the child is able to hear and distinguish the quietest sound vibrations, and we slip him decibels of prohibitive strength. This is very traumatic. However, we are not talking about morphological changes. You show your child to any ENT doctor or neurologist, and we will not find any significant deviations during a routine examination. We are talking about very subtle disorders that can be seen in the aggregate of a number of neuropsychiatric signs,but they will not always be distinguishable anatomically.


- What then should we do now?

- As for drug treatment, here, on the one hand, everything is simple, on the other, not quite. It will not be difficult for any doctor to select and prescribe medication neurometabolic therapy for you, but whether it will be really effective in your particular case is a big question, and you yourself spoke about it. You should understand that your child is special. Children with a sound vector have the potential to be very powerful abstract intelligence. They can be smart beyond their years in some areas where their abilities can be applied. However, they are far from being as lively and mobile as most of their other peers. It is necessary to create a quiet environment in the family. Get your AC / DC out of the way, buy some quiet classical music, let it be.

You can turn it on in the house very, very quietly, like a subtle background. In no case raise your voice to the child, do not demand from him, for example, what a daughter can easily do. He will always be comparatively slow. But we have a chance to teach him to pronounce the words little by little. Try for him to ask and name what he needs. Of course, good contact with his mother is important for him. If she gives him a sense of security, it will be easier for him to adapt. As for your relationship with your spouse, take your time to make a final decision so soon. I strongly recommend that you, both of you, listen to at least a basic level of training in system-vector psychology by Yuri Burlan. You will always have time to divorce, then, after the lectures, you will make a decision with a new understanding of yourself, your relationships and your children.

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