Дитячий аутизм. Лікування дітей, реабілітація новонароджених. Неонатус САНУС – дитяча клініка в Санкт-Петербурзі

Дитячий аутизм. Лікування дітей, реабілітація новонароджених. Неонатус САНУС – дитяча клініка в Санкт-Петербурзі

Дитячий аутизм

Дитячий аутизм – порушення психічного розвитку, що характеризується аутистической формою контакту з оточуючими, розладами мови і моторики, стереотипності діяльності та поведінки, що приводять до порушень соціальної взаємодії. Поширеність аутизму складається 4-5 чоловік на 10 тис дітей.

В даний час розрізняють такі типи аутистических розладів:

    cиндром раннього дитячого аутизму Каннера (класичний варіант дитячого аутизму) cиндром Аспергера (аутистическая психопатія) cиндром Ретта aутізм, що розвивається після нападу шизофренії (дитячий «процесуальний» аутизм).

Для аутизму Каннера характерні аутистическая відгородженість дітей від реального світу з нездатністю формування спілкування і нерівномірним дозріванням психічної, мовної, моторної і емоційних сфер життєдіяльності. Дітям характерні недостатня розрізнення морського і неживих об’єктів, поведінка та ігри стереотипні, відсутня наслідування, виявляється недолік реакції на навколишнє. Форма спілкування з рідними – симбиотическая або індиферентна, тобто, без емоційної реакції, аж до відмови спілкування з ними.

Зміна звичного життєвого стереотипу або поява нових об’єктів може викликати агресію чи самоагресії. У дітей застигла міміка, спрямований в порожнечу погляд, відсутність реакції «очі в очі». Моторика незграбна зі хами, ходьбою на «навшпиньки». Мова розвивається слабо, порушено вимова звуків, немає інтонаційного переносу, голос гучний, то стає тихим. Хворі практично нездатні до діалогу. Іноді мова відновлюється до 6-8 років. Особливостями дитячого аутизму є відносна збереження абстрактних форм пізнання дійсності. Особливо різко змінена ігрова діяльність. Ігри часто стереотипні, відсутня сюжетність.

Для дитячого аутизму Каннера характерні негативні реакції на будь-які спроби змінити звичний життєвий стереотип. З раннього віку у дітей порушується інстинктивна життя: змінюється апетит, утруднене засинання, реакція на оточуючих або відсутня, або відзначається підвищена чутливість. Аутизм набуває найбільш завершену форму у віці 3-6 років. До 5-6 років прояви ТАК частково компенсуються, але розумовий розвиток різко відстає.

При синдромі Аспергера діти нагадують хворих з синдромом Каннера, але відрізняються від них достатньої збереженням мови і більшої збереженням інтелекту, а також більш сприятливим прогнозом в цілому.

Синдром Ретта відрізняється від описаних двох синдромів аутистических розладів його наявністю лише у дівчаток, виникненням після періоду нормального розвитку, вираженої нейроморфологіческіх патологією і поєднанням психічних розладів з важкими неврологічними порушеннями. Синдром Ретта виникає у дітей з нормально протекавшими вагітністю, пологами і розвитком в перші місяці життя (іноді до 18 міс). Потім відбувається зупинка в розвитку і катастрофічний регрес всіх форм психічної діяльності з виникненням моторних стереотипий, аутизму і прогресуючого моторного зниження, подальшої інвалідизації і смерті.

Аутизм після нападу шизофренії починається у дітей 3-5 річного віку після періоду нормального психічного розвитку за типом психозу. Зміни в стан і розвиток виникають без видимихпричин і наростають поступово. Стан може проявлятися неврозоподобнимі розладами, кататоническими, порушеннями настрою. По виході з психозу в клінічній картині виявляються зупинка в розумовому розвитку, зміна в моториці, порушення мови, розлад самосвідомості, емоційне зубожіння і виражений аутизм.

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