Principles of neuroanatomical and neurophysiological changes at autism and Asperger's syndrome

Autizam je pervazivni neurološki razvojni poremećaj koji se teško detektira prije treće godine života, a pokazuje nedostatak u verbalnoj komunikaciji, socijalnoj ili emocionaloj uzajamnosti te ograničene i ponavljajuće obrasce ponašanja. Aspergerov sindrom, kao i autizam, također pripada autističnom spektru poremećaja no razlikuje se od ostalih poremećaja po tome što se normalno ili približno normalno razvijaju jezične sposobnosti uz probleme s korištenjem jezika u socijalnim interakcijama, kao i socijalnim neugodnostima, izraženim nedostacima neverbalne ekspresije, idiosinkratizma, opsesivnih interesa i motorne nespretnosti pa je prema tome nešto blaži oblik poremećaja od autizma. Oba ova poremećaja pripadaju već spomenutom skupu poremećaja koje obuhvaća autistični spektar poremećaja, uz Rettov sindrom, dječji disintegrativni poremećaj i PDD NOS (eng. pervasive developmental disorder not otherwise specified). Ovaj rad je kratki pregled dosadašnjih istraživanja dvaju poremećaja na području neuroanatomije, neurofiziologije i molekularne genetike. Zadnjih 25 godina, provode se intezivna istraživanja na ta tri područja te još uvijek nisu nađeni sigurni uzorci.Autism is pervasive neurodevelopment disorder which is difficult to detect before the third year of life. It shows a lack of verbal communication, social or emotional reciprocity and limited and the repeated patterns of behavior. Asperger's syndrome, like autism, also belongs to autistic spectrum disorder but differs from other disorders because it is normal or nearly normal development of language skills with the problems of using language in social interactions, as well as social inconvenience, lacks non-verbal expressions, idiosincratism, opsessive interests and clumsiness. It is therefore somewhat milder form of the autism. Both of these disorders belong to the set of disorders which includes, already mentioned, autistic spectrum disorder, with Rett's syndrome, children's disintegrative disorder and PDD NOS (pervasive developmental disorder not otherwise specified). This article is a brief overview of previous researches of these two disturbances in the area of neuroanatomy, neurophysiology and molecular genetics. In the last 25 years, it is conducted intensive researches on these three areas and still have not found certain patterns

REHABILITATION OF AUTISM WITH IMMUNE MODULATION THERAPY

Autoimmunity may play a key role in the pathogenesis of autism, an early-onset disorder of the developing central nervous system. Viruses such as measles virus might induce autoimmunity as evidenced by a strong correlation of brain autoantibodies and measles antibodies. Autistic children also harbor brain-specific autoantibodies and elevated levels of autoimmunity-specific cytokines interleukin-12 and interferon-gamma. Collectively, there is compelling reason to believe that autism involves immune activation and autoimmunity to brain and patients show responsiveness to immune modulation therapy. Furthermore, for the purpose of identifying Autoimmune Autistic Disorder (AAD), a protocol for testing autoimmunity is developed. In this article, novel research developments are described to suggest that autoimmunity is a very important target that should be used to offer rehabilitation to autistic patients through immune therapy

Neurobiological basis of autism

Autizam predstavlja kompleksnu skupinu neurorazvojnih poremećaja koji utječu na normalan razvoj mozga u područjima društvene interakcije, komunikacijskih vještina i kognitivnih funkcija. Nedostatak jedinstvenog biološkog uzroka, simptoma i kliničkih značajki ovog poremećaja posljedično otežava postavljanje dijagnoze i terapije. Od prvotnih psiholoških teorija i teze da je autizam uzrokovan nenormalnim psihičkim interakcijama unutar obitelji, istraživanja su proteklih desetljeća utvrdila snažan genski utjecaj uz interakciju okolišnih faktora na razvoj istog. Počevši s kratkim uvidom u neuropatološke promjene i regije mozga zahvaćene autizmom, pregledom neurotransmitera i njihove uključenosti u etiologiju autizma, zatim razvojnom psihopatologijom autizma, uz poseban naglasak na endofenotipove te konačno genetskim i epigenetskim pristupom, ovaj seminarski rad predstavlja pregled ključnih otkrića i dosadašnjih spoznaja o poremećajima iz spektra autizma. Patogeneza neurorazvojnih poremećaja, uključujući i autizam, nedovoljno je razjašnjena te buduća istraživanja uz dostupnije moderne tehnike trebaju uključiti multidisciplinarni pristup koji će omogućiti daljnji napredak u otkrivanju biološke osnove ovog poremećaja.Autism refers to a complex group of neurodevelopmental disorders that influence the normal development of brain in terms of social interaction, communication skills and cognitive functions. The lack of a single biological pattern of symptoms and clinical aspects of the disorder, hinder the ability to make a diagnosis and prescribe the appropriate therapy. Beginning with the initial psychological theories and theses that autism is caused by abnormal psychological interactions within the family, the research during the past decades affirmed the role of a strong genetic influence and interaction with environmental factors in developing the disorder. Starting with a short insight into the neuropathological changes and regions of the brain affected by autism, followed by a neurotransmitter overview and their involvement in the etiology of autism as well as an introduction to the developmental psychopathology of autism while putting a particular emphasis on endophenotypes, and lastly, a genetic and epigenetic approach, this bachelor’s thesis presents the overview of key discoveries and current understanding of autism spectrum disorders. Pathogenesis of neurodevelopmental disorders including autism is still inconclusive and therefore, further research along with more readily available modern techniques should include the interdisciplinary approach which will enable a further progress towards the discovery of the biological basis of the disorder

Genetic and epigenetic foundation of autism

Autizam je definiran kao poremećaj u razvitku mozga i živčanog sustava u kritičnom periodu. Autizam, uz Rettov sindrom, Aspergerov sindrom i druge pripada u poremećaje autističnog spektra. Temeljni simptomi autizma su teškoće u socijalnim ponašanjima, komunikaciji i repetativna ponašanja, interesi i aktivnosti. Fenotip autizma je varijabilan i individualan što čini proučavanje i otkrivanje patofiziologije kompliciranim. Kroz godine istraživanja pokazalo se da je genetička komponenta vrlo jaka u autizmu. Identificirani su mnogi geni koji su bitni za pravilan razvoj mozga, a u slučaju disfunkcije sudjeluju u razvoju autizma. Nadalje, aktualna istraživanja pokazala su da i epigenski mehanizmi imaju značajnu ulogu u nastanku autističnog poremećaja. Mehanizmi poput DNA metilacije ili histonske acetilacije mogu utjecati na ekspresiju gena koji se smatraju rizičnim faktorima za autizam. Genski i epigenski fiziološki putevi su isprepleteni i dvosmjerni, mogu utjecati zasebno na razvoj autizma, ali i mogu utjecati jedan na drugoga i tako sudjelovati u razvoju autizma. Važno je razumjeti da identificirani geni, epigenske promjene, kemijske neravnoteže i okolišni faktori svi djeluju zajedno ili jedni na druge ili na razvoj živčanog sustava pridonoseći razvoju autizma. Zbog opsežne količine dostupne literature, pisanje radova koji sažimaju informacije o autizmu pridonijeti će istraživanjima i staviti u perspektivu trenutna znanjAutism is a neurodevelopmental disorder that falls under the Autistic spectre which encompasess other disorders like Rett syndrome, Aspergers syndrome, etc... The core symptoms of autistic disorder are: reduced social and communication abilities and repetative behaviour, interests and actions. The phenotype for autism is extremely variable and individual which makes understanding the patophysiology of the disorder difficult and complex. Throughout yeras of reasearch it has been established that many autism cases have a genetic cause. Specific genes have been identified which have an important role in neurodevelopment and in autism cases were shown to be dysfunctional. Furthermore, recent studies have shown the significance of epigenetics in autism reasearch. Epigenetic mechanisms such as DNA methylation or histone acetylation have been proven to influence gene expression of risk-factor genes for autism and expedite its development. Both genome and epigenome physiological pathways are intertwined and can influence the progress of autism development, but they can also influence each other in negative or positive ways. It is important to understand, all the identified genes, epigenetic changes, chemical imbalances and environmental factors work together and influence each other and neurodevelopment. As there is a significant amount of literature available on the topic, writing reviews summarizing all current data will be beneficial and will offer new perspective

TREATMENT OF CHILDREN WITH AUTISM WITHIN THE GROUP OF CHILDREN WITH MENTAL RETARDATION

The World Health Organization defines autism as a pervasive development disorder with impaired development in children manifested before the third year of life. This disorder is manifested with characteristic form of functioning in the three live spheres: * In reciprocal social integrations; * In disordered ability for communication; * In limited interest in the happenings around oneself, with dominant stereotypical behavior

Autism spectrum disorders in preschool children

Posljednjih nekoliko desetljeća bilježi se znatan porast prevalencije poremećaja iz autističnog spektra (PAS) u cijelom svijetu, što je rezultiralo i pojačanim interesom stručnjaka, znanstvenika i šire javnosti za ovaj poremećaj. Od pojavljivanja u dijagnostičkim priručnicima do danas, dijagnostičke kategorije i kriteriji za pojedine kategorije su u relativno kratkom razdoblju doživjele velik broj izmjena, kao što su promjene u nazivima i broju dijagnostičkih kategorija, promjene u samim dijagnostičkim kriterijima, promjene u broju kriterija koje dijete ili osoba mora ispunjavati, te oznakama i/ili stanjima koji dodatno opisuju ili pak isključuju ovu dijagnostičku kategoriju. U ovom radu prikazani su dijagnostički kriteriji, njihove povijesne promjene, obilježja djece s poremećajem iz autističnog spektra po područjima razvoja, terapijski postupci te uključivanje djece s poremećajima u redovite predškolske programe.For the last couple of decades, a significant increase of autism spectrum disorder (ASD) prevalence has been noted worldwide, which resulted in experts, public and scientists showing more interest in that area. Since being mentioned in diagnostic manuals, diagnostic categories and the criteria for some of them have been altered in a very short period of time. For example, changes made in titles and the numbers of diagnostic categories, changes in diagnostic criterias, changes in the number of criterias that a child or an adult have to fullfill and marks which additionally describe or exclude any of the diagnostic categories. Diagnostic criterias, changes made throught the history and child characteristics from the autistic spectrum, these are all the facts shown in this paper. Furthermore, therapeutic treatments and inclusion of children with disabilities in regular preschool programs are also explained

The role of the preschool in early autism detection and intervention

Autizam je kompleksan poremećaj koji se kreće na kontinuumu od visokofunkcionirajućih do niskofunkcionirajućih autista. Principom inkluzije sva djeca s poteškoćama imaju pravo biti uključena u redovne programe odgoja i obrazovanja pa dječji vrtić ima važnu ulogu u otkrivanju autizma. Nedovoljna educiranost i nekompetentnost odgojitelja uvelike otežava inkluzivni odgoj i obrazovanje jer se javljaju problemi pri pružanju odgovarajuće podrške autističnom djetetu. Pravovremena intervencija od strane odgojitelja, koji dobro poznaje faze tipičnog razvoja djece ,upućena stručnom timu vrtića kojeg čine rehabilitator, logoped, psiholog i pedagog može doprinijeti ranom otkrivanju, koje ima važnu ulogu u daljnjem napretku djeteta s autizmom. Iako nitko iz vrtićkog okruženja ne može postaviti dijagnozu dovoljno je uputiti roditelja dječjem pedijatru koji će poduzeti daljnje korake u otkrivanju autizma. Bihevioralni tretmani, kao i drugi programi podrške koje mogu provoditi isključivo certificirani terapeuti pokazali su se kao učinkoviti intervencijski programi u liječenju djece s autizmom. Vrtićki tim može koristiti dijelove pojedinih programa u suglasnosti s roditeljima svakog djeteta s autizmom.Autism is a complex disorder in the continuum of highly functional down to low functional autistics. Through inclusion, all children with disorders have the right to be included in the regular educational programmes so kindergarten has an important role in detecting autism. Insufficient education and incompetency of the kindergarten teachers imposes difficulties in inclusive education due to problems with providing adequate support to the autistic child. Timely intervention from the kindergarten teachers with sufficient knowledge of typical child development phases and the cooperation with the expert team, consisting of rehabilitator, speech therapist, psychologist and pedagogue, can lead to early recognition of autism, what has a very important role in the future progress of autistic child. Kindergarten experts are not educated to diagnose, but it is enough to suggest to the parent to go to a paediatrician who will take certain steps to recognize autism. Behavioural treatments together with other support programmes provided by certified therapists have been proven as the efficient intervention programmes in the treatment of the autistic children. Kindergarten team can use parts of certain programmes in their work, but only with the consent of the parents of autistic children

Visual support for preschool children with autism spectrum disorder

Autizam, odnosno poremećaji iz spektra autizma se odnose na grupu stanja karakteriziranih poteškoćama u socijalnim vještinama, ponavljajućim radnjama, govoru i neverbalnoj komunikaciji. Iako se ne zna točan uzrok, smatra se kako je povezan s više različitih čimbenika. No poznato je kako je često praćen senzornom osjetljivošću i problemima zdravstvenog karaktera, poput poremećaja u gastrointestinalnom traktu, napadajima i poremećajima sna, kao i problemima sa mentalnim zdravljem gdje osnovu problema čine anksioznost, depresija i poremećaj pažnje. U odnosu na sveobuhvatnu podršku koja djeca s poremećajima iz spektra autizma trebaju, iznimno je važno da odgojitelji poznaju primjerene strategije rada s djecom te da znaju poticati djecu na suradnju s vršnjacima u redovnom vrtićkom okruženju.Autism, or autism spectrum disorder (ASD), refers to a group of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication. Although, there is not the exact cause of autism, it is considered to be related with different factors. Autism is often accompanied by sensory sensitivities and medical issues such as gastrointestinal (GI) disorders, seizures or sleep disorders, as well as mental health challenges such as anxiety, depression and attention issues.In relation to the comprehensive support that children with autism spectrum disorders need, it is extremely important that educators know the appropriate strategy for working with children and know how to encourage children to work with peers in a regular kindergarten environment

Preschool teachers' role in encouraging peer interaction of autistic children

Autizam je neurobiološki poremećaj u mozgu koji se javlja u ranom djetinjstvu ili pri samom rođenju djeteta. Autizam sprječava dijete da ostvari uobičajene društvene odnose i da razvije normalnu komunikaciju. Kao posljedica autizma javlja se djetetova izoliranost od drugih ljudi i djece, te njihova zaokupljenost nizom opsesivnih radnji i interesa koji se neprestano ponavljaju. Poremećaj iz autističnog spektra ili autizam danas se definira kao neurobiološki razvojni poremećaj mozga, koji je primarna dijagnoza kod pojedinaca koji imaju poteškoće u socijalnoj komunikaciji i interakciji, te neuobičajeno ponašanje. Svaki roditelj, odgojitelj koji se susreo s djetetom koje ima poremećaj iz autističnog spektra želi znati kako pomoći djetetu da uspostavi komunikaciju. S obzirom da dijete često ima poteškoća u verbalnom izražavanju treba uspostaviti druge načine komunikacije. Među djecom s autističnim poremećajem velike su individualne razlike. U planiranju i neposrednom radu odgojitelja, primarnom postaje usmjerenost na potrebe djeteta i područje njegova razvoja. Odgojitelj bi trebao osmišljavati okruženje za aktivnosti u kojima će djeca samostalno ili na osnovi indirektnog utjecaja (od odgojitelja), a ne putem verbalnog poučavanja, istraživati i otkrivati zakonitosti materijalne i socijalne sredine. Aktivnosti i materijali za učenje moraju biti konkretni, stvarni i važni za život mlade djece sa posebnim potrebama. Odgojitelj prestaje biti direktni učitelj, a postaje djetetov promatrač, voditelj i pomagač. Odgojitelj, kvalitetno pripremljen za rad, fleksibilno se prilagođava situacijama odgojno - obrazovnog procesa u vrtiću zavisno od potreba, interesa i mogućnosti djece u određenom trenutku. O odgojitelju u velikoj mjeri ovisi kvaliteta življenja u ustanovi. Ako odgojitelj želi djecu aktivno angažirati u procesu učenja i saznavanja, onda mora planirati aktivnosti i strategije u ovisnosti o tome gdje je razina dječje uključenosti najviša. Pored toga mora biti spreman za stalne korekcije i fleksibilnost u planiranju zbog promjenjivih interesa djece, a u cilju pružanja novih izazova i održavanja njihove uključenosti u procesu konstrukcije znanja.Autism is a neurobiological disorder of the brain that appears in early childhood or in the birth of a child. Autism prevents children to achieve normal social relationships and to develop normal communication. As a result of autism, there is a child's isolation from other people and children, and their preoccupation with a series of obsessive actions and interests that are constantly repeated. Autistic spectrum disorder or autism is defined today as the neurobiological developmental disorder of the brain, which is the primary diagnosis in individuals who have difficulty in social communication and interaction, and unusual behavior. Among the children with autistic disorder are large individual differences. In planning and direct work of educators, the primary becomes the focus on the needs of the child and the area of its development. Educator should devise environment for activities in which children are alone or on the basis of indirect impact (by educators) rather than through verbal instruction, exploring and discovering the legality of the material and social environment. Activities and learning materials must be concrete, real and important for the life of young children with special needs. Trainer ceases to be a direct teacher and becomes the child spectator, leader and facilitator. Educator, well prepared to work flexibly adapts to situations upbringing - educational process in the kindergarten depending on the needs, interests and abilities of children at a given time. A preschool teacher depends largely on the quality of life in an institution. If the educator wants children to actively engage in the process of learning and knowing, it must plan activities and strategies depending on where the level of children's involvement is the highest. Additionally, educator must be prepared for constant corrections and flexibility in planning due to changing interests of children, and to provide new challenges and maintain their involvement in the process of construction of knowledge

A PRESENTATION OF A CASE OF A CHILD SUFFERING FROM AUTISM

The autism is the most common out from the group of pathological conditions called pervasive developmental disorders (PDD). It affects three crucial parts of development: verbal and nonverbal communication, social interaction, and the creative, or the imaginative game. It affects all the races, ethnicity and socio-economic spheres.The first signs of autism are 80% usually noticeable by the third year of the child’s development. The autism affects boys three to four times more than it does to girls with an equal level of intelligence.Around 75% are of low level of intelligence, whereas 10% of them can demonstrate high level of intelligence in specific areas, such as mathematics.Even if the reasons for speaking and language problems in autism are not known, most of the experts believe that the difficulties are caused by different conditions, present in the prenatal, natal, and the postnatal time period affecting the brain development