due figlie autistiche

Da Medscape
#91 of 93, Added By: An_1874191, MD, Family Medicine, 9:39PM Jan 07, 2010
I have 2 girls with developmental delays and autistic features. As if my wife and I don't have enough stress without worrying about a lack of bonding? Isn't that just a rehash of a really old theory? I have 3 girls- the eldest one is severely delayed and has autistic features, and I have fraternal twins, one of which also has dev delay and autistic features. How would they fit into the theory? And I live with this every day.

NBl'intervento è stato stimolato dal dibattito in corso in quel forum (solo per medici iscritti) sull'autismo e il ritorno di attenzione alle situazioni ambientali dopo anni di attenzione solo alla genetica, e da un mio contributo che riporto qui:

#90 of 93, Added By: GB, MD, Psychiatry/Mental Health, 11:00AM Jan 06, 2010
I have experience with some adopted children coming from east europe orfanages. They were very retarded when they arrived in their adopting family. If their arrival was in early 2 or 3 years, they changed very much in few time, but not if they arrived later. Similarly, I saw a deaf child, who had also her face deformed by in utero problems. Her parents remained ' freezed' by traumatic event of this baby's birth. When I saw the child, at age 8 months, she was very akin to an autistic child, she had no eye contact with anybody, but everyones 'hands', the only object she looked at fascinatedly. After she had an acoustic prothesis, and after nearly one year of good 'maternage' by an expert language therapist who worked with mother and child together, the child was no more autistic and after some years she is frequenting normal school without any problem, but those of aesthetic damages of her face.
IMO these are example that a great distortion of early emotional and communication experience can provoke a 'cistic', autistic, arrest of psychic development. I don't know how these children could be if they wouldn't have the described interventions, i.e I have no a double blind evidence, but I remember that there were many Down (trisomia XXI) children who were also autistic, in orfanages of forty years ago, but now I see no trisomic autistic children in present days, when they remain with their families.
These are of course no 'statistic or "scientific" evidences', but maybe the science in not based only on statistic evidences...
We know that children with Bourneville sindrome, or prenatal rubeola, or fenilchetonuria, etc, have more possibilities to be autistic.
I have developed the theoric model, in my experience, that many 'obstacles' to normal interactive exchanges in early period of life can product a psychobiologic reaction that has the appearence of autistic syndrome. The obstacle in interactive communication may be in the child side or in the enviromental side of the interactive channel...

Risposta: #93 of 93, Added


#93 of 93, Added By: GB, MD, Psychiatry/Mental Health, 4:54AM Jan 08, 2010

Sorry for your difficult situation. I think yours is a case more close to genetic extreme in the continuum between the genetic ("child") extreme and enviromental (interactive) extreme I said in #90. I knew about autistic twins, but never a situation as you describe. When there is severe delay (both of motor and psychic skills), usually there is a (genetic, metabolic,)brain pathology, and 'autistic' features are a consequence of the severe difficulties. It's not true 'autism', IMHO. As in Rett syndrome, where the 'autistic' feature are not true 'autistic'(even if DSM puts it in 'autistic spectrum', but consequence of severe mental retardation.
I think the problem is that of the right diagnosys. Another problem is that of guilt. Parents usually feel guilty for their children problems, even when they are not too big. Of course parents of children with psychic problems feel more and more guilty. A way of escape from this trap is to consider the situation not as a Tribunal, but in order to know the reality and all playing factors and front them in the best possible way. That is my way of thinking and working.

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