ILEANA_MITELEA Autismul Infantil

Analele Universitii Constantin Brncui din Trgu Jiu, Seria tiine ale Educaiei, Nr. 2/2010

Annals of the Constantin Brncui University of Trgu Jiu, Education Sciences Series, Issue 2/2010

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RISCURILE AUTISMULUI INFANTIL

Ileana MITELEA Colegiul Teologic Sfntul Nicodim,

Trgu -Jiu

Rezumat: Autismul infantil, o tulburarea

pervaziva de dezvoltare, de etiologie necunoscuta creeaza uneori mari probleme unei parti a personalului didactic. Dificultatea celor care lucreaza cu copiii care sufera de autism provine, pe de o parte, din faptul ca referirile la aceasta problema in publicatiile romanesti de pedagogie sau chiar psihologie sunt practic inexistente.

Cuvinte cheie: autism, copil, comunicare, terapii

1.Definiia i caracteristicile autismului Termenul a fost definit n mod frecvent ca un sindrom comportamental constnd n refugiul subiectului n lumea sa interioar, imaginar, prin excelen subiectiv, n refuzul contactului cu persoane sau obiecte exterioare.

P. Popescu Neveanu precizeaz n Dicionarul de psihologie c autismul cunoate diverse grade de dezvoltare ntre normal i patologic, fiind un termen aplicat uneori situaiilor sau cazurilor de introversiune accentuat, care se ntlnete destul de frecvent n momentele critice ale psihogenezei (prima copilrie i nceputul adolescenei) .

Dorind s punctez cteva din aspectele caracteristice ale autismului infantil, n accepiunea sa patologic, trebuie sa subliniem mai nti, c, el reprezint o tulburare rar, social, comunicaional i comportamental.

Copilul autist abandoneaz aciunea dirijat, comunicarea sentimentelor i gndurilor, ntorcnd spatele vieii reale, umanitii, n ansamblul ei.

Dar, cu ct un individ se retrage mai mult din realitate, cu att viaa sa interioar

INFANT AUTISM RISKS

Ileana MITELEA Theological College of St. Nicodemus,

Trgu - Jiu

Abstract: Infantile autism, a pervasive development disorder, of unknown etiology sometimes create big problems to a part of the teaching staff. The difficulty of working with children with autism comes first, the fact that references to the problem of Romanian publications pedagogy or psychology are practically nonexistent.

Key words: autism, child, communication, therapies Definition and characteristics of autism The term was frequently defined as a behavioral syndrome consisting of refuge subject to the inner world, imaginary, subjective par excellence, in refusing contact with people or objects outside. P. Popescu Neveanu affirms in the

"Dictionary of Psychology that autism has different degrees of development between normal and pathological," a term often applied to situations or cases of pronounced introversion, which is seen quite frequently in critical moments of psychogenesis (early childhood and early adolescence). Wishing to emphasize some of the characteristics of infantile autism in acceptance to pathological, we must emphasize first, that it is a rare disorder, social, communicational and behavioral. Autistic child abandons directed action, communicating feelings and thoughts, turning back the real life, humanity as a whole.



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devine mai goal, mai stereotip, cu att senzaiile sale devin mai vagi, iar personalitatea sa mai puin structurat.

Asemenea sugarului, copilul autist nu se intereseaz, n mod obinuit, de ceea ce se petrece la o oarecare distan.

El se intereseaz eventual de propriul su corp, sau de cteva obiecte pe care le manipuleaz i le folosete ntr-o manier ritual.

Privirea vag, fr int are rolul de a-l feri, de a-l ajuta s nege att lumea exterioar care incit la aciune, ct i lumea interioar care ar putea reaciona.

Pentru copilul autist timpul, la fel ca i aciunea pare s distrug identitatea.

Definind cauzalitatea ca o succesiune n timp, n care un eveniment l urmeaz pe altul sau este provocat de altul i ntre care exist o relaie, nelegem de ce pentru copilul autist nici timpul, nici cauzalitatea nu au sens.

Ateptarea unui eveniment este la fel de stresant ca orice schimbare exterioar.

Ambele apar ca terifiante, ca ameninri la adresa identitii persoanei i sfresc prin a fi negate.

Chiar i atunci cnd unii copii autiti vorbesc despre evenimente petrecute n trecut, folosind corect timpul verbului, exprimarea lor este neltoare, fiindc pentru ei aceste evenimente fac ntotdeauna parte din prezentul lor.

ntr-unul din articolele sale, L. Kanner descria cracteristicile autismului astfel: retragerea puternic a tuturor contactelor cu ceilali oameni, o dorin obsesiv de a-i pstra identitatea, o anumit ndemnare n utilizarea obiectelor, un mutism sau un tip de limbaj care nu pare a fi pus neaparat n serviciul comunicrii interpersonale.

Printr-un aspect important, acest comportament difer de ritualul obsesiv obinuit: copilul autist obliga indivizii din jurul su s fie mai obsesivi, mai stereotipi n aciuni dect el nsui.

2. Originile i cauzele autismului

But, as an individual to withdraw more than the reality, both inner life becomes more naked, more stereotypical, his feelings become even more vague and less structured personality. Such infants, autistic child is not interested in what happens to some remote location. He is interested in any of his own body, or a few objects they manipulate and use them in a ritual manner. Vague look, aimlessly aims of the guard, to help deny the outside world so that incite to action, and inner world could react. For autistic child while, just as the action it seems to destroy the identity. Defining causality as a time sequence in which one event follows another, or is it caused by another and between which there is a relationship for the autistic child understand why neither the time or causality does not make sense. Pending event is as stressful as any exterior changes. Both appear as terrifying as threats to individual identity and training end up being denied. Even when some autistic children talk about events that occurred in the past, using correct tense, their expression is misleading, because for them these events are always part of their presence. In one of his articles L. Kanner described autism as: "strong withdrawal of all contacts with other people, an obsessive desire to keep their identity, a certain skill in using objects, a silence or a type of language seems not necessarily put in the service of interpersonal communication. By important, this behavior differs from usual obsessive ritual: the autistic child force people around him to be more obsessive, more shares than the stereotype itself.

Origins and causes of autism



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Prerile privind etiologia autismului variaz de la un autor la altul. Astfel, n lucrarea intitulat semnificativ La forteresse vide, B. Bettelheim consider c autismul are origini sociale i nu biologice.

Acesta afirma c Sistemul Nervos Central al copiilor care sufer de autism este normal dezvoltat.

O serie din aciunile, reaciile lor sau, lipsa acestora nu vin dintr-un defect al capacitii virtuale ci, din aceea c, dintr-un motiv sau altul, ceea ce este virtual nu s-a realizat.

Aceste capaciti nu ajung s se realizeze datorit unor piedici exterioare.

Spre deosebire de debili mintali, reaciile sunt de asemenea primitive comparativ cu vrsta lor, personalitatea copiilor autiti se poate dezvolta i atinge o anumita bogie.

Dac acest lucru se produce, graie unui tratament special, aceasta se ntmpla la o vrst mai ntrziat dect cea normal, fiind necesar parcurgerea tuturor etapelor de dezvoltare ale personalitii, care au fost abandonate.

C. Gillberg afirma deopotriv, c: Autismul este generat de o serie de mecanisme patogene specifice, presupunnd disfuncia unor grupe de neuroni din sistemul nervos central.

De aceea, diagnosticarea acestui sindrom implic de regul investigaii neurologice minuioase. Gillberg considera fals mprirea n autism cu i fr probleme organice, ntruct ambele au comportamente asemntoare.

La psihiatrul suedez, aa-zisul autism fr probleme organice este autismul la care bazele sale biologice nu au fost nc descoperite.

Consider c, chiar dac se accept multiple etiologii biologice retragerii autiste, una dintre cauzele iniiale rmne interpretarea corect pe care copilul o d afectelor negative cu care este nconjurat de persoanele mai importante din mediul su.

Acest lucru este posibil avnd n vedere

Opinions on the etiology of autism varies from one author to another. So in significant book entitled "The Empty fortress, B. Bettelheim believes that autism has biological rather than social origins. He says the central nervous system of children who developed autism is normal. Some of their reactions or lack of actions do not come from a defect but the virtual capacity that a reason which is virtually not been performed. These capabilities are unable to achieve due to external constraints. Unlike the mentally primitive reactions are also compared with their age, personality autistic children can develop and achieve a certain richness. If this occurs due to a special treatment that happens at a later age than normal delayed as needed through all stages of personality development have been abandoned. C. Gillberg said that autism is caused both by a series of specific pathogenic mechanisms assuming dysfunction groups of neurons in the CNS. Therefore diagnosis of the syndrome usually involves neurological investigations. Gillberg considered false sharing in autism with and without organic problems because both have similar behaviors. At Swedish psychiatrist, so-called organic smoothly autism is autism in the biological bases have not yet been discovered. I think even if it accepts multiple organic etiologies autistic withdrawal remains a correct interpretation of the initial causes that give children a negative affects which is surrounded by important people in his environment. This is possible considering that non-verbal communication prior and support the emergence of verbal communication will accompany further.



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faptul c, comunicarea non-verbal precede i susine apariia comunicrii verbale pe care , ulterior o va acompania.

Afectele negative ale adultului, n mod special ale mamei, strnesc reaciile negative ale copilului, care vor favoriza creterea tensiunii i apariia sau accentuarea conflictului.

Se tie c excesul de tensiune mpiedic desfurarea normal a vieii psihice, el fiind resimit ca neplcut.

Astfel, cu ct aciunile cu obiecte sau persoane ale copilului sunt mai lipsite de succes, cu att mai mare va fi tensiunea psihic care se acumuleaz i care are un efect distructiv asupra dezvoltrii personalitii sale.

n acest caz, echilibrul emoional este tulburat datorit lipsei de afeciune a adultului care nu-l ajuta pe copil sa-i dezvolte propriul ataament.

Ori ataamentul se construiete n timp susine Patricia Regis-Faure de-a lungul mai multor etape legate intre ele. Autoarea vorbete de trei etape fundamentale:

I. De la natere pn la 12-15 luni,

copilul cunoate afeciunea cea mai puternic. El este n faza caracteristic prin intimitate maxim cu mama sa, faz care, constituie baza relaiei simbolice dintre copil si mam.

El nu implic doar sugerea i nghiirea hranei, ci i aspecte importante precum: modalitatea n care sugarul e inut, suplu sau rigid, sigur sau angoasant, cu cldura sau nedorit.

Ca experien central, suptul este punctul de plecare al sentimentelor noastre ulterioare.

Atunci cnd unii nou - nscui par s ntoarc spatele snului matern, o serie de mame neatente pot ndeprta uor copilul, iar aceasta pare s fie, cum artam i mai sus, sursa unor nencrederi de baz.

II. De la 15 la aproximativ 30 de luni

copilul afl c este separat de mediul nconjurtor. El devine contient de sine insusi si de vulnerabilitatea sa. Lumea nu i se mai

Adult negative affects specially from the mother makes the child to evoke negative reactions will increase tension and promote the emergence or increased conflict. It is known that excess of mental tension prevent the normal course of life and it is felt as unpleasant. Such as actions with objects or persons of the child are unsuccessful will be even greater psychological tension that builds up and has a destructive effect on the development of his personality. In this case, emotional balance is disturbed because of lack of affection to an adult who does not help the child to develop his own attachment. The attachment is built over time, says Patricia Faure-Regis, is connected through several stages. She speak about three fundamental steps: I. From birth to 12 to 15 months, the

child knows the strongest affection. He is in phase with maximum privacy feature by his mother, phase, which is the 'symbolic relationship' between child and mother. It involves not only sucking and

swallowing food, but important issues such as: how the baby is kept safe or anguishing flexible or rigid, with heat or unwanted.

As a central experience, sucking is the starting point of our later feelings.

When some babies seem to turn back womb, some inattentive mothers can easily remove the child, and this seems to be, and show how the above basic source of mistrust. II. From 15 to about 30 months that the

child was separated from the environment. He becomes aware of himself and his vulnerability. The world still does not even hold them.

It is the time when self-affirmation is the need to oppose. This stage is important to the extent that if everything went well a child has acquired sufficient



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supune, ba chiar i rezist. Este momentul afirmrii de sine, din

nevoia de a se opune. Aceast etap este important n msura n care, dac totul a trecut cu bine, copilul a achiziionat o ncredere suficient n anturajul su i n lumea exterioar.

ncrederea i securitatea sunt eseniale pentru viaa sa relaional viitoare.

n decursul primelor doua etape, copilul triete experiene ntr-o mare msur mai intense dect ale copilului mai mare sau ale adultului.

De aceea, el trebuie nconjurat cu mai mult tandree i atenie, pentru a se putea integra n mediul su.

III. A treia etapa cuprins ntre 3-4 ani

i pn la 7 ani. Copilul triete acum experiena relaiei triunghiulare tata-mama-copil.

Orice aciune a copilului va trebui sa fie aprobat nu numai de mama, dar i de tata.

Admind existena relaiei triunghiulare, Rose Vincent sublinia: prinii comunic verbal, dar n aceasta comunicare ntrebuineaz uneori i semne care difer mult de cele folosite de copil pentru a se face neles de mama.

El trebuie sa adopte acest sistem de comunicare pentru a ptrunde n lumea adulilor i a le mprti iubirea.

Copilul se confrunt cu dreptul de a iubi si de a fi iubit. El experimenteaz rivalitatea i gelozia prin opoziie cu atracia fa de printele de sex opus.

Trebuie precizat c dac un mare numr de psihologi considerau sntoas i necesar pentru echilibrul copilului o difereniere net a celor doua roluri, alii n lucrri mai recente vorbesc de prini ca de o unitate, ntr-o perspectiv n care conflictul oedipian ocup un loc din ce n ce mai mic.

Bruno Bettelheim afirma c n cadrul acestor etape mari exist momente critice hotrtoare pentru dezvoltarea ulterioar a activitii psihice a copilului. Ele trebuie nelese ca perioade mult mai sensibile, n

confidence in his entourage and the outside world.

Trust and security are essential for future relational life.

During the first two stages, then child lives more intense experience than the older child or adult. Therefore, it should be surrounded with more tenderness and care, in order to integrate in his environment.

III. The third stage between 3-4 years and up to seven years. The child is now living experience "triangular relationship" father-mother-child.

Any action the child will be approved not only by the mother, but also by father.

Admitting the existence of "triangular relationship", Rose Vincent pointed out: "parents communicate verbally, but in this communication which uses signs sometimes differ much from those used by children to make mom understood.

He should adopt this system of communication to penetrate the adult world and share their love.

Child has the right to love and be loved. He experimented with rivalry and jealousy by opposition attraction of the opposite sex parent.

Should be noted that "if a large number of psychologists considered healthy and necessary for a child's balance net difference of the two roles, others in more recent works speak of " parents" as a unit in a perspective that takes an Oedipus conflict plays an increasingly smaller.

Bruno Bettelheim says that there are large steps in these critical moments decisive for further development of the child's mental activity. They must be understood as more sensitive periods, during which, specific experiences can be more decisive and radical and lasting effect. The first critical period of the stage "symbiotic relationship" between mother and child, between 6 and 9



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cadrul crora, experienele specifice sunt mai decisive si pot avea un efect radical si de durat. Prima perioad critic, din cadrul etapei relaiei simbiotice dintre mama si copil, este cuprins ntre 6 si 9 luni, iar cea de-a doua, din etapa afirmrii de sine ntre 18 si 24 luni. B. Bettelheim susine c retragerea autist se profileaz n decursul acestor perioade.

3. Posibiliti terapeutice n problema posibilitilor de tratament,

studiul lucrarilor destinate autismului releva existenta unei atitudini destul de pesimiste la majoritatea autorilor, indiferent dac sunt adepii ipotezei psihogene sau a celei organice privind originea bolii.

Manifestndu-se specific de la un caz la altul, autismul nu cunoate o singur cale de tratare.

Un copil cu retard psihic sever nu se poate atepta s beneficieze de un tratament similar celui destinat unui copil autist cu un intelect relativ dezvoltat.

De asemenea, programele de tratament par a fi mai eficiente n cazul copiilor care utilizeaz limbajul dect n cazul celor care nu vorbesc.

Tratamentul trebuie adaptat n funcie de forma de autism ntlnit.

Autorul Fortreei vide este de prere c pesimismul asupra posibilitilor de ameliorare este nejustificat i trebuie pus pe seama faptului c prea puine eforturi terapeutice au fost suficient de intensive i ndelungate.

La cei mai muli copii cu autism, cauza care le-a provocat boala nu este precis, dar chiar i n extrem de puinele cazuri cnd etiologia bolii este cunoscut, nu toi pot spera la tratament, din simplul motiv c nu avem nc metode terapeutice eficiente (cum este cazul celor cu scleroza tuberculoasa sau cu sindromul X).

Cel mai adesea tratamentul se aplic n afara familiei, prin internarea ntr-o clinic special.

n familie, copilul ar putea fi expus

months, and the second stage of self-affirmation between 18 and 24 months. B. Bettelheim says is autistic withdrawal emerging during these periods.

Therapeutic possibilities

The problem of possibilities of treatment for autism research papers reveal a rather pessimistic attitude to most authors, whether followers of the organic or psychogenic hypothesis of the origin of disease.

Manifesting specific to one case to another, autism knows not only one way of treatment.

A child with severe mental retardation can not expect to receive similar treatment easy for a child with autism a relatively developed intellect.

Also, treatment programs seem more effective in children using language than those who do not speak.

Treatment should be tailored according to the form of autism.

The author of "empty fortress" believes that pessimism on the possibilities of improvement is unjustifiable and should be on that too few therapeutic efforts were sufficiently intense and prolonged.

In most children with autism, case which caused the disease is not accurate, but even in very few cases when disease etiology is known, not all can hope for treatment, simply because we do not have effective therapeutic methods (such as those with tuberculosis sclerosis or syndrome X).

Most often the treatment is applied outside the family through internment in a special clinic.

In family child could be exposed to pressures of anxious parents eager to see their child as quickly progressing.

Thus effective treatment of children remaining in family or simultaneous treatment of mother and child where



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presiunilor nerbdtoare ale prinilor, dornici s-i vad copilul ct mai repede progresnd.

De aceea, eficiena tratamentului aplicat copilului rmas n familie sau tratarea simultan a mamei si copilului, acolo unde este cazul, este discutabil.

Tratarea simultan, n mediul familial apare ca posibil atunci cnd copilul este foarte mic i dac forma autismului nu este grav.

Una din cele mai vechi metode de tratament psihiatric, socul este n continuare invocat, n principal pentru c d rezultate.

Faptul c, pe aceasta cale bolnavul i pierde i ultimul dram de umanitate care i-a mai rmas, conteaz uneori mai puin.

O alt metod utilizat este cea a condiionrii prin recompens sau pedeaps.

ns, obinerea unor reacii condiionate la copilul autist, nu numai c nu rezolv nimic, dar mai poate adauga un nou simptom celor deja existente.

Astfel, dresarea copilului care nu vorbete sau a celui care a renunat s vorbeasc n scopul restituirii unor sunete poate duce uneori la ecolalie, la repetarea cuvintelor i gesturilor interlocutorului, fr ca semnificaia lor s fie cunoscut.

C.Gillberg arat c orice tratament poate cuprinde trei aspecte eseniale:

I. o evaluare complet a diagnosticului. II. un program special de educatie a

copiilor si prinilor. III. un ajutor social si eficienta ingrijirii

celor spitalizati pe termen lung sau scurt. Oprindu-ne asupra celui de-al doilea

aspect, se poate arta c programul de educaie special a copiilor autiti include, la rndul su, cteva elemente eseniale: raportul terapeut-copil este de 1 la 3 dar, n funcie de handicap, el poate fi de 1 la 1, necesitile variaz n acord cu vrsta i nivelul dezvoltrii copilului autist, continuitatea terapeutului n munca lui cu copilul, n aceeai camera i la ore exacte, este deosebit de important.

Continuitatea presupune deci, c acelai terapeut va ncerca s antreneze, s nvee acelai lucru, pe acelai copil, n acelai loc, n

appropriate is debatable. Simultaneous treatment in the family

environment appears to be possible when the baby is small and if autism is not so serious.

One of the oldest methods of psychiatric treatment shock is still relied mainly because it gives results.

The fact that this way the patient loses and the last touch of humanity that has left some less than matter.

Another method used is that of conditioning by reward or punishment.

But obtaining conditioned reactions to the autistic child not only solves nothing, but may add a new symptom of existing ones.

Such "training of" the child who does not speak or who gave the talk in order to refund some sounds can sometimes lead to echolalia, repeating words and gestures to the other party, without their significance to be known.

C. Gillberg show that any treatment can include three essential aspects:

I .complete diagnostic evaluation II. a special education children and parents III. social assistance and efficiency of hospitalized long-term care or short. Stopping on the second point, it may look like special education program includes children with autism, in turn, some essential elements: therapist-child ratio is 1-3, but the disability, it may be 1-1, "needs vary according to age and level of development of autistic children, continuing his work with the child therapist, in the same room and the exact hours, is very important. Continuity implies that the same therapist will try to train, to learn the same thing on the same child in the same place at the same time of day. A good treatment can lead to obtaining positive effects on child behavior and skills.



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aceeai perioad a zilei. Un bun tratament poate conduce la

obinerea unor efecte pozitive n comportamentul i priceperile copilului.

Rezultatele bune sunt posibile atunci cnd ntre educator i copil se stabilete o legtur afectiv, aceasta putnd deschide poarta spre dezvoltarea mental a copilului.

Reuita aciunii educative depinde n mod esenial de terapeut, de calitatea interaciunii lui cu copilul, de preocuparea lui pentru nevoile psihice ale acetuia, de sensibilitatea i felul de a fi profund uman.

Terapeutul trebuie s-l nvee pe copilul autist s triasc experiena plcut, s contientizeze c ntmplrile din jurul lui au o istorie, o cauz sau un nceput, ca i o soluie sau un sfrit.

n concluzie, pentru a mpiedica rmnerea unora dintre copii n zona obscur a psihicului uman trebuie s fim contieni de nsemntatea contactului pe care copilul l stabilete, nc de la natere, cu cei din jur i n special cu mama sa, pentru dezvoltarea sa viitoare.

Pentru a se dezvolta normal, copilul trebuie s gseasc la cei din jurul su, prini sau terapeut-educatori, suficient afeciune i nelegere.

Altfel, pericolul auto-abandonrii devine mai amenintor. Bibliografie: 1. Cucuruz, D., Autism. Cartea pentru prini, Editura Publishing, Bucureti, 2004. 2. Murean, C., (2002), Comportamentele stereotipe ca mecanisme de aprare n autismul infantil, Societate i handicap, 1. 3. P.Popescu Neveanu, Dicionar de psihologie, Editura Albatros,Bucureti, 1978. 4. R. Vincent, Cunoaterea copilului, Editura didactic i pedagogic, Bucureti,1972, pp. 127-128. 5. Verza, E. (1993), Delimitri conceptuale n autism, Revista de educaie special, 2.

Good results are possible between teacher and child when a link is affected, this can open the door to the child's mental development. Successful educational action depends essentially on the therapist, the quality of interaction with the child's concern for the psychological needs of his sensitivity and profound way of being human. The therapist should teach him to live pleasant experience autistic child, to realize that the happenings around him have a history, a cause or a beginning, as a solution or an end. In conclusion, to prevent some children staying in the murky area of the human psyche must be aware of the significance of contact that a child sets, since its birth, with others and especially his mother, for its future development. To develop normally, the child must find the people around him, parents or therapists, educators, enough affection and understanding. Otherwise, the danger of self-abandonment becomes more threatening. Bibliography: 1. Cucuruz, D., Autism. Cartea pentru prini, Editura Publishing, Bucureti, 2004. 2. Murean, C., (2002), Comportamentele stereotipe ca mecanisme de aprare n autismul infantil, Societate i handicap, 1. 3. P.Popescu Neveanu, Dicionar de psihologie, Editura Albatros, Bucureti, 1978. 4. R. Vincent, Cunoaterea copilului, Editura didactic i pedagogic, Bucureti,1972, pp. 127-128. 5. Verza, E. (1993), Delimitri conceptuale n autism, Revista de educaie special, 2.

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ILEANA_MITELEA Autismul Infantil