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[Basic information] Female, 3 years old and 9 months old
[Disease type] Autism spectrum disorder Child autism
[Treatment Hospital] Weinan Branch of Xi'an Traditional Chinese Medicine Brain Disease Hospital (Third Class A)
[Treatment Plan] Comprehensive rehabilitation treatment, including speech training, cognitive function training, guided education training, behavior modification treatment, sensory integration training , low-frequency pulse therapy, etc. At the same time, based on the treatment principle of "refreshing the brain and resuscitation" of traditional Chinese medicine, scalp acupuncture, ordinary acupuncture and partition moxibustion were given.
[Treatment period] Hospitalization for 4 months. After discharge, daily rehabilitation training was maintained.
[Treatment effect] After rehabilitation treatment + traditional Chinese medicine treatment, The patient's social and speech abilities have improved significantly compared to before.
1. Getting to know the patient
The first time I saw the patient was in the outpatient clinic, led by the patient's mother. The patient's mother looked anxious and told me that the child was over three years old and still could not communicate with others like children of the same age. She repeatedly and eagerly asked me what to do and whether it could be cured. I patiently comforted the patient's mother and asked her to relax. After detailed questioning, I learned that the child could be called "Dad" and "Mom" when she was 1 year old, but when she was 2 years old, she could only simply pronounce "Dad" and would not respond to her name and would not make eye contact with others. However, the family members of the child did not pay attention to it at this time. The child
was unable to speak when he was 3 years old and 9 months old. He liked to be alone and did not take the initiative to communicate with others. Only then did the family members pay attention and took the child to an outside hospital for treatment. The brain MRI, electroencephalogram, ceruloplasmin test, organic acid test, etc. were completed and no obvious abnormalities were found. An evaluation of the patient's intellectual development showed that all indicators were lower than those of normal peers. The child's autism assessment score was 34 points, and the child's autism parent rating scale was 113 points. The patient was diagnosed as "autism spectrum disorder" and was given oral nutritional brain cell drugs (the specific drug is unknown) and behavioral modification (the specific drug is unknown) and other treatments. One month later, the child's condition showed no significant change compared with before, and he was discharged from the hospital to guide himself at home.
The child was found to be unresponsive, unable to communicate with others, and unable to express his wishes in words. In order to seek further treatment, he came to our outpatient clinic for treatment. I conducted a physical examination on the child and found that the child was retarded in development, moderately nourished, slow to respond, unable to speak, had social difficulties, had poor initiative awareness, understanding, cognitive ability, and judgment, had no calculation ability, was inattentive, had no attention to the surrounding environment, had narrow interests, and liked to wave his hands. The muscle strength of the limbs and muscle tension were normal, with bilateral biceps reflex (++), bilateral radial periosteal reflex (++), bilateral knee tendon reflex (++), and bilateral Babinski sign (-). I considered a preliminary diagnosis of "autism spectrum disorder childhood autism" and admitted her to our department for inpatient treatment.
2. Treatment process
After the child was admitted to the hospital, in order to further clarify the cause of the patient's disease, I completed relevant examinations for the child. There were no obvious abnormalities in blood routine , electrolytes, liver and kidney function, coagulation function, routine defecation, and brain MRI. The "Development Examination Report for Children Aged 0-6 (Gese11)", "Autism Behavior Scale for Children (ABC)" and other related examinations were completed. The examination results showed that the patient had moderate signs of autism.
Based on the patient's symptoms, signs and examinations, the child can currently be diagnosed with childhood autism. In response to his condition, I decided to provide the patient with rehabilitation training to improve his attention and ability to sit still, improve his social barriers, and then improve his speech and self-care ability. Therefore, he provided comprehensive rehabilitation treatments such as speech training, cognitive function training, guided education training, behavior modification therapy, sensory integration training, and low-frequency pulse therapy. At the same time, based on the treatment principle of traditional Chinese medicine acupuncture to "refresh the brain and rejuvenate the mind", the children were given scalp acupuncture, ordinary acupuncture and partition moxibustion (Baihui point). The acupuncture prescription was as follows: main points: Neiguan , Shenmen , Xuan Zhong, Yongquan ; acupoints: Pishu , Xinshu, Sanyinjiao, Lianquan; Scalp acupuncture: Baihui, Sishen acupuncture, Dingshen acupuncture, Zhisan acupuncture, parietotemporal anterior oblique line 2/5, language area 2, Naohu.
During the treatment, I asked the patient's family to guide the child to communicate with others, pay attention to the child's care, and prevent dangerous situations such as falls, burns, self-injury, and loss.
3. Precautions for patients in treatment and life
1. Treatment: Parents should participate deeply and comprehensively in the rehabilitation treatment process. They cannot just rely on hospitals or rehabilitation centers for training. They should also adhere to scientific training in daily life to improve the prognosis.
2. In daily life: Parents should encourage children to improve their daily activities independently, and urge them to carry out self-care, social and other skill training, and scientifically formulate the children's diet to enhance the children's physical fitness and promote development.
3. Condition monitoring: Due to the particularity of children with autism, parents should monitor their children's risks of self-injury and aggression, monitor their children's daily sleep, diet, physical discomfort, etc., and pay attention to their children's daily emotional changes.
4. The patient’s therapeutic effect
After more than four months of hospitalization , the child's social and speech abilities have improved significantly compared to before, he can actively communicate with others, his stereotyped behaviors have decreased, and his attention to the surrounding environment has also increased. After reviewing the "Development Examination Report for Children aged 0-6 years old (Gese11)", it was suggested that the child's various abilities have improved to varying degrees, so he was discharged from the hospital, and parents were asked to continue to carry out rehabilitation training for the child in daily life and to review regularly.
5. Doctors’ insights
Autism is an increasingly common neurodevelopmental disorder, more common in boys. The results of my country's second national sampling survey of persons with disabilities show that children with mental disabilities (including multiple) aged 0-6 account for 1.10‰ of the total number of children aged 0-6, approximately 111,000, of which children with mental disabilities caused by autism account for 36.9%, approximately 41,000.
The treatment of autism in children focuses on early and long-term , that is, children should be diagnosed early, early intervened, and long-term treated, with an emphasis on daily intervention. Early educational intervention should also be carried out for suspicious children. Most children with autism can have corresponding symptoms before the age of 3, and the same is true for this child. However, parents did not pay attention to the symptoms when the children appeared, which led to the gradual worsening of the children's symptoms and the gradual increase in the difficulty of treatment.
In recent years, with the improvement of medical diagnosis ability, early intervention, and rehabilitation training quality, the prognosis of autism is gradually improving. After early treatment, some patients with autism can have their cognitive level, social adaptability, and social skills close to normal levels. Therefore, once a child is found to have similar symptoms, such as language development lagging behind peers, not liking to communicate actively, not liking to play with other children, having single interests, etc., he should go to a regular hospital in time to avoid further aggravation of symptoms, which may lead to irreversible defects in life and social abilities.
Name: Guo Xiaocheng
Unit: Weinan Branch of Xi'an Traditional Chinese Medicine Brain Disease Hospital
Department: Pediatric Neurorehabilitation Department
Professional title: Attending physician
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