1.Is autism a withdrawn personality? When you first hear the term “autism” or “autistic”, you often associate it with a withdrawn or introverted personality, that is, you associate it with some type of purely psychological disorder, thinking that the child must be stimulated by some kind of external environment and the disorder occurs. It has also been suggested that they often have a poor family environment, such as parents with strange personalities, or mothers who are busy with work and neglect the child in early development (infancy) …… etc. Such factors, called “psychological environment”, have been denied by research findings. The findings suggest that autism is related to abnormalities in the physical structure of the brain system, but it is not yet possible to determine what causes the abnormal structure of the brain system. Although autism is not a purely psychological disorder, individuals with psychological disorders may also trigger autistic manifestations because they are affected in their perceptual processing functions. 2. Can children with autism have a psychological disorder? Although this autism is not a purely psychological disorder disorder, it is not possible to ignore the psychological disorders of children with autism. On the contrary, it is important to take into account the psychological characteristics of children with autism when engaging with them or training them for intervention. The autistic child, because of his very weak social interaction skills, has difficulty in engaging in normal communication behaviors with the people around him, which can lead to abnormalities in his psychological structure and the occurrence of psychological disorders specific to autistic people. In other words: just as blind, deaf, and physically handicapped people can develop psychological stress due to their own impairments, children with autism can develop psychological developmental deviations and abnormalities due to their autistic impairments as they grow up. The most common phenomena are: increasing withdrawal in interactions with others, such as playing with a part of their body, attachment to an object or a single activity; averting their eyes or running away when they have to talk to someone; crying or laughing seemingly inexplicably; hurting themselves or attacking others. 3. How does autism come about? The cause of autism is still unknown, but it is certain that there are neurophysiological variants. Genetics was once considered to be one of the important influencing factors, and research on the cause is currently being conducted worldwide, but the findings do not yet prove that genetics is the only cause of autism. Another clue focuses on the search for variants in brain function. The presence of various variants has been found in different regions of the brain system, and it is now possible to affirm that neurophysiological damage in large areas of the brain is an important factor. In conclusion, the results of recent studies on the cause of autism tend to be “multifactorial”, i.e., there is more than one factor that causes the disorder. 4. Is autism an acquired disorder? Although there has not been a substantial breakthrough in the research on the causes of autism, the belief that autism is a result of an acquired disorder has not yet been fully understood. However, the notion that autism is due to an acquired environmental cause has been rejected. It is now agreed that brain damage occurs before birth or during the birth process. An important criterion for diagnosis is that “the child has symptoms before the age of 36 months”. 5. How can I be sure that my child has autism? First of all, when you notice that your child has a speech delay, you should take him/her to the hospital for an examination. The diagnosis is usually made by a child psychiatrist. An American psychiatrist once said, “If your child is weaker in speech than other children, the first thing to suspect is that he may have autism.” Since there are no accurate experimental data and effective testing tools for the site and causative factors of autism, the diagnosis is not based on laboratory or instrumental test results, but on the abnormal external behavioral manifestations of young children. DSM (American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders) and ICD (International Classification of Diseases – published by the World Health Organization). 6.What is the difference between autism and language development disorder? The condition of children with language disorders differs from that of children with autism in that the former do not have abnormalities in their perceptual responses and are normal in the way they relate to people and objects. They are able to imitate others and use gestures to express abstract content (similar to children with hearing loss), although sometimes with less “parrot-like” conversation. They are as interested as normal children in participating in imaginative play and group activities. The characteristics of autistic children’s own language impairments are described in Autism and Hearing Disorders. In addition, they show significant discomfort (non-involvement) in group activities and games, and are even less able to participate in imaginative play. They completely ignore or do not understand the rules of the game, do not care about the outcome of the game (whether they win or not), and are often not interested in group activities and games in the first place. They tend to wander away from the game while other children are focused on it. 7. What is the difference between autism and hearing impairment (deafness)? Hearing impaired children are often referred to as deaf children because of damage to individual sensory organs (auditory system). Although they have a speech impairment (loss of the ability to express themselves in words) due to the loss of hearing, they do not lose interest in actively seeing, understanding, and interacting with the outside world. Children with hearing loss will use other tools such as body movements, eyes, and facial expressions in an effort to communicate and interact with others. Although children with autism are most likely to be seen as “non-verbal,” “hearing but not listening,” and “ignoring external sounds,” their auditory system is essentially intact. However, their auditory system is basically intact, but they are unable to respond normally to the outside world because of a disorder in the central brain system. In addition to being barely able to use language to interact, autistic children are also characterized by their inability to use other communication tools such as gestures, eyes, and facial expressions to communicate with others. After the book “Dancing in the Rain” was translated into Chinese, there was a lot of interest among parents who hoped that “auditory integration therapy” could save their children like it did for Jocie. However, it is worth noting that according to Dr. Brad’s (the doctor who treated Jocie) treatment statistics, he has treated a total of 8,000 patients with Auditory Integration Therapy, including 48 with autism, and only Jocie has fully emerged from autism. The current study by the Autism Research Institute of America concluded that “auditory integration training is based on the patient’s auditory hypersensitivity. However, current experiments show that auditory training does not change auditory hypersensitivity, but changes the patient’s behavior?! So this theory of treatment has yet to be proven by more research.” Finally, it should be noted that it must first be determined whether the child participating in auditory integration training is autistic due to auditory sensitivity, otherwise auditory integration training would lose its prerequisites for him. Is an autistic child mentally retarded? Mentally retarded children are usually slower than the general population in all aspects of development, but the sequence of development remains basically normal. The IQ of mentally retarded children is measurable, and their development in the areas of perception, social interaction, interests, and language is proportional to their IQ. In children with autism, although there is a generalized developmental delay, the developmental sequence is abnormal and uneven in all areas. For example, some children are unable to take care of themselves, but have strong numeracy and drawing skills; some children have no or very little language, but excel in memory and color recognition. Children with autism are much less capable of interpersonal interaction and initiative than children with mental retardation due to their extremely weak social nature, and there are no tools available to accurately measure the IQ of children with autism. As a teacher at a Pei Chi school who has taught both mentally retarded children and autistic children experienced: mentally retarded children are willing to learn but cannot learn; autistic children are able to learn but are unwilling to learn. 9.Does early training belong to the category of treatment or education? Early training can also be called early education. When a doctor gives a child a diagnosis of autism, all that can be done at this time is to recommend training for the child, and training for children with autism (English: Herapy) will fall more into the category of special education in terms of methodology. However, functionally speaking, it has the role of helping autistic children to reduce other symptoms and the degree of impairment, so it is also often translated as “therapy” in Taiwan. In developed countries such as Europe, the United States and Japan, it is stipulated by law that those who train autistic children should have a degree in special education. 10.Can we just teach but not treat? When a child has autism, he or she should receive special education instead of medication. This is a modification of the customary “seek medical help if you are sick” concept, i.e., children with autism are now “sick and need to be taught”. Many parents are skeptical of this at first, and some think they should seek medical help first and then teach after they are cured. This is because they don’t know what it takes to rehabilitate their autistic child and what it takes to truly help them. There is only a superficial understanding of children with autism and a lack of understanding of their essence. In fact, the biggest obstacle for children with autism is the interaction barrier, including the language communication barrier. They are often immersed in a closed world of self, and the reason for this is their lack or inability to interact with the outside world. And only through education can we help them build this ability and bring them out of the world of self into real life. Of course we do not rule out that with the development of medicine, drugs will play a role. But so far, there is no medical treatment that can replace the role of educational training. Because the ability to acquire is not innate, is to rely on the cultivation of education gradually. Drugs can only return a person to a sound body and provide the possibility of acquiring abilities, but cannot play a decisive role. This is just like the well-known example of the “wolf child” who, despite having a sound body, can only howl like a wolf due to the absence of a human educational environment, and the limited language she can eventually produce is due to the role of education. Therefore, it can be said that the help for autistic children should be based on education and supplemented by medication. 11. Is there an optimal training period for autistic children? The earlier a child with autism is trained, the better the results will be. Once a child is diagnosed (or suspected of having “autistic tendencies”), intervention training should be provided, as training is the only proven way to treat the child. In developed countries and regions, most children with autism are diagnosed around the age of three, so “3-6 years old” has been the best training period recommended by experts, and because this period is also an important stage of brain development for children. Experiments have shown that children with autism can increase their IQ by 12 points if they are trained before school, and this was confirmed by a study conducted at the University of New Jersey in 1991. This study even showed that the potential for intellectual development of children with autism who were trained at the preschool stage exceeded that of normal children, because normal children in the study who also received preschool training could achieve good grades with little or no change in IQ. The results of this test, prove that early training of children with autism works and show that 3-6 years is the critical period. However, many cases also confirm that even beyond this age, training in the right way will lead to great improvements in the child, and that abandoning training to correct the condition will only make the child worse; it is never too late to start! 12.How long should the training take? Training for children with autism is a long-term and systematic intervention project. Training is different from taking medication or surgery, where recovery is evident after a course of treatment or a procedure. Training is a complex process that requires extensive experience and great patience and persistence on the part of the trainer. For children with autism, training needs to be accompanied by corrective treatment for almost all stages of their development, so parents must first be prepared to fight a constant battle. With the right training approach, you will find that your child learns things you didn’t think were possible before, and has abilities you didn’t think were possible before. Dr. Rimland, director of the Autism Research Institute of America (a parent and child psychiatrist), once said, “When you’re dealing with a lonely child, try to feel what he’s learned over time.” A German mother who has helped her autistic daughter succeed in her independent life exclaimed, “God only knows how far an autistic child can go, what I want to know is what my daughter has learned today compared to yesterday.” A Chinese mother, after more than ten years of trying to keep her autistic child in a normal school through sixth grade and watching her enter middle school, said with pride, “I just now feel how accomplished I am.” 13. Can autism be cured? Since the cause and location of autism are not yet known, there is still no medical treatment with significant effect. In this sense, autism is currently incurable, meaning that it will be with the person for a long time or even a lifetime. However, if “treatment” is defined as not only medical treatment, but also any training therapy that can effectively promote the improvement of the child’s condition and enhance his or her social interaction and adaptability, there is a wide range of training therapies available internationally. Since the various features of autism may occur at different times in the child’s development, and the specific manifestations of autism often vary from child to child, it is difficult to compare them. Therefore, when dealing with different therapies and training methods, it is important not to consider a particular method to be universally applicable because it is suitable for a particular child or because it has had a significant effect on the improvement of a child’s condition. Children who do not look at people are children who do not look at people and avoid eye contact are common in children with autism. The eyes are not only used to look at things, but also to communicate messages. 15.What do you mean by “high functioning”, “medium functioning” and “low functioning”? How are the functions of autistic children classified? The term “functioning” refers to the ability of the autistic child, which is generally determined by IQ or developmental quotient. 16.Since autistic children have language impairment, why don’t they learn sign language? Autistic children are not mute. The reason why they have language impairment is not because they cannot pronounce words, but because they cannot understand the abstract concepts expressed by sounds. Therefore, although the autistic child is flexible, it does not mean that there is no obstacle for him to learn sign language. Are there any diseases that are inherited to become autistic and will autistic children become mentally ill when they grow up? Congenital aphasia, specific learning disabilities, delayed language development and other types of cognitive disorders are disorders that are more associated with autism and have a higher incidence in families, but autism is not entirely genetic. Some autistic children grow up with a lot of symptoms of autism and appear to be emotionally bland and strange in speech and behavior, and are easily “mistaken” for a psychiatric disorder rather than “turned into” one. 18. Some physicians say “yes” and some say “no” to autistic children, how do I know if my child is or is not autistic? The identification of autistic children is related to experience and knowledge. It is helpful to find a specialist in this field and to learn more about it. 19.Will the symptoms of autism change as we get older? Yes, usually the symptoms of autism will diminish, but follow-up should be done to get more accurate information, which is something we should work on more in the future. I am not sure if all autistic symptoms will disappear, but it is possible that some people with autism have mild symptoms and can live like normal people. However, this characteristic does not constitute an obstacle to life, just like everyone has their own personality. Is it normal for children with autism to have partial speech development when they are one or two years old, but it disappears after that. Is it possible to recover? Usually, most children with autism have a slow development of language skills, but in a very small number of cases, the development is followed by disappearance. The mechanism of this language deterioration is not known, but perhaps neurodevelopmental conditions may explain part of the cause. After birth, the nerve cells in the brain have to partially degenerate to make room for the rest of the nervous system to develop, so at some point, if the nerve cells have not degenerated properly, normal development will be hindered. In this case, with appropriate instruction, there is a good chance that the child will still be able to speak. It is not possible to determine the relationship between autism and language developmental disorders, but from a family history perspective, there is a high proportion of autistic or other language disorders in families with autism compared to other families without such disorders. A child who does not have meaningful oral expression by age 2 is identified as having a delayed language development disorder and further evaluation is appropriate. 21. What percentage of children with autism will not have language development? The development of language skills in children with autism does not usually correspond to their biological age. Some children with autism lack the ability to express themselves verbally and cannot communicate with others, but the numbers are not yet available. However, there are several principles in teaching language, namely, practicality and living, and teaching the child to express basic needs and communicate in daily life without forcing him to learn abstract cognition. 22. What is the effectiveness of other treatments such as vitamin B6, Mg or acupuncture? Vitamin B6 is useful for neuronal disorders and neuronal stability, but not for autistic symptoms; Mg is a rare element, and some degree of deficiency may cause psychiatric symptoms, but it usually occurs under very specific circumstances, such as a large loss of Mg due to a medical condition or a long-term failure to ingest it. If you are afraid that your child will have problems due to partial eating, you can use natural food supplements, otherwise you need to find an experienced specialist to administer it. Acupuncture is a newer treatment, and its efficacy is still inconclusive and needs to be evaluated in more rigorous controlled studies. I think parents are eager to find an effective treatment for their children and will try all kinds of treatments without harm and within their ability, which is human nature. 23.In the limited time available, should we focus on making up for the child’s lack of ability or should we strengthen the ability we already have? Before the child is six years old, especially before the child is three years old, it is a critical period for the child. Early on, the child should try not to give up training in all aspects, but should not be paranoid about a certain aspect, which will cause the other abilities that the child already has to degenerate and be wasted. 24.Does infantile autism affect the intellectual development of children? Infantile autism is a mental disorder that starts at a young age and is associated with congenital rubella, often accompanied by epilepsy. Most children with autism are mentally backward, but may have special abilities in music and number memorization.