Autism spectrum disorders (ASD)

Tanya was about 6 y.o. when they applied to our institute with the complains of communication problems, periods of excitation, learning disability,

Anamnesis: the threat of pregnancy termination, lack of vagitus. Up to 15 months the girl’s development was according to the age, including cooing, babbling. But the number of babbling words decreased as she was growing up. There appeared sleep disorders. The girl didn’t like being taken in arms, didn’t look into eyes. When she was 2, a local psychiatrist made a diagnosis “autism” (F 84.0 – ICD-10).

The objective diagnostic findings showed that only EEG had immature developmental biorhythm structure, while the index of cerebral hemodynamics according to REG (rheoencephalogram) was within normal limits.

The neurologist’s diagnosis before the first course of tDCS ( transcranial direct current stimulation) was: coarse neuropsychic and speech developmental delay with residual-organic pathology, vertebral-basilar insufficiency, hypertension - hydrocephalic syndrome.

The speech theacher marked that the girl could say many words, but she repeated them in echolalia way, she did not use familiar words. She knew letters, could read words, count forward up to 20 (her mother had been training her). Tanya did not listen to someone reading books for her, but she liked turning ropes. She did not maintain eye contact, cried when protested.

The psychologist emphasized autistic features in the girl’s behavior: the first contact was possible only when her mother assisted, and only by the end of testing the girl could follow the psychologist’s verbal instructions. Work speed was quite high, impulsive, working capacity was poor with fatiguability being increased. She performed tasks on visual perception only with simple shapes, while with more complicated - on the touch. The girl had a good aural mechanical memory, namely, she could remember the names of pictures, commercial reels. The tasks on analysis-synthesis did in half only with object images, not with geometric ones. Tanya classified subjects only on grounds of one at a time (color or shape).

The first tDCS course had only two sessions (because of the external circumstances). Nevertheless some substantial changes occurred. As early as 2 days later the first session Tanya became calmer, more pacific (according to her mother). Then, at home, in customary conditions during next 4 months the girl’s behaviour became more appropriate, though still impulsive. She became more talkative, but mostly with adults. In the kindergarten, however, Tanya was still excitable, when being managed, she ran away and hid in the corner.

For planned extension of disability certificate the girl was taken to the asylum in a residence and treated with psychotropic drugs. Tanya’s mother observed gradual loss of positive changes in mental development of the child. Slow recovery began only after cancellation of pharmacotherapy at the initiative of her parents at an early discharge from the hospital. Half a year later, before the second course of the tDCS the logopedist marked some progress in Tanya’s behavior: she could show a toy, a picture, following the other people instruction. Sometimes she was able to answer a question. She could call her actions: “I will not do”,” I will leave”, “good-bye…” Tanya became more sociable, maintained eye contact. She could countdown within 10, but she still could not do sums. The girl was able to recognize some written words. She did not like drawing, wrote badly, but her movements were good enough in everyday life. She also could understand speech better.

The psychologist also payd attention to quieter and adequate behavior of the child, her readiness for contact.. Tanya performed most tasks with pleasure, using not only physical effort, but visual correlations as well. She was in hand with nesting blocks and inserts. When tested the girl named pictures, colours, gave instructions to herself.

The second course of 4 session tDCS taken at the age of 6.5 was carried out also without correctional - developmental training. During the course Tanya started talking with relatives by phone and counting objects. Her mother marked, that compared to the first course of treating Tanya was “the gold child”.

Before the third course of tDCS the speech teacher marked that Tanya began to use phrase speech, but mostly in echolalia way. The girl got interested in dolls, collected photos of actors, knew their names, showed them. She remembered what was shown on the previous testing (nearly half a year ago), tried to repeat it.

The psychologist emphasized that Tanya maintained eye contact longer, could give her favorite toy without a shout and follow instructions. Her behavior during the test was quite adequate, regulated by her mother. In visual perception tasks she carried out purposefully the full volume of tests, knew all geometrical shapes, did all object inserts. She only refused to work with split pictures. The girl got more capable with a pencil, namely, she could copy elementary images: the sun, flowers, grass. Tanya watched what she did. Her attention became steadier, it was easier to attract it. She was good at tasks with descriptive material – she found quickly two pictures of 8 which were a match. When asked by her mother, she could name all the objects, answer questions.

Tanya had the third course of 4-sessons tDCS at the age of 7. Progress in her behavior made it possible to combine the course with correctional - developmental training carried out by the psychologist - speech pathologist. During the first session the girl came into contact with a new person at once, but she did not show interest to tasks. Nevertheless she performed perceptive tasks without effort, attention was steady. Tanya could understand speech, but did not answer, called nothing. But when she wanted to take a toy herself she asked: “the soldier, the elephant…” During the next session the girl looked into the doctor’s eye and smiled, but she did not answer the psychologist’s questions. By the end Tanya got tired and refused to work saying “You don’t want! Go away! Her mother noticed Tanya foresee the relatives’ actions, naming them. She got more difficult to be deceived. Her tendency to stereotypies decreased and it became possible to change a trip route. Her sleep became better, she began to show affection. Tanya became more sociable with children, used such words as “give me, go away, good-bye…” She started walking around the puddles (which she had not done before in spite of her mother’s efforts). Tanya stopped breaking flowers and flower pots. She got able to choose footwear according to the weather. The girl reacted to a ban more appropriately. Her active vocabulary had increased.

During the last sessions the girl was excited, shouted, jumped. She carried tasks only with 3D-objects, denying others. But Tanya used such words as “help”, “take away”, “give the car”.

We consider that the results of our activity could be more essential taking into account the speed with which the girl had advanced in many ways though they applied for our help rather late, but external circumstances did not allow to carry out the correctional work in full.

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