這個小孩會否患有自閉症傾向或亞氏保加症?

Chingsma

我的姐姐有一個現年兩歲四個月大的女兒。近來她的情緒令人關注。我近來閱讀到有關幼兒自閉症和亞氏保加症的資料，開始擔心她會否有相關問題，但她母親卻相信那些都是小孩的個性特徵，並不願尋求專業的意見或輔導。因此希望有經驗的父母們能給我一些意見作為參考。這個小孩的個性和情緒特徵如下：

1) 她的記憶力強，在兩歲時已經能由一諗到一百五十，能辨認幾十個國家的國旗和辨認幾十個中文字；
2) 情緒激動時，會有撞頭的行為，並不能阻止；
3) 有時會不停轉圈(如有她喜歡的小吃時)；
4) 除了父母和照顧她的工人外，她不許其他的人接觸或觸摸她；
5) 她喜歡與某些小孩玩耍，但都不許他們觸摸她 ；
6) 有時呼喚她名字許多次，即使她聽見，她都不回應；
7) 去別人家時，她會主動稱呼人；
8) 她跟別人會有眼神接觸；
9) 她喜歡到kindergarten 上 playgroup；
10) 她有好的說話能力，能說很多英語，但比較多描述性的說話 ，比較少交流性的說話 (如告訴別人她不喜歡一個地方，只會大哭)；
11) 有時有鸚鵡學舌的表現，如其他人不許她做一些事情，她會一邊哭，一邊不停重複那人阻止她時所說的說話；
12) 她有時不會說出她的要求，如她想要一些東西，她可能只會抓住母親的手和走向那東西；
13) 在家中，她喜歡玩耍，看電視，聽歌，唱歌，跳舞；
14) 她比較不容易接受新的轉變，如學習洗手，使用便盆等，她都哭得很劇烈；
15) 以前有一段時間，出外時，她不願走路，只要人抱，現在肯走路，但要告訴她下一步要往哪裡走。

希望有經驗的父母們能給我一些意見，謝謝。

hinhinmummy

2) 情緒激動時，會有撞頭的行為，並不能阻止；

--------------自傷行為

3) 有時會不停轉圈(如有她喜歡的小吃時)；
-------------自我刺激

4) 除了父母和照顧她的工人外，她不許其他的人接觸或觸摸她；
5) 她喜歡與某些小孩玩耍，但都不許他們觸摸她 ；

--------- 吾比人觸摸, 吾知點統稱, 但都應該係吾好既野

6) 有時呼喚她名字許多次，即使她聽見，她都不回應；

---------- 好多自閉症既小朋友都有呢個特徵

10) 她有好的說話能力，能說很多英語，但比較多描述性的說話 ，比較少交流性的說話 (如告訴別人她不喜歡一個地方，只會大哭)；
-----------吾懂交流?

11) 有時有鸚鵡學舌的表現，如其他人不許她做一些事情，她會一邊哭，一邊不停重複那人阻止她時所說的說話；
-------- copy language

12) 她有時不會說出她的要求，如她想要一些東西，她可能只會抓住母親的手和走向那東西；

---------- 吾會point out 想要既野

14) 她比較不容易接受新的轉變，如學習洗手，使用便盆等，她都哭得很劇烈；

--------- 固執行為


因為只係單憑你抽述, 外人好難就甘講小朋友係有自閉症傾向/阿氏保亞

都係果句, 有懷疑, 早評估

正如我大女甘, 依家對自閉症認識多左, 看返佢細時, 都有好多特徵似自閉症, 好似
1. 將公仔係床邊排列, 位置吾可以郁動, 郁左小小都大吵大鬧
2. 要果樣野就要果樣野, 吾比佢又係大吵大鬧


還有d 例子吾記得左...........

Justin2002

I agree with hinhinmummy that early assessment and intervention (if necessary) is most beneficial and helpful to the kid.

Yes, every kid has their own style and character, but the points you mention are far more than 'normal' behavior, I'm afraid.  I am also a mom of a kid with a-features, some of your points coincide with my boy when he was small.

So, please urge your sister to seriously consider of arranging an assessment for the girl, or she will regret later.

Justin2002

shunshunma

4) 除了父母和照顧她的工人外，她不許其他的人接觸或觸摸她；
5) 她喜歡與某些小孩玩耍，但都不許他們觸摸她 ；

--------- 吾比人觸摸, maybe is 感統問題?  

Anyway, better to take her for early assessment.

JigJig

我以過來人身份勸你-如果有懷疑,盡早做評估.如果評估無問題,就心安里得.  但萬一真的有問題,盡快提供適合的訓練和治療是必須的.  

有D小朋友可能有一些行爲或情緒上的問題,儘管不一定是自閉症和亞氏保加症,這些行爲或情緒上的問題會可能影響小朋友的社交及其他的發展,亦可能會影響到返學老師點處理這些小朋友. 以我所了解,在三歲之前好難確定小朋友是不是真的自閉,因爲有D幼兒行爲同某些自閉症症狀類似 (相信你都聽過trouble 2).

anyway, what I am saying is irrespective of whether your niece is autistic or not, if she has behaviour or emotional problems, then there are things that can be done to help her.  Don't worry too much about the label - what is most important is to identify if she has weaknesses that needs to be addressed.

My son is 22 months and recently been diagnosed has having impairment in social and communication skills.  Since then we have sent him for training and do home training at home.  He has already shown some improvement in 2 weeks time and sometimes I wish I had faced the problem earlier and sent him for assessement and training earlier.  Just remember that once time has passed, you cannot turn back the clock!!

mungmung

I agree with that:我以過來人身份勸你-如果有懷疑,盡早做評估.如果評估無問題,就心安里得. 但萬一真的有問題,盡快提供適合的訓練和治療是必須的.

mungmung

Chingsma

Thanks a lot for all your advice.

JigJig, you mentioned that you are sending your son for training.  I want to ask where you send your son for those training.  Can my sister bring her girl to have similar training without bringing her to do any formal assessment?  My sister is very reluntant to have assessment because she strongly believes that her girl is not 自閉 nor 亞氏保加.  She thinks that those assessors will automatically "label" her girl as having problems and she knows her girl must cry heavily during the whole process (because everytime she brings her daughter to see a doctor, the kid crys and struggles very heavily and every doctor will ask the same question "Does she behave like this normally?).

Instead of bringing the kid for any assessment, now my sister takes the approach of not triggering her girl's temper.  Once she notices that she may lose control, she will have her own method to comfort her to prevent her from crashing her head.

JigJig

Chingsma,

You must understand that assessment is a necessary part of the process so as to:-

1. correctly IDENTIFY the PROBLEM; and
2. prescribe APPROPRIATE TREATMENT.

對症下藥is critical.  Just sending her to training (in any case, I don't think you will be able to get training without the trainer doing some kind of evaluation/assessement first - without going through assessment to identify her problems or whether she has problems, the trainer does not even know what to train her for!!)  

As for whether or not your niece may cry at the assessment, of course you need to make sure that she is not sleepy nor hungry.  My son HATES being examined by the doctor and he fights and cries each time the doctor touches him.  However, he was perfectly happy during his assessment.  You need to take the child to the place where the assessment will be conducted a little bit earlier than your scheduled appointment so that he/ she can "warm up" to the place.

I also use to think my son only has a strong personality but now I think he has problems which he needs help with.

Anyway, as I said before, the label is not important. The important objective of assessement is not to attribute a label to a kid, but to identify his/her weakness/ problems so that treatment can be provided to help the child.  

If you don't mind me saying so, I think your sister is just trying to avoid the problem.  小朋友咁細又不懂得表達,所以我地做父母的除左照顧他們的起居飲食物之外, 亦需要觀察他們行爲和發展,提供適合的教導及治療.  I think your sister just has to understand that by depriving her kid of the chance for training / treatment (if it is necessary), your sister can possibly ruin her life.

lingchuling

Hi,

我個仔都是被醫生認為自閉傾向, 後來再被看為亞氏保加, 現在我就很慶幸當初我的堅持, 現在他除了小肌肉及大肌肉比較差少少外, 重有社交理解方面都需要跟進,  但是在學校老師根本不覺得他是有自閉症, 只除了情緒比較不隱定, 因他想每個人都需要按照他的意思, 所以他比較自我, 現在看回, 早去面對問題是對的, 即使其後發現小朋友實不太嚴重, 其實可能就是當初早去處理問題, 當問題未變嚴重時就去處理, 從小就去處理小朋友的特別行為是比較容易, 免得日後定型後才處理, 問題就變大, 再補救郤變得更難, 更根深柢固。

所以, 我很肯定的與大家分享, 早去正視問題是對的, 而且那些訓練也很好, 我覺得無論對有冇問題的小朋友都是好的, 從中我也學到很多教小朋友的方法, 如果我有下一個小朋友, 我亦會用那些訓練, 其實亦只不過是一些遊戲, 只不過現在的家長比以往的更忙於工作及少了朋輩的幫助(大家都生少了小朋友及不太容許小朋友落街玩的結果), 所以現今的小朋友才會出現這麼多問題, 以上都是我對現在與自已小時候生活的觀察及感受。

Chingsma

Thanks for your advice & sharing.

In fact, I share your view that my sister should bring her kid to have the assessment.  But both of my sister and her husband strongly believe the kid is only a kind of difficult child (i.e. in the stage of terrible 2)!  When I first mentioned to her that I found the kid has some 自閉 characteristics, she was very sad and angry, thinking that I have already treated her daughter as 自閉.

Really don't know how to make her understand...Yesterday she even told me that she had decided to stop thinking this and would just concentrate on taking care of the child, until further problems arise after the kid goes to pre-nursery in Aug this year.  Seems to implying that I better not discuss this topic with her again.

JigJig

chingsma,

pls check PM

Chingsma

JigJig,

I've checked my PM.  Thanks for your information and I will check for more about the center you mentioned.  

I will try to find a good chance to relay this advices to my sister.  Thanks very much.

ckf

More information here :

http://maapservices.org/MAAP_Sub_Find_It_-_About_Autism_Aspergers.htm

http://gopher.udel.edu/bkirby/asperger/

annie7711

lingchuling,
   
  hi! How old is your son now? what kinds school  you choose for him? can you reply to me, i had PM  my information to you,Thanks a lot!

Chingsma

ckf, thanks a lot.

Chingsma

JigJig / lingchuling,

can you please share some of your experience what triggered you to bring your kid to have those assessment?  Any particular behaviours or what happended that made you think you should do so?

And, did you have strong "bad feeling" about that and how did you overcome it?

If this is too personal, you may choose not to tell me or you can send to my PM.  In any way, thanks in advance.

sjmama

Dear Chingsma,

我有兩個自閉症的孩子, 大兒的問題出現在兩歲後, 當時他主要是語言遲緩, 後來情緒,社交, 感统等問題逐一浮現.我們當時並無自閉症這方面的知識, 上了K1一個學期後, 學校要求我們做評估,我們也只做了語言的評估, 後來語言治療師告訴我們說大兒可能有其他的問題, 這才做了全面的評估, 但因當時正值SARS, 結果要等到大兒4歲3個月才說他有自閉症傾向, 雖然我們一直給他許多的訓練, 但可惜他的問題仍是很多, 所以6歲前證實是自閉症.

小女的情況卻到2歲半才浮現, 我們雖有大兒的經驗, 但是開始的時候卻很不願意面對, 尤其是她開始時學語言方面沒太大的問題.其實知道孩子是自閉症對父母來說是很難過的事. 不願意面對也是人之常情. 我們也帶孩子參加PLAYGRUOP, 慢慢就會看到她跟別的孩子不一樣.終於她3歲3個月時, 因情緒問題越來越嚴重, 我們才帶了她找專門做評估的私家醫生, 因她當時年紀還小, 醫生只給她PDD(發展遲緩), 但說她極大可能是Asperger(主要是智力,語言遲緩不多)

你的外甥女的情況跟我的小女很相似, 但若你的姊姊暫時不願面對, 其他人也很難勉強, 不過, 根據你所說的特徵#2-5,
她應是有感統問題(sensory integration),這方面需要Occupational Therepist(職業治療師)的跟進. 按我們的OT 所建議, 如今可做的是:
1)多帶她玩千秋(每次至少30分鐘), 或跳彈床(反斗城有售小型的), 這對她的前庭感統會有幫助, 會減少自我刺激(自轉)的行為, 也會幫助平穩情緒,
2)用小刷(大的牙刷也可)每天刷她的雙臂雙腿內外側,對她的觸感有幫助,
3)提前告訴她下一步會發生的事, 減少她對轉變的恐懼, 一般這類的小孩接收視覺資訊較好, 可用圖卡幫助.

也許你可試試跟你的姊姊說感統問題, 這可能要比告訴她自閉症/Asperger容易接受, 事實上孩子還小, 有些問題很快能改善, 等她上了幼稚園, 如有問題, 學校也會告訴父母.

JigJig

Chingsma,

I have noticed my son is different from his peers since around 1 year old. He does not like us to hold his hand to show him how to do things and he would rather explore and try himself.  However, he will try only once or twice and give up easily if he cannot do it.  Also, I notice that he was unable to play with the toys that his peers can play with (e.g. putting circular hoops into a stand, matching shapes toys, matching games) and is also uninterested in a lot of the toys which his peers would show some interest in (e.g. stacking blocks, pretend play).

More remarkably, his lack of eye contact (i.e. he would intentionally avoid eye contact with others), unresponsive to his name being called, lack of communication skills (not just verbal but also body gestures, such as lack of pointing), likes to spin things esp. wheels, and more recently, head banging (softly) when he is bored, pulling his own hair and biting (himself and others) when he is extremely angry (i.e. lack of self-regulation) had given me course for concern.  All these conditions did not develop overnight, but over a course of time and some of these intensified, whilst others lessened even before he started therapy and training.

The trigger for taking him for assesement was when we noticed that his classmates in his playgroup (who are all younger than him) were able to follow the gestures that the teacher showed them on their second class, whilst my son, who had been attending for almost one year, still could not do a lot of it.

As i have always suspected there is a problem with him, the results of the assessment did not hit me so badly initially.  However, once the whole thing sinks in and I realise we may have a tough road ahead, I became very upset and worried.  This is most acute before my son started his therapy and training.  I felt very, very helpless at the time.

I began to feel more hopeful after he started his training classes and the trainer observed and said he is a quick learner and perhaps his problems are more behvioural.  At the same time as commencing formal therapy and training, I also started doing home training with him and his improvement in terms of listening to instructions and concentration span, has improved quite a lot in a short period of time.  I also got a lot of help, enouragement and advice from other BK mothers who are in similar situations as I am.

I have to put in a lot of time and effort for the home training aspect but it is necessary. Seeing my son's improvement is the best reward and gives me great faith, joy and strength.

I am sure all of us in the same situation had been through a period of sadness and inability to face the reality.  But the hard fact is there irrespective of our feelings.  One of the BK mothers reminded me that my sorrow will not help my son's situation but getting myself together to get help and give him help is much more positive and conducive to my son's well being - just bear that in mind!!

Chingsma

Sjmama & JigJig,

Really thanks for your sharing.  I will keep this in record and keep my niece's situation in view.  

Thanks x 100.

lingchuling

我對我小朋友的社交訓練安排, 我就在協康會的健樂會做社交訓練(便宜些),及每天儘量抽時間比他在家樓下與不同年齡的小朋友玩去訓練他的社交能力, 或者參加各區的青少年中心活動, 總之有一些活動是有互動性就可 , 未來我會比我仔參加童子軍, 因他今年只得4歲, 因童軍都是一個要與大家合作的團體, 所以可以給予更多社交訓練

其實, 有時有很多活動是不須要金錢的, 只是你是否肯抽時間陪他們, 重有我準備間中請在樓下玩開的小朋友上我家講故事及玩玩具, 這樣便可增加小朋友之間的社交訓練, 你亦可從中看看自己小朋友有什麼問題, 以及在當中即時教育他與人相處的技巧, 我想即使沒有問題的小朋友亦需要, 因為現今個個都只是生一個或兩個, 所以現今的小朋友已少了很多機會去學習與人相處。

希望能與大家一齊分享