Autismo

L’autismo è un disturbo di tipo neuro-psichiatrico, che riguarda la funzione cerebrale del paziente il quale manifesta un tipico comportamento riconoscibile per una scarsa capacità di integrazione relazionale ed una altrettanto scarsa capacità di comunicazione con il mondo esterno: le persone affette da questa patologia sono solite ritirarsi in un mondo interiore, anche se queste manifestazioni possono avere un grado ed una intensità variabili.

AutismoQuesta patologia rientra nella categoria dei disturbi pervasivi dello sviluppo: si ricordano, oltre all’autismo, anche altre sindromi come la Sindrome di Asperger e la Sindrome di Rett.

L’autismo si può collegare a cause organiche specifiche e diverse tra loro, ma in generale si presenta quasi sempre con un particolare modo di comportarsi e di costruire una propria realtà. I sintomi più evidenti di questo disturbo riguardano per lo più l’incapacità del paziente di comunicare con gli altri secondo criteri considerati normali; inoltre, il paziente affetto da questo disturbo può avere un comportamento aggressivo ed autolesionista, oltre ad essere quasi o del tutto insensibile al dolore ed alla presenza del pericolo.

Storia dell’autismo: quando fu riconosciuto come patologia

La prima volta che si iniziò a parlare di autismo fu il 1801, con Jean Itard che aveva condotto in quegli anni una ricerca sul bambino selvaggio classificandone i comportamenti tipici.

Circa cento anni dopo, fu la volta di Eugen Bleuler, che, studiando i sintomi dell’autismo e le sue manifestazioni tipiche, lo collegò al disturbo della schizofrenia. Fu nel 1943 che questa patologia ricevette una descrizione più precisa sulle varie tipologie e manifestazioni della malattia, con Leo Kanner; qualche anno dopo, Hans Asperger, dedicò i suoi studi e le sue ricerche ad un altro tipo di autismo che, pur avendo delle caratteristiche simili, se ne differenziava per alcuni aspetti.

Come si presenta l’autismo e quali sono i sintomi della patologia

Come abbiamo anticipato, i sintomi generali dell’autismo si riconoscono soprattutto nella difficoltà di interazione sociale: l’individuo affetto dall’autismo fa fatica ad interagire ed a relazionarsi con gli altri nella maniera ‘normale’, ed è spesso portato ad isolarsi dal mondo esterno evitando ed in alcuni casi addirittura rifiutando il contatto.

La sintomatologia tipica dell’autismo, quindi, si caratterizza con:

  • Rifiuto del contatto con altre persone, sia a livello semplice (con lo sguardo) sia nella maniera più complessa (con la voce).
  • Isolamento dal mondo circostante e tendenza a rifugiarsi in un proprio mondo interiore.
  • Disturbi del linguaggio: molto spesso, il paziente affetto da autismo non parla, oppure parla molto poco o addirittura in maniera incomprensibile. Talvolta sembra che non si rivolga a nessuno in particolare, ma che parli ‘da solo’.
  • Incapacità di interazione con gli altri.
  • Ripetizione di rituali, comportamenti ripetuti e reiterati nel tempo.
  • Difficoltà ad accettare i cambiamenti e tendenza a rifugiarsi in un mondo ‘statico’, che in qualche modo gli garantisce sicurezza e serenità. È caratteristico di alcuni pazienti affetti da autismo l’ordine: per diversi pazienti, è importante che gli oggetti rimangano al loro posto e non vengono spostati. Questo ordine garantisce sicurezza e stabilità, e nel momento in cui si verifica una mancanza di quest’ordine o semplicemente alcuni oggetti vengono spostati, la persona ha una reazione immediata di inquietudine.
  • Ecolalia: l’ecolalia è la ripetizione (o imitazione) di frasi pronunciate da altri. Essa è un sintomo caratteristico del paziente affetto da autismo, e può presentarsi in forma immediata (si ha quando il paziente ripete immediatamente dopo l’ascolto frasi o parole pronunciate) oppure ecolalia differita. Quest’ultima si ha quando la ripetizione si verifica a distanza di tempo.

Molti pazienti mostrano, oltre ai tipici problemi di interazione sociale e difficoltà nella comunicazione verbale e non verbale, anche problemi di ansia, difficoltà a prendere sonno, inquietudine.

Bisogna comunque sottolineare che la gravità di questi sintomi è variabile, e che molti di essi possono migliorare, sia con il passare dell’età (specialmente se il ritardo mentale è assente), sia grazie ad un corretto trattamento terapeutico.

…Ma non bisogna ridurre tutto alla sola sintomatologia

Come è facile capire, anche se è facile riconoscere nel soggetto affetto da autismo la presenza dei sintomi dei quali abbiamo parlato, ciò non significa che necessariamente questa sintomatologia sia sempre ricorrente e sia sempre indicativa dal punto di vista diagnostico.

AutismoDire che tutti i pazienti autistici presentano gli stessi sintomi, e dire in particolare che questi sintomi siano la sola ed unica indicazione della presenza di patologia sarebbe troppo riduttivo. Può capitare di avere uno o più di questi sintomi senza per forza essere un soggetto autistico: in questo senso, è abbastanza facile comprendere che anche se è importante valutare la sintomatologia, essa da sola non può rappresentare una chiave di lettura efficace.

Molto spesso, ciò che viene considerato come ‘sintomo’ dell’autismo, può essere semplicemente un chiaro segno di introversione del paziente.

Inoltre, ciò che spesso non si dice – ma che andrebbe sottolineato – in merito all’autismo, è che esso non è una deficienza: e ne è la prova il fatto che ogni soggetto reagisce in modo diverso al trattamento effettuato, spesso di tipo cognitivo-comportamentale e rieducativo, e che ognuno di questi pazienti va trattato in maniera individuale, valutando anche diversi fattori.

Cause dell’autismo

Secondo le ricerche più importanti, l’autismo ha cause organiche e fisiologiche. Un paziente può essere affetto da autismo per problemi di tipo cerebrale, genetico, ma gli studi più frequenti associano l’autismo anche ad altri disturbi, come ad esempio intolleranze alimentari senza sintomo.

In ogni caso non vi sono, allo stato attuale dei fatti, delle ricerche che abbiano dato certezze sulle effettive cause scientifiche dell’autismo.

Secondo Kanner, uno degli studiosi che maggiormente si occupò di questa patologia, l’autismo è da considerarsi come un disturbo innato, ma che può essere determinato anche da caratteristiche genetiche: in famiglie in cui vi erano stati soggetti affetti da autismo, era probabile, secondo Kanner, che si sviluppasse una maggiore possibilità di insorgenza della patologia.

Secondo studi più recenti, i fattori possono essere sia ereditari che non ereditari: giocano comunque un ruolo importante, oltre al carattere genetico, anche la presenza di elementi ambientali.

Trattamento dell’autismo

L’autismo non è una patologia di semplice trattamento. Infatti, non è possibile identificare e dare indicazioni in merito ad un tratta mento che sia specifico ed esclusivo, perché l’autismo va trattato a seconda della variabilità, del grado e della complessità dei sintomi.

Trattamento AutismoPertanto, una volta diagnosticato, è importante intervenire sull’autismo con un percorso terapeutico preciso, che abbia tenuto in considerazione una serie di elementi importanti.

In ogni caso, i trattamenti più diffusi sono di tipo farmacologico e di tipo comportamentale, ed il loro obiettivo consiste da un lato nel rendere la sintomatologia meno evidente e problematica soprattutto nel soggetto in cui la patologia è particolarmente grave. Dall’altro lato, gli interventi terapeutici per questa patologia sono volti all’arricchimento dell’interazione sociale e della comunicazione, che rappresentano alcuni dei punti fondamentali di interesse nel paziente affetto da autismo.

Il percorso terapeutico deve essere valutato dallo specialista solo dopo la diagnosi e la valutazione della gravità dei sintomi, ma è comunque molto importante che vi sia un coinvolgimento attivo da parte dei genitori e del contesto sociale in cui il paziente vive.

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