BY CRISTINA RUIZ. Doctor, mother, ASPAU member and good friend.
This is the extract part of the talk we gave medical students the other day. My intention as mother and doctor is not to repeat the mistakes of the past and present medicine. They are the immediate future, and understanding the information generated. Hope you like it (of course, like everything, is much improved)
1.-Stay tuned to the warning signs that indicate that my neurological development is not adequate. You can detect abnormalities even after six months (but usually you do from the 18). Ask my parents for my game, my relationship with my peers, by my attitude ... you know the M-CHAT and have a copy handy if you need pass it along to my parents. Spend five minutes short of your valuable time, because of your early suspicion may depend on my future. Also, take an interest if I have my brothers, the rate of autism is much higher in them (up to 50 times more than in the rest of the population)
2.-Listen to my parents if I go for consultation it is they who see that something is not working properly. Do not think that they're hysterical (especially if they are first-timers because they are more vulnerable.) They are best know me, and in fact 80% of cases they are the first to realize). Take the trouble to investigate briefly if they could be right.
3.-If a founded suspicion that I can have an autistic spectrum disorder, my parents informed your suspicion. Do it in a firm but understanding. It is necessary to alert not alarm. Do not use the word autism, say that it seems that I have no communication and social development appropriate for my age. Derívame soon to specialized care for further investigation. The diagnosis and the tests done takes time (this can be up to one year delay), and it runs against me.
4 .- Do not judge my parents. There will always be able to understand / accept the problem. Even so, you must be firm. Be positive with the message that you give to the process of adaptation / acceptance to be effective. Also depend on your attitude about my future. It is important that advised to seek other parents in your situation, or to contact with parents' associations, may assist in these first difficult time for everyone.
5.-Do not make me wait long in the waiting room, especially if crowded. My senses are often saturated and will be much more difficult then come to me. You know I can have sensory issues: the strong light, loud noises and crowds of people especially may affect me. I need my personal space. Understand that for me this is a new situation and I have trouble adapting to it. I need your help. In addition, a long waiting also increases the stress of my parents because they can not always be calm, and then they too are in a position to help. For less than one year, our community was the notion of preferential treatment, as indicated in the top right of the health card as AA. This means that I must address a priority, and that if I go into hospital or go into emergency, make sure there is always someone with me. Obviously my parents did not use this resource unless they are necessary. Is problem as is obvious in pediatric neurology consultation, where many children we can have this card
addition, my parents have told me orally or by means of pictographs (pictures that represent a reality or concept), which we do at the doctor. This is what is known as social history. The anticipation of what will happen helps me understand and accept the process.
6.-When addressing me, use short sentences and direct. Simple, no pun intended. Keep a calm but the situation also may be new to you. Use visual aids (pictograms) if you can. If you're not, ask my parents if they can get them for you again, or for another child. Sure do love it. And if they do not the can provide, contact the parents' associations so that you get them. Also used distractor anything that might catch my attention and calm down: for example a pompero ... anyway, my parents certainly go for consultation with one of my favorite objects (a doll, a Nintendo ...). Use it.
lean on my parents or caregivers to make me understand what you want. They are the foremost experts on me. Still, you should know that this is not always possible, get frustrated, just do the best you can.
If you can, refuérzame positively to finish with stickers, jelly beans ... or if you're not just saying that I have done very well, with a big smile.
7.-Rate
always stress / benefit of performing a procedure that involves physical contact or manipulation, I can live it as an aggression. My response to pain is not always what you expect, I can be hypo-or hypersensitive to it. Adapt the procedure to me if possible, and again lean on my parents (for example, can catch him and colocármelo fonen where you say). Think if the information is always going to get with the procedure is necessary to stress you're going to lead. But if necessary, so do it as quickly as possible, do not stop.
8.-It is possible that in the office, my parents tell you about alternative therapies: Diet, relation to vaccines or environmental toxins ... your obligation as a physician is to explain that this type of therapy has no scientific basis, which there is no single medical journal that support. A man named Wakefield, MD, published in 1988 in The Lancet a link between the mercury preservative in vaccines (thimerosal) and autism. In 2004, the magazine placed the item in quarantine and retired in 2010. The British Medical Journal referred to the cited article as deliberate fraud. Ie not exite no relationship between vaccines and autism, in fact has been to remove thimerosal from the same does not prevent the incidence continues to increase, and in countries where it was never used is the same. Recommend that take into account only the recommended interventions by professionals. But although it sounds paradoxical, if they insist on following these therapies, accept it. Your duty is only to inform, advise, but not impose. But the decision is theirs. The vaccination schedule is not mandatory, it is authority of parents decide whether their children are vaccinated or not, and restrictive diets, although not highly recommended, probably not cause significant damage (not the drugs that often give me are harmless). Autism is a complex, sometimes difficult to understand for people who are not stuck in this area, and parents of children with autism are trying to find what may be best for us, but not always right. They will need for health problems, and it is important for them to feel accepted, even when not share it.
9 .- Do not have preconceived ideas about me. I'm not autistic, I am a child with the problems of children I have also just autism. Each of us is different (like all people). Do not think that we are not loving, you're probably going to surprise positively, let us do it. If you have questions about me, my parents will clarifications.
10.-Finally, I ask you to be humble. The physician's role in my process is relatively low. Follow me on routine health examinations and solve my medical problems associated. But the approach of my disorder is multidisciplinary: it involved psychologists, therapists, educators, teachers of pedagogy or PT treatment ... they are going to follow me in my daily life. Autism is a puzzle in which all are parts If you are interested in my progress you can contact them whenever you want, and perhaps find that my universe is wider than you think.
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