Zusammenfassung
Autismus ist eine angeborene und/oder früh im Kindesalter manifeste tiefgreifende Entwicklungsstörung, für deren Erkennung der Ausschluss einer relevanten Hörstörung eine große Bedeutung hat. Autistische Kinder zeigen ein charakteristisches Muster von sozialen, kommunikativen und stereotypen, repetitiven Verhaltensweisen. Die Störung persistiert ins hohe Erwachsenenalter, eine kausale Behandlung ist bis heute nicht möglich. Frühkindlicher und atypischer Autismus gehen mit schwerer sprachlicher und nonverbaler Kommunikationsstörung neben Verhaltensstereotypien und Veränderungsangst einher; häufig besteht eine geistige Behinderung. Bei Kindern mit einem Asperger-Syndrom ist eine Spracherwerbsstörung nicht typisch. Wenn sich eine Hörstörung als Ursache von Kommunikations- respektive Sprachentwicklungsproblemen speziell bei Klein- und Kleinstkindern nicht bestätigt und außerdem durch reine Entwicklungsverzögerung nicht erklärliche Verhaltenspathologika beschrieben werden, sollten HNO-Ärzte differenzialdiagnostisch an eine autistische Störung denken. Dieser Beitrag stellt die aktuelle Diagnostik und Therapie vor.
Abstract
Autism is a behavioural syndrome, present from early life and defined by deficient social interaction, language and communication, and play. Variations in symptomatology and in prognosis among characteristic persons display a variety of other signs such as attention deficits, mental retardation and seizures that are not specific to autism and that denote dysfunction in other brain systems. Its aetiology is unknown in the vast majority of cases. There is a small minority of persons in whom autism has a known aetiology, such as fragile X chromosome abnormality, congenital rubella, tuberous sclerosis and a variety of structural abnormalities and metabolic diseases of the brain. A causal treatment is so far not possible, and there remains a regrettable lack of evaluated treatment standards. Prognosis depends on many factors, most notably the limiting factor provided by the severity of the underlying brain dysfunction and its consequences for communication, cognition and other behaviour. ENT specialists are confronted with children, adolescents and even adults in whom autistic disease has already been diagnosed in the course of investigations/treatment. If the suspicion of hearing impairment as the cause of problems in daily life is not confirmed in a patient not hitherto known to have autism ENT specialists should also consider autism in the differential diagnosis. In this report the diagnostic and therapeutic strategies currently applied for autism and its importance for ENT specialists are presented.
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Schwemmle, C., Schwemmle, U. & Ptok, M. Autistische Kommunikationsstörungen. HNO 56, 169–176 (2008). https://doi.org/10.1007/s00106-007-1638-1
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DOI: https://doi.org/10.1007/s00106-007-1638-1