Ivanova Violetta Andreevna, Head of the Department of Medical Rehabilitation of the Children’s Rehabilitation and Restoration Center of the Federal Scientific Center for Rehabilitation of the Disabled named after G.A. Albrecht, 50 Bestuzhevskaya Street, 195067 Saint-Petersburg, Russian Federation. Tel.: 89811888202, e-mail: email@example.com
Kormushkina Elizaveta Aleksandrovna, psychiatrist, psychotherapist of the Children’s Rehabilitation and Restoration Center of the Federal Scientific Center for Rehabilitation of the Disabled named after G.A. Albrecht, 50 Bestuzhevskaya Street, 195067 Saint-Petersburg, Russian Federation.
In the heading: Original researches
Year: 2021 Volume: 3 Journal number: 1
Article type: scientific and practical
UDC: 612.81: 159.922.7
Introduction. In recent years, the number of children with speech disorders, social communication and limited forms of behavior meeting the diagnostic criteria for autism spectrum disorders has been steadily growing. To correct these disorders, pedagogical methods based on applied behavior analysis are successfully used. However, the clinical manifestations of autism spectrum disorders are based on an unspecified neurobiological deficit, which can be caused by a large number of etiopathogenetic factors. This necessitates a comprehensive approach to the rehabilitation of children with autism spectrum disorders. In the search for non-drug means of improving adaptive self-regulation in children with autism spectrum disorders, a promising direction is the study of acoustic exposure with external feedback on the parameters of the bioelectric activity of the brain, which does not require active participation from the patient and does not imply the performance of cognitive and volitional tasks.
Aim. To study the effectiveness and safety of the complex use of the bioacoustic correction method in the rehabilitation program for children with autism spectrum disorders. To determine the feasibility of using this method in a comprehensive rehabilitation program for children with autism spectrum disorders.
Materials and methods. The study was conducted on the basis of the Children’s Rehabilitation Center named after G.A. Albrecht. The study involved 24 children, 22 boys and 2 girls, with speech and communication impairments that met the diagnostic criteria for autism spectrum disorders. The average age of the children was 4.8 years. Сhildren received 15 sessions of acoustic EEG-dependent stimulation using the Synchro-S computer complex (manufactured by SynCor LLC, St. Petersburg, Russia). The listening procedure lasted 20 minutes. The subjects were in a horizontal position in a darkened soundproof room. Before the start of the course and 1.5 months after its completion, all children underwent a routine electroencephalographic study. The sound volume during stimulation was chosen comfortable for each subject and averaged 60±10 dB. The sounds were presented binaurally. Drug therapy was not carried out during the course.
Results. A questionnaire survey of the parents of the subjects 1.5 months after the course revealed a subjective improvement in the psychoemotional state of the child in 45.76 % of cases, improved mood in 29.12 %, improved sleep in 16.68 % and appetite in 4.17 %. Stimulating and restorative effect in terms of increasing speech activity, expanding active vocabulary in 62.4 % of cases, increasing active attention in 74.88 %, cognitive interest in 49.92 % and learning ability in 37.44 %. The lack of effect from the course was noted in 12.48 % of children. On the background of the course, 1 child had the appearance of enuresis, which is 4.17 %. This condition was stopped without treatment within a month after the end of the last procedure. Negative effects in terms of a temporary increase in undesirable behavior were observed in 5 children, which amounted to 20.8 %. Mood instability against the background of the course was noted in 9 children, which amounted to 37.44 %. As a result of a clinical study conducted after the end of the course by a neurologist and psychiatrist, to assess the child›s ability to navigate in the environment, space and time, the ability to carry out mental operations (analysis, synthesis, establishment of cause-and-effect relationships), the general level of knowledge and ideas about the world, the degree of severity of symptoms of autism, existing concomitant mental and neurological disorders, a pronounced change in the state was not noted.
Also, there was no significant effect on the severity of stereotyped behavior. A repeated electroencephalographic study did not reveal significant changes in the parameters of the bioelectrical activity of the brain in dynamics for the better or for the worse. Also, none of the studies revealed the appearance of any pathological or paroxysmal activity.
Summary. The experience of studying the method of bioacoustic correction has shown the simplicity, availability and safety of its use in the complex rehabilitation of young children with impaired cognitive and emotional-volitional spheres. According to the assessment of the majority of parents, the method showed its unconditional effectiveness in terms of improving speech production and cognitive interest. Therefore, it is optimally suited for use in pediatric patients and can be used in the development of an optimal complex of rehabilitation therapy and rehabilitation measures in children with autism spectrum disorders.
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