Xu Jiannan synthesized what he had learned now and carefully analyzed Li Yating's condition. First of all, the causes of mental retardation can be divided into several types for a long time. For example, chromosomal abnormalities, chromosome inversion, deletion, translocation, duplication, etc., the most common symptoms are Down syndrome, congenital stupidity. Or because of genetic abnormalities, the activity of enzymes required for the body's metabolism is insufficient or lacking, resulting in inherited metabolic diseases. There are also congenital cranial malformations, maternal infections during pregnancy, or drugs that act on the central nervous system, endocrine system, and anti-tumor drugs. This is why if the mother has a tumor and happens to be pregnant, she can only choose not to take medicine or not to have children. But these reasons have been ruled out one by one. The only possibility is complications during childbirth, where the umbilical cord is wrapped around the neck for too long, causing head damage and hypoxia in the child. This kind of accident does not want to happen, and it cannot be reversed if it happens. Xu Jiannan told Li Yating's mother about this analysis, wanting her not to get along with her anymore. She had been blaming herself for the guilt that it was the responsibility of both of them to give birth to the child and cause her the pain she is now. But they probably don't know what they're doing wrong...... Therefore, Xu Jiannan carefully explained to her in the way of elimination, letting her know that the fault was not her, nor was it her husband.

Li Yating's mother listened to Xu Jianan's words, her mood eased a lot, she looked at her daughter who was playing with paper and pen not far from the office, and asked sadly, "Doctor Xu...... And what is her autism? Does it have anything to do with the accident I had when I gave birth to her?"

Xu Jiannan said: "The cause of autism is hereditary and has obvious effects, but your husband and wife do not have a history of this kind of disease. There are also viral infections, perinatal factors, birth trauma, intrauterine asphyxia, or dysfunction of neuroendocrine and neurotransmitters, to name a few. In the current situation, I recommend treating Autism from Yating first, because after all, this common cause of physiology and psychology is easier than congenital physiological diseases. Moreover, you can only give her the next rehabilitation, special education and treatment if she can accept you. If her lack of listening and not speaking is getting worse now, it will be more difficult to treat the mental retardation. ”

Looking at Yating's mother's painful expression, Xu Jiannan had no choice but to say: "The child is too young, and I can't ask about her condition through her current state." So it's all up to you, and you have to make yourself strong before we can continue. The next thing I need to know is likely to make you sad or miserable, but there is no way, if we want to help the child, we have to know what she is doing, do you say?"

Xu Jianan's persuasion was obviously very useful, Li Yating's mother said sorry again and again, wiped her tears, took a deep breath and said: "I'm sorry, it's me who is not good, I can't even control my emotions, how can I help my children...... Dr. Xu, I'm sorry, please forgive me for the state I just had...... Let's get started, what do you want to know?"

Xu Jianan looked at the young mother in front of her, forcing herself to be strong, and couldn't help but feel sad, so she had to smile and say: "It's okay, Yating can have parents who care about her like you, she is very lucky, everything will be fine." Tell me about her at home, is she resisting you?"

In general, children with autism are unable to establish normal interpersonal relationships with others, they do not make eye contact, have no expressions, lack expressions or gestures that expect hugs and caresses from their parents or others, and even refuse hugs and caresses from their parents, let alone others. Patients do not show pleasure and satisfaction when they are loved by others. They can't tell the difference between intimacy and alienation, treat their relatives the same way as they treat strangers, and can't establish attachment relationships with their parents.

But fortunately, Li Yating's situation does not seem to be so bad, her mother recalls Yating in daily life and says: "My daughter... Usually when I'm at home, I just don't talk or look at people. She won't come and stick to us, but if I have to hug her, she won't get angry or refuse, she just ...... Expressionless, let me hold it. Actually, Dr. Xu, that feeling ...... It saddens me more than she rejects. She wouldn't look at me, her eyes were blank and she was looking elsewhere, and this reaction made me feel like my hug was a burden and torture for her. So every time at this time, I let her go and didn't want her to feel uncomfortable. ”

"And what happens when you let go?" asked Xu Jianan.

Yating's mother smiled bitterly and said, "She will indifferently turn away and continue to play with her toys and indulge in her own world." They won't look at me more, and they won't feel reluctant. ”

"Was this already obvious in kindergarten?" asked Xu Jianan.

Yating's mother replied: "At that time, we all just thought that this child was too quiet, but because she was small, she was praised by the kindergarten teacher for being very well-behaved, but she was not very gregarious. In kindergarten, she liked to be alone, not to play with her friends, and she had no interest in watching other children play, let alone want to participate. Even when she is forced to play with other children, she will not take the initiative to reach out to others, nor will she devote herself to group activities. Now that I think about it, I was just too ignorant. I didn't think much about it at that time, I just thought that there were many children who didn't like to go to kindergarten and school, and I even thought that it might be because she was reluctant to go home and me, so she would show that state in kindergarten. ”

Xu Jiannan nodded, saying that she could understand Yating's mother's thoughts, after all, autism is a very distant and unfamiliar disease for most ordinary families. In the early years, there were many children with autism, and in the absence of mental health institutions, parents did not know that the child had a serious mental illness, and only regarded the child as an introvert. Modern medical care has gradually matured and developed, and psychology and spirit have gradually begun to receive attention, and only then have people slowly understood autism, depression and other diseases, and people have begun to realize that they or the people around them are "psychologically sick".

According to Yating's mother, she really began to feel that it was not normal for her child to be like this, or because Yating's language and hearing skills were getting worse and worse, and she thought that the child had hearing and ear problems, so she went to see a doctor. For this reason, she is still blaming herself for not finding out about her child's abnormality earlier.

In fact, language development lags significantly behind that of children of the same age, which is the main reason why most small patients are present. Generally, at the age of two or three, they are not able to speak meaningful words and the simplest sentences, and they are unable and unwilling to use language for interpersonal communication and communication. At the age of four or five, he began to speak simple words, but he still didn't use pronouns, he didn't care at all about what others said, and he didn't care if anyone was listening when he spoke, as if he was talking to himself. When speaking, the sentences are monotonous and flat, lacking intonation and emotion, and rarely look at the other person's gaze.

Yating's mother said: "I have always thought that the child is quite smart, but he is too introverted and does not like to talk. Her father always persuaded me, saying that there is nothing wrong with girls being quiet, good girls, quiet and quiet. The reason why we didn't think it was too serious was because even though my daughter didn't like to talk, she would say, like mom and dad, that calling out was no different from other children, just that there wasn't much emotion...... But she knows how to point her finger at what she needs, and when asked her, she clearly nods and shakes her head. The most important thing is that Yating's memory of calendars, timetables, car license plate numbers in the parking lot downstairs of the community is very, very good! We even thought that our daughter was a genius at the time, she was still so young, she remembered it so well! But it was very ...... We found that she seemed to be able to only remember what she wanted to remember...... She couldn't remember anything else we told her. Even when she just finished talking to her and asked her again, she would show a blank face. ”

Yating's mother looked at Xu Jiannan very confused, and Xu Jiannan explained: "Actually, this is normal. Seventy or eighty percent of children with autism have varying degrees of mental retardation. In the intelligence test, the results of the problems completed by using mechanical memory and spatial vision ability are better, while the problems that rely on the ability to grasp meaning will be poor. Due to the compensatory mechanism, there are many patients who will have good mechanical memory and spatial vision. The gap between a patient's best and worst abilities is very large. Generally speaking, even if it is the best ability, it should be lower than most children of the same age, Yating belongs to high-functioning autism, you should be more confident in this, as long as the autism gradually improves, the child's intelligence and spirit will also begin to gradually improve. But...... I have to tell you the truth, the process is not easy, and it is not too fast, as parents, you have to be mentally prepared......"

Yating's mother was very excited when she heard this, her eyes suddenly brightened, and then she asked Xu Jianan: "Doctor Xu, is it really? Can my daughter still get better? I don't ask her how smart she is, as long as she is close to a normal child! In this way, I don't have to worry about when I die...... She was bullied and lonely......"