"Children from two years old are recommended haloperidol"

The Ministry of Health is preparing to accept “patriotic” recommendations for children with autism. Doctors and parents warn - these are outdated and dangerous tips

The community of parents of children with an autistic spectrum disorder (RAS) and advanced Russian doctors hit the alarm. In their opinion, in the near future, children with RAS in Russia will be treated unproven, backward and even dangerous methods. The reason for the unrest was the publication of the project of new clinical recommendations for the treatment of children with RAS, which the Ministry of Health submitted for universal discussion.

The “New newspaper Europe” was versed in why doctors who adhere to the principles of evidence -based medicine, and also how the adoption of new recommendations will affect the life of a family raising a child with RAS, are sorting out the proposed recommendations.

"Patriotism" in psychiatry

What is autism

In a modern medical approach, autism (an autistic spectrum disorder) is considered not as a disease, but as a condition. This is a disorder that remains throughout a person’s life.

The autistic spectrum has a huge number of manifestations. If people with low -functional autism often have intellectual disorders, as well as problems with self -care, then among high -functional carriers of races we see, for example, Ilona Mask and Stanley Kubrick.

All people with autism are characterized by two groups of features: violations in the field of social interaction and communication, as well as a narrow focus of interest and repeating behavior.

The reasons for the occurrence of races have not been fully studied, but the main one today is the theory of the genetic nature of autism.

Information that the Ministry of Health is preparing to accept some bad recommendations for children with races, one of the first
reported
The Anton is nearby fund, which helps adults with autism. The Fund drew attention to the fact that, among other things, these recommendations were the statements that in Russia “Autism is hyperdiagnost”, that about 75% of children with races have intelligence violations, that the main evidence -based behavioral tools of correction “in some cases are not only useless, but also harmful”, well, the most noteworthy: “Children with autistic spectrum disorders are recommended with the purpose of correcting aggression. haloperidol ".

The fund urged all those who are not indifferent to write response on the merits to the draft recommendations published by the Ministry of Health in order to prevent the adoption of the document.

This news provoked a whole wave of sharp comments.

“On the eve of World Wide Day of Autism (
Which is annually marked on April 2.
-
Approx. Ed.
) In Russia, they plan to approve clinical recommendations for the races of very dubious quality, ” -
wrote
In his telegram channel, Russian pediatrician Sergei Botri, dad of the child with races.

“The Ministry of Health had new impressive ideas about how to make our life with you even more independent from the West,” said psycho -activist Sasha Old Age on her Facebook page.

"
This is very bad. And so it is customary to feed children with a races with neuroleptics that is unknown why. Now all the corrective approaches and practices of inclusion will be declared undesirable (thanks for not extremist). Dense, illiterate, smug - that’s on whose street the holiday is now. Finally, they waited and will be everywhere and everywhere “patriotism” - forcibly leading practices to the level of their competence - that is, to the area of ​​the baseboard. Destroying everything that has been worked out over the years - but it is incomprehensible to them.

-
Added
The famous psychologist Lyudmila Petranovskaya.

Specialists working in the field of evidence -based psychiatry and modern correctional pedagogy began to refute the theses of new recommendations. In particular, the assertion that the races in our country is “hyperdiagnosis” was easily broken about a specific fact: according to WHO statistics, the prevalence of this state around the world ranges in the region of 1%, while in Russia the number of officially identified cases of autism is significantly lower.

The statement of almost universal diagnosis in children with races also of intellectual deficiency caused doubts about the competence of the authors of recommendations. “In 2023, the studies showed that among all children with RAS only 37.9% had concomitant mental retardation,” the St. Petersburg psychiatrist Stepan Krasnoshchekov said in his telegram channel.

Well, in general, they discouraged all the allegations that the modern behavioral methods of intervention, which have a colossal evidence base that are successfully used throughout the world, "are not only useless, but also harmful." But for the treatment of races, haloperidol is useful, moreover, from the age of two.

“This contradicts the principles of the humanity of medicine and deprives parents of the right to choose,” a group of behavioral analysts and parents of children with races wrote in their feedback on clinical recommendations. “The choice of a progressive community lies in the field of evidence -based methods for the development of communication and the life competencies of children.”

“In some cases, haloperidol can be useful, and in some cases not only useless, but also harmful. In some cases, a mobile phone/car/TV/psychiatrist can be useful, and in some cases not only useless, but also harmful, ”the psychiatrist of the Krasnoshchekov was already frankly trolling.

How are the “recommendations” of the Ministry of Health differ from the present?

Contrary to the deceptive name, the “Recommendations of the Ministry of Health” is not a recommendation at all, but a mandatory document that regulates the diagnosis of the disease and its subsequent treatment.

The Ministry of Health reviews recommendations for the treatment of various nosologies about once every three years. It is assumed that such a frequency allows our medicine to keep up with progress.

Clinical recommendations are developing a professional medical community, after which the Ministry of Health makes these recommendations for public discussion. After listening to comments and, if necessary, making adjustments, he approves these recommendations.

The last time clinical recommendations for children with RAS in our country were adopted in 2020. As now, then there was a clash of two different projects. One of them was proposed by the Russian Society of Psychiatrists (ROP), and the other-the Association of Psychiatrists and Psychologists for Scientific and Building Practice (APSIP). ROP, of course, the structure is more systemic, the Grands of state psychiatry, the head physicians of regional psychiatric clinics and PNI, employees of various research institutes are included there. While APSIP is a young organization that mainly united private specialists who insist on revising many outdated dogmas of domestic psychiatry.

At that time, the fundamental discrepancy between the two proposed recommendations were the following this: ROP insisted on the priority of drug correction with “verified drugs”, and the APSIP spoke about the preference of behavioral interventions.

Then, in 2020, the concept of APSIP “won”.

This year, the Association of Psychiatrists and Psychologists updated the previous version of its recommendations, brought it into line with new knowledge. However, during the next review, the Ministry of Health took on the discussion of the option proposed by ROP, thereby making it clear that it was he who is prepared for the statement.

"Hand of the West" or savings?

If desired, in the new project, you can really see the “following the anti-Western trend”: most methods tied to applied behavior analysis (classic Ava-therapy, PFA-ton, Denveric model, Leap, Teacch), the invention of the Anglo-Saxon world. And as the basic values ​​of all these methods, respect for the personality of the child with races and soft, non -violent teaching his vital skills unconditionally understands. Compared to the post -Soviet approach, which is very characteristic of Russian classical psychiatry, such a tolerant attitude to the dissimilarity of children with autism on “norms” seems simply defiant.

Respect for the personality is clearly not what Russia will consolidate in official documents.

However, the parents of autistic children quickly saw in the project of clinical recommendations and the second message - purely mercantile.

- Even today, officially diagnosed the “autism” to a child in Russia is a very big adventure! - says Moskvich Sergey, raising his son with races. -This is due to the fact that autism is the basis for the design of disability, but the state does not really want to fork out on benefits and pensions, so doctors put anything, but not autism. Especially in the regions. Yes, even in Moscow, in order to put autism, you need to go through a hundred circles of hell. Everywhere in the queue to the second coming. As a result, we, for example, went through a commission in the center of Sukhareva (
Scientific and practical center of mental health of children and adolescents.
-
Approx. Ed.
) on a paid basis, for 11 thousand rubles. But this path is not for all parents. But money is not the most important thing that you lose, do not know the diagnosis yet. The most important thing is the time. In time, making the correct diagnosis of autism and start working with it - this means giving your child a chance for socialization.

- Children with autism are very different, and everyone has different prospects. But what is the same for everyone: the sooner you start, the more you achieve, ”says Maria Podolsk, a resident of the Podolsk near Moscow. -It is proved that regular and long-term AVA therapy classes give a good result. Here mine is engaged in three days a week for two hours. We have huge successes, but it is so expensive! We used to go to Moscow, to a large, very famous Ava Center. One hour there cost 3600 rubles. Now we go to the place of cheaper, but the amount is still in the amount of the amount! The rehabilitation of the child is now the main article of the expenses of our family budget.

Maria believes that if AVA therapy and other modern correction methods are included in clinical recommendations, then the state will have to provide them with patients in one or another volume. And the budget is not ready to take such a load. It is better to reduce the number of patients, indicating that in Russia it is “ranging”, and upon reaching 18 years of age, to put schizophrenia to these children, followed by the prospect of sending to PNI.

“The life of the Autist’s parent is difficult and non -casual,” Maria is ironic. - It is necessary to plow, plow and plow. Many sell apartments or other property, because it is a hope to pull the child into some relative norm. We know very well that our society is intolerant of people with features. Especially with mental. Therefore, the better the child mimifies under this society, the more happy his prospect is seen.