Yiziphi izindlela zokwelapha ezikhona ze-Autism?
Context:Izindlela zokwelapha i-autism zihlanganisa izindlela zokwelapha ezihlukahlukene ezisiza abantu abane-autism, noma imikhaya yabo. Izindlela ezinjalo zokwelapha zifuna nokwandisa ukuzimela okusebenzayo kubantu abane-autism. Izindlela zokwelapha eziningi ezithengiselwa abantu abane-autism kanye/noma abazali babo zithi zinemiphumela engakaze isekelwe yi-Level of Research (LOE) Level 1 (izinga eliphakeme kakhulu elinikezwe ngokusekelwe kwikhwalithi yezindlela zokuklama, ubuqiniso, nokusetshenziswa ekunakekelweni kweziguli). Ucwaningo lwe-Level 1 lubandakanya ubufakazi obuvela ekubuyekezweni okuhleliwe noma ekuhlaziyweni kwe-meta yazo zonke i-RCT ezifanele (isivivinyo esilawulwa ngokungahleliwe) noma imihlahlandlela yokusebenza yokwelashwa esekelwe ebufakazini esekelwe ekubuyekezweni okuhleliwe kwama-RCT noma ama-RCT amathathu noma ngaphezulu asezingeni elifanele anemiphumela efanayo.   I-autism iyinhlobo yezinzwa ebonakala ngokuhluka okuzwelayo nokuxhumana, uma kuqhathaniswa nabantu abane-neurotypical kanye ne-allistic. Ayikho kulezi zindlela zokwelapha eziqeda i-autism kumuntu, ingasaphathwa eyokuba nokuphila okuphezulu. Izingane ezine-autism zikhula zibe abantu abadala abane-autism abasengozini yokushiswa kanye ne-post-traumatic stress disorder (PTSD) ebangelwa ebuntwaneni nasebusheni, okuvame ukunganakwa yilabo ababeka phambili ukuqedwa kwe-autism kunenhlalakahle ejwayelekile yabantu abane-autism. Ngokuvamile ukwelashwa kunqunywa ngokwezidingo zomuntu. Izindlela zokwelapha zihlukaniswa zibe izigaba ezimbili eziyinhloko: izindlela zokungenelela kwezemfundo nokuphathwa kwezokwelapha. Ukuqeqeshwa nokusekelwa kunikezwa nasemikhayeni yalabo abatholakele benezifo ezihlobene ne-autism spectrum disorders (ASDs)   Izifundo zokungenelela zinezinkinga ezithile zendlela ezivimbela iziphetho ezicacile mayelana nokusebenza. Yize ukungenelela okuningi kwengqondo kunobufakazi obuhle, okusikisela ukuthi uhlobo oluthile lokwelashwa lungcono kunokungekho ukwelashwa, ukubuyekezwa okuhlelekile kubike ukuthi ikhwalithi yalezi zifundo ngokuvamile ibimpofu, imiphumela yabo yomtholampilo imvamisa iyisampula, futhi kunobufakazi obuncane bokusebenza kahle kwezinketho zokwelashwa. Izinhlelo zemfundo ekhethekile ezinamandla, eziqhubekayo kanye nokwelashwa kokuziphatha ekuqaleni kwempilo kungasiza izingane ezine-ASD ukuba zithole ukunakekelwa, kwezenhlalo, kanye namakhono omsebenzi, futhi kaningi zingathuthukisa ukusebenza, futhi zinciphise ubukhulu bezimpawu nokuziphatha okungafanele; izindlela ezitholakalayo zifaka phakathi ukuhlaziywa kokuziphatha okusetshenzisiwe (i-ABA), amamodeli okukhula, ukufundisa okuhlelekile, ukwelashwa kwenkulumo nolimi, amakhono okuxhumana nabantu, kanye nokwelashwa komsebenzi. Ama-Occupational Therapists asebenza nezingane ezine-autism ngokwakha izindlela zokungenelela ezikhuthaza ukusebenzisana kwezenhlalo njengokwabelana nokubambisana.Aphinde asekele ingane ene-autism ngokubasiza ukuba babhekane nenkinga njengoba i-OT ilingisa ingane futhi ilinde impendulo evela enganeni.Ukungenelela kwezemfundo kunokusebenza okuthile ezinganeni: ukwelashwa okujulile kwe-ABA kukhombisile ukusebenza ekuthuthukiseni ukusebenza jikelele ezinganeni ezingaphambi kwesikole,futhi kusungulwe kahle ekuthuthukiseni ukusebenza kwengqondo kwezingane ezincane.Imibiko ye-neuropsychological ivame ukuxhumana kabi nabafundisi, okuholela ekutheni kube negebe phakathi kwalokho okunconywa umbiko nalokho okufundiswayo.Ucwaningo oluncane ngokusebenza kwezinhlelo zokuhlala zabantu abadala lukhombisa imiphumela ehlukahlukene.   Imithi eminingi isetshenziselwa ukwelapha izinkinga ezihambisana ne-ASD.Izingane zase-US ezingaphezu kwengxenye ezitholakale zine-ASD zinikezwa imithi ebulala ingqondo noma i-anticonvulsants, kanti izigaba zemithi ezivame kakhulu ziyi-antidepressants, i-stimulants.Ngaphandle kwama-antipsychotics,kunocwaningo oluncane oluthembekile mayelana nokusebenza noma ukuphepha kokwelashwa kwezidakamizwa kwentsha kanye nabantu abadala abane-ASD.Umuntu one-ASD angaphendula ngokungajwayelekile emithini, imithi ingaba nemiphumela emibi, futhi awukho umuthi owaziwayo okhulula izimpawu eziyinhloko ze-autism zokukhubazeka kwezenhlalo nokuxhumana.   Kusukela ngo-2008, ukwelashwa okubekelwa izingane ezine-ASD kwakubiza; izindleko ezingaqondile zibiza kakhulu. Umuntu owazalwa ngo-2000, ucwaningo lwase-US lwaqagela ukuthi isilinganiso sezindleko zokuphila esikhishwe isaphulelo singama-$4.66 million (ama-dollar angu-2023, alungiswe ngokukhushulwa kwemali kusukela ku-2003), cishe ngo-10% wokunakekelwa kwezokwelapha, u-30% wemfundo eyengeziwe nokunye ukunakekelwa, no-60% ulahlekelwe umkhiqizo wezomnotho. Ucwaningo lwase-UK lwaqagela izindleko zokuphila ezikhishwe isaphulelo ku-£1.9 million kanye ne-£1.23 million kumuntu one-autistic onokukhubazeka kwengqondo futhi ngaphandle kokukhubazeka kwengqondo, ngokulandelana ((£2023, elungiswe ngokukhushulwa kwemali kusukela ku-2005/06). Amalungelo angokomthetho okwelashwa ayinkimbinkimbi, ayahlukahluka kuye ngendawo nobudala, futhi adinga ukwesekwa ngabanakekeli. Izinhlelo ezisekelwa umphakathi ngokuvamile azanele noma azifaneleki enganeni ethile, futhi izindleko zokwelashwa noma zokwelashwa ezingabuyiselwa ngaphandle kwephakethe zihlotshaniswa namathuba ezinkinga zezezimali zomndeni; Ucwaningo lwase-US lwango-2008 luthole ukulahleka okuphakathi kuka-14% kwemali engenayo yonyaka emindenini yezingane ezine-ASD, futhi ucwaningo oluhlobene luthole ukuthi i-ASD ihlotshaniswa namathuba aphezulu okuthi izinkinga zokunakekelwa kwengane zizothinta kakhulu ukuqashwa kwabazali.
Kunezindlela zokwelapha eziningi ezikhona ze-Autism kuye ngohlobo lwayo. Izinhlelo zemfundo ekhethekile ezinzulu, eziqhubekayo kanye nokwelashwa kokuziphatha ekuqaleni kwempilo kungasiza izingane ezine-ASD ukuthi zithole amakhono okuzinakekela, ezenhlalo nawomsebenzi, futhi kaningi zingathuthukisa ukusebenza futhi zinciphise ubukhulu bezimpawu nokuziphatha okungalungile; izindlela ezitholakalayo zifaka phakathi ukuhlaziywa kokuziphatha okusetshenzisiwe (i-ABA), amamodeli okuthuthuka, ukufundisa okuhlelekile, ukwelashwa kwenkulumo nolimi, ukwelashwa kwamakhono ezenhlalo, kanye nokwelashwa okusebenzayo. Ochwepheshe bezokwelapha basebenza nezingane ezine-autism ngokwakha izindlela zokungenelela ezikhuthaza ukusebenzelana nomphakathi njengokwabelana nokubambisana. Futhi basekela ingane ene-autism ngokuyisiza ukuba ixazulule inkinga njengoba i-OT ilingisa ingane futhi ilinde impendulo evela enganeni. Ukungenelela kwezemfundo kunokusebenza okuthile ezinganeni: ukwelashwa kwe-ABA okunzulu kubonise ukusebenza kahle ekuthuthukiseni ukusebenza jikelele ezinganeni ezingaphambi kwesikole futhi kusungulwe kahle ekuthuthukiseni ukusebenza kwengqondo kwezingane ezincane.