Health Challenges in Autism and Strategies for Care in the Republic of Macedonia

Editorial

Individuals with autism have difficulties with communication, social interaction and sensory processing. These characteristics pose very unique challenges in a dental setting. All dental team members have to better understand patients with this disorder and prepare themselves as professionals for the rewarding experience of helping patients with autism.

The most challenging difficulties for dental professionals who have never worked with patients on the spectrum are communication and sensory processing difficulties. According to the Center for Disease Control and Prevention (CDC), “Autism Spectrum Disorders (ASDs) are a group of developmental disabilities that can cause significant social, communication and behavioral challenges. People with ASDs handle information in their brain differently than other people [1].

The rights of patients with autistic disorders are governed by legal regulations contained in Statute of the Republic of Macedonia, Convention on the rights of the child convention on the rights of persons with disabilities, Law on protection of children, Law on primary/secondary education and Law for prevention and protection against discrimination.

“Prohibition of discrimination / equality in access to justice”

Among other activities that the Ministry of Education and Science and the Bureau for Development of Education have undertaken, and refer to the children with autism is the signing a memorandum of understanding between AUTISM SPEAKS (Andy Shih, Senior Vice- President - Scientific Affairs, New York) and the Ministry of health of the Republic of Macedonia, Ministry of labor and social policy of the Republic of Macedonia and Ministry of education and science of the Republic of Macedonia.

The field of cooperation between Autism Speaks and the Ministry of health, Ministry of education and science and Ministry of labor and social policy covers harmonization of activities on the recommendations contained in the resolutions passed autism from the World Health Organization and the General Assembly of the United Nations; Support the activities of the South East European Network For Autism (SEAN) through: participation in annual meetings, presentation of national achievements in the field and research and capacity building (i.e training in the diagnosis and treatment).

On 13.12.2006, the Republic of Macedonia has signed the UN Convention on the Rights of Persons with Disabilities (among 144 states signatories). On 05.12.2011, the Parliament of the Republic of Macedonia (such 107 countries) has ratified the Convention on the Rights of Persons with Disabilities, unanimously. Ongoing is its implementation.

In the Republic of Macedonia the exact number of people with autism is still unknown, because the registry for these patients is still not ready. Doctors say that the number of newly diagnosed people with autism grow, but how is it in absolute terms; we could not speak, but only to perform arbitrary conclusions.

In the making of registry records about the number of people with autistic spectrum disorder are working more institutions, but it needs time, because it has consistently adhered to legal norms relating to the protection of personal data. Taking in mind the sensitivity and nature of the condition in children with autism and their families, which requires a serious and thorough approach of making the registry. Must consistently comply with the legal norms for the protection of personal data, because the registry will stand all patient data, and we have to know who will have access to them and how these data will be protected. Preparations have started between the institutions, and we expected that this year register will be ready. From the clinical practice figures have been shown that the number of people with autism grows every day, as grows more and more worldwide. The prevalence of children with autism on the world level is in rapid growth through the past few decades, and walked up to 1% in the United States and Great Britain.

Autism is a serious developmental disorder, which is characterized by deficits in social communication, encompassing social, communication and speech-language barriers, the presence of restricted and repetitive behavior, including hypersensitivity to sensory stimuli.

The first manifestations of autism are subtle and minimal, but around the second year of a child’s life become manifest and clearly visible to the wider environment. Symptoms are manifesting themselves in a wide range, there are variations in terms of quality, type and severity, and children with autism between each other are different and every child with autism is special in its own way.

The cause of autism is so far undefined, undiscovered and the science believes that its occurrence is result of the genetic, metabolic, neurological, internal and environment factors. Research indicates other factors besides the genetic component are contributing to the rise in increasing occurrences of autism, such as environmental toxins (e.g., heavy metals such as mercury), which are more prevalent in our current environment than in the past. Those with autism (or those who are at risk) may be especially vulnerable, as their ability to metabolize and detoxify these exposures can be compromised [2].

References

1. Centers for Disease Control and Prevention (CDC). Autism Spectrum Disorders (ASDs) – Facts about ASDs, 2013.
2. Autism Society, Causes. 2013.