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    <font face="Times New Roman">La ringrazio e saluto.</font><br>
    Piero Crispiani<br>
    <div class="moz-cite-prefix">Il 20/03/2023 17:02, Claudia
      Nicchiniello ha scritto:<br>
    </div>
    <blockquote type="cite"
      cite="mid:4BC5EF32-E46B-4968-835A-A478A7DC71AD@me.com">Salve,
      Professore.
      <div><br>
      </div>
      <div>La leggo sempre con piacere.</div>
      <div><br>
      </div>
      <div>Come economista credo che abbia centrato il punto: spreco di
        risorse, su cui alcuni soggetti si avvantaggiano .</div>
      <div><br>
      </div>
      <div>Soprattutto quando i fondi sono stanziati per " autismo "
        senza far riferimento al controllo delle NPIA/Salute Mentale.</div>
      <div>Un bel business per il terzo settore e i crescenti " centri "
        che lucrano su diagnosi estemporanee e progettazione degli
        interventi ... </div>
      <div><br>
      </div>
      <div>Claudia Nicchiniello </div>
      <div>Ex presidente Angsa Campania </div>
      <div><br>
      </div>
      <div><br>
        <br>
        <div dir="ltr">
          <div><br>
          </div>
          <div><br>
          </div>
          <div><br>
          </div>
          Inviato da iPhone
          <div><span>Le informazioni, i dati e le notizie contenute
              nella presente comunicazione e i relativi allegati sono
              di natura privata e come tali possono essere riservate e
              sono, comunque, destinate esclusivamente ai destinatari
              indicati in epigrafe. La diffusione, distribuzione e/o la
              copiatura del documento trasmesso da parte di qualsiasi
              soggetto diverso dal destinatario è proibita, sia ai sensi
              dell’art. 616 c.p., sia ai sensi del D.Lgs. n. 196/2003.
              Se avete ricevuto questo messaggio per errore, vi
              preghiamo di distruggerlo e di darcene immediata
              comunicazione anche inviando un messaggio di ritorno
              all’indirizzo e-mail del mittente.</span></div>
        </div>
        <div dir="ltr"><br>
          <blockquote type="cite">Il giorno 20 mar 2023, alle ore 16:27,
            Piero Crispiani <a class="moz-txt-link-rfc2396E" href="mailto:pierocrispiani@gmail.com"><pierocrispiani@gmail.com></a> ha scritto:<br>
            <br>
          </blockquote>
        </div>
        <blockquote type="cite">
          <div dir="ltr"> Gentili signori della Lista,<br>
            pochi mi conoscono e pochissimi sono interessati a ciò che
            dico e tantomeno ad interloquire. <br>
            Non è un problema. <br>
            Ciò detto vi informo che intorno all'Autismo o Spettro c'è
            grande confusione, in parte giustificata dalla fase di
            transizione teorica degli ultimi tempi (quindi
            giustificabile), ma in parte si deve alla certificazione
            frettolosa che generalizza categorie a danno di altre.<br>
            Accade che condotte critiche del linguaggio e della
            relazione - addebitabili al ritardo del linguaggio ed alle
            conseguenze strategie di difesa o di compensazione -
            diventino condizione autistica.<br>
            Non è un gioco di parole.<br>
            Tanti afasici o con ritardo dell'eloquio (neanche del
            linguaggio complessivo, ma solo della produzione verbale
            orale, cioè dell'eloquio) sono corredati della diagnosi di
            autismo, quindi Legge 104, se non da invalidità.<br>
            La disprassia comporta a volte tratti associabili
            all'autismo (ipersensibilità, motricità afinalistica, lento
            incipit, disorganizzazioni, realismo verbale, ecc.) ma
            comportano autismo solo nei casi severi.<br>
            Questa platea di soggetti con "disorganizzazione" (usiamo
            questa categorie provvisoria) è certamente in crescita (e
            per diversi motivi): ma si può dire ai genitori che si è di
            fronte all'autismo?.<br>
            Provo a sintetizzare alcuni assunti:<br>
            - ad oggi la diagnosi di autismo è sindromica, si fa dai
            sintomi (in realtà è così sin dal 1943 .. senza nulla
            togliere alle ricerche in ambito genetico, proteico ....),
            anche se a qualcuno non va bene (mi pare);<br>
            - la diagnosi di autismo è difficile e delicata ed ha un
            grande bisogno della "valutazione funzionale", per aree di
            funzioni, per funzionamento, competrenze, reattività,
            condotte....;<br>
            - l'autismo è sensibile all'educazione (terapia,
            trattamento, training ....), a volte in termini
            sorprendenti, non ai bypassamenti, al non fare, alle APP
            SUPPLETIVE, al condizionamento o allo Stimolo Avversivo.<br>
            <br>
            Infine:<br>
            la gravità della condizione è fattore fondamentale poiché
            rendeuna condizione diversa e diversamente rispondente,
            quindi grande rispetto all'autismo grave ed all'autismo in
            comorbilità con alterazioni psichiche o neurologiche
            cerebrali. In questi ultimi casi, e con gli adulti, valgono
            le pratiche suppletive fondate su rinforzo, condizionamento,
            avversione, ecc.<br>
            <br>
            Se fossi genitore di un caso "vero", contesterei lo spreco
            di risorse (ad es, i docenti di sostegno) per i casi non
            autistici.<br>
            Il dibattito è, comunque, di notevole interesse.<br>
            <br>
            Se può interessare: <br>
            Piero Crispiani -  maestro elementare, Direttore Didattico
            (di cui 18 anni Direttore di una grande Scuola Speciale
            Statale per gravi e pluriminorati), Ordinario di Pedagogia
            Speciale Università di Macerata, Libero Docente Università
            Politecnica delle Marche e Link Campus University di Roma.<br>
            <br>
            <br>
            <br>
            <br>
            <br>
            <br>
            <br>
            <br>
            <br>
            <br>
            <br>
            <div class="moz-cite-prefix">Il 20/03/2023 11:35, <a
                class="moz-txt-link-abbreviated moz-txt-link-freetext"
                href="mailto:albertofagni@libero.it"
                moz-do-not-send="true">albertofagni@libero.it</a> ha
              scritto:<br>
            </div>
            <blockquote type="cite"
cite="mid:1407522784.241680.1679308527207@mailapp-notification-service-9fbf75b4-xtkz5">Brava
              Stefania. <br>
              Ormai è chiaro come, in questa discussione, alcuni
              professionisti vogliano difendere delle diagnosi che tali
              non sono e vogliano farci credere che per il bene del
              paziente, si debba accogliere la sua richiesta di avere
              una diagnosi di autismo.. E per chi non rientra nella
              diagnosi da manuale, l'unica esistente al momento, si
              gioca con le parole e, come più volte ho scritto nei miei
              interventi, si vendono loro per diagnosi di autismo quelle
              che sono semplicemente delle valutazioni di tratti
              autistici. <br>
              Hanno trovato il modo di vendere diagnosi di autismo senza
              disturbo o se preferite di livello zero. <br>
              Poco importa che si possano o meno definire diagnosi
              psicologiche perché NON SONO DIAGNOSI DI DISTURBO DELLO
              SPETTRO AUTISTICO e chi le ha non è definibile autistico.
              <br>
              Capisco che po' questa gente serva anche a perorare le
              vostre cause, come questa, cioè di banalizzare l'autismo
              vendendo "diagnosi" che non rientrano nei manuali. <br>
              Ma si genera confusione, nelle persone e anche nella
              ricerca. <br>
              <br>
              Quindi come te, Stefania, spero che qualche professionista
              si schieri o avremmo sempre più persone che si diranno
              autistiche per fare i video su tik tok. <br>
              E la colpa è di chi banalizza lo spettro. <br>
              Scusate l sfogo, ma questa discussione è un paradosso
              perché viene letta da chi i manuali diagnostici li
              dovrebbe difendere <br>
              <br>
              Saluti <br>
              Alberto Fagni<br>
              Inviato da Libero Mail<br>
              <br>
              <div class="gmail_quote"><br>
                Il 19 marzo 2023 20:52:20 UTC <a
                  class="moz-txt-link-abbreviated moz-txt-link-freetext"
                  href="mailto:ftstellino@inwind.it"
                  moz-do-not-send="true">ftstellino@inwind.it</a> ha
                scritto:
                <table>
                </table>
                <blockquote class="gmail_quote">Scusate,<br>
                  Ma qui si rischia veramente di fare danni epocali. <br>
                  <br>
                  Come a dire che ad una persona con depressione che va
                  da un oncologo perché pensa/spera di avere un tumore,
                  che non ha, il medico glielo diagnosticasse per farlo
                  sentire meglio e magari provare a vedere se "esce"
                  dalla depressione.<br>
                  <br>
                  È assurdo parlare di funzionamento autistico.<br>
                  Così si ingenera solo confusione nella persona, che
                  tra l'altro ha evidentemente delle
                  problematiche/disturbi psichici. <br>
                  E poi ci ritroviamo a doverci confrontare con persone
                  che credono di essere autistiche, che pensano di avere
                  una diagnosi di autismo e che pretendono di parlare a
                  nome delle persone autistiche, a volte anche
                  aggredendo verbalmente ritenendo di avere la 'luce
                  della conoscenza'.<br>
                  <br>
                  Così rischiamo di fare danni epocali. Ripeto.<br>
                  Perché pure chi ci deve ascoltare per poter
                  indirizzare le politiche del welfare sanitario e
                  sociale va in confusione.<br>
                  <br>
                  Mi auguro che i tanti camici bianchi presenti ed amici
                  (perdonatemi la metonimia, ma è per meglio
                  identificarvi), non sostengano questa presunta
                  deontologia degli psicologi.<br>
                  <br>
                  Perdonatemi anche lo sfogo.<br>
                  <br>
                  Un caro saluto <br>
                  <br>
                  Stefania Stellino<br>
                  <br>
                  <br>
                  <br>
                  Inviato da Libero Mail<br>
                  <br>
                  <div class="gmail_quote"><br>
                    Il 19 marzo 2023 17:12:07 UTC David Vagni <a
                      class="moz-txt-link-rfc2396E"
                      href="mailto:david.vagni@gmail.com"
                      moz-do-not-send="true"><david.vagni@gmail.com></a>
                    ha scritto:
                    <table>
                    </table>
                    <blockquote class="gmail_quote">Cara Raffaella, 
                      <div>condivido quanto hai riportato anche se sai
                        bene che mi scontro con alcuni advocate, come
                        hai detto sono adulti autodeterminati ed
                        eventuali differenze di vedute non dovrebbero
                        far venir meno un clima di collaborazione tra
                        professionisti, famiglie e advocate.</div>
                      <div>Concordo sul resto dei punti della tua
                        risposta.</div>
                      <div><br>
                      </div>
                      <div>Vorrei approfittare dell’occasione per
                        specificare un aspetto che reputo rilevante
                        all’interno della discussione (non con te, ma
                        con chi dice che “non vanno fatte diagnosi") e
                        che reputo sia parte della confusione. Te sei
                        psicologa, come sono psicologi le persone che
                        fanno diagnosi presso il centro a cui sono
                        associato.</div>
                      <div>In quanto psicologi è un dovere cercare di
                        seguire la deontologia della propria professione
                        in accordo con i codici e pareri dell’Ordine</div>
                      <div><br>
                      </div>
                      <div>A questo link c’è un parere a mio avviso
                        molto importante <a
                          href="https://www.psy.it/allegati/parere_diagnosi.pdf"
                          class="moz-txt-link-freetext"
                          moz-do-not-send="true">https://www.psy.it/allegati/parere_diagnosi.pdf</a> sulla
                        possibilità degli psicologi di fare diagnosi
                        psicopatologiche ma che, lateralmente, riporta
                        la più generale definizione di diagnosi.</div>
                      <div><br>
                      </div>
                      <div>[…] Il concetto di diagnosi ha vari
                        significati non univoci lungo un continuum che
                        va da un’accezione ristretta di identificazione
                        di una patologia ad <b>un’accezione ampia di
                          identificazione di un fenomeno sulla base
                          dell’individuazione dei fattori che la
                          caratterizzano </b>(storia del soggetto,
                        sintomi fisici e psichici, modalità
                        comportamentali, attività mentale, informazioni
                        ottenute con varie modalità di valutazione). I<b>l
                          concetto di diagnosi, pertanto, non è
                          univocamente ed esclusivamente connesso a
                          quello di “identificazione di patologia”</b>,
                        come usualmente viene inteso poiché quest’ultimo
                        riguarda soltanto l’ambito biomedico e, anche in
                        ambito medico, è praticabile solo in alcuni
                        settori e per alcune patologie, non in tutte le
                        branche della medicina e per tutte le malattie.
                        <b>La diagnosi assolve molteplici funzioni e
                          compiti a più livelli: a) necessità di
                          categorizzare le informazioni, b)
                          facilitazione della comunicazione fra addetti
                          ai lavori, c) facilitazione della
                          comunicazione con il paziente, d) orientamento
                          delle scelte terapeutiche. In questo senso, la
                          diagnosi è, nell’accezione ampia dei suoi
                          significati possibili, insieme un atto
                          conoscitivo di raccolta e categorizzazione
                          delle informazioni ed un atto pragmatico di
                          comunicazione fra i soggetti implicati a
                          diverso titolo e livello nel fenomeno oggetto
                          di osservazione </b><span>[…] </span>La
                        diagnosi psicologica può essere realizzata a
                        diversi livelli a seconda del contesto in cui
                        trova applicazione e in relazione alle funzioni
                        interessate, dall’ambito lavorativo <b>al
                          disagio psicologico di livello pre-clinico</b>,
                        alla psicopatologia maggiore, alle malattie
                        mediche <span>[…] </span>La diagnosi basata sui
                        sintomi non è tuttavia l’unico modo per
                        effettuare una diagnosi descrittiva, e anzi
                        questa modalità viene ampiamente criticata dalla
                        comunità scientifica internazionale. Pertanto
                        anche la diagnosi differenziale basata sui
                        sintomi non è l’unica possibile. Modalità
                        alternative di effettuare la diagnosi
                        descrittiva e differenziale sono state a più
                        riprese proposte alla comunità scientifica e si
                        basano sull’osservazione e l’identificazione <b>delle
                          funzioni psicologiche che sottendono i
                          fenomeni clinici osservati,</b> e non
                        meramente sull’osservazione e l’identificazione
                        dei sintomi. […].</div>
                      <div><br>
                      </div>
                      <div>Riporto questo per dire che, se una persona
                        va da uno psicologo e gli chiede “aiutami a
                        capire come funziono” rilasciare in una <b>diagnosi</b> (perché
                        comunque è una diagnosi il documento che si
                        rilascia): “non hai nessun disturbo, quindi non
                        hai niente”, <i>forse </i>può essere
                        accettabile per un medico che opera all’interno
                        di un modello medico, ma sicuramente non è
                        deontologicamente corretto per uno psicologo.</div>
                      <div>Riportare che la persona ha un “funzionamento
                        cognitivo autistico pur in assenza di difficoltà
                        clinicamente rilevanti che costituiscono un
                        disturbo” o che “soddisfa i criteri dell’autismo
                        ma <i>al momento</i> non sono presenti
                        difficoltà rilevanti nel funzionamento
                        adattativo” o qualsiasi simile definizione (e
                        spiegando in cosa, perché, in quali processi
                        emotivi, cognitivi, etc.) è un <i>atto dovuto</i> da
                        un punto di vista etico e deontologico a mio
                        avviso e ritengo che contestarlo significhi non
                        capire in cosa dovrebbe consistere il lavoro di
                        un psicologo, che in primo luogo dovrebbe
                        riguardare il comprendere e aiutare le persone e
                        solo in quanto funzionale a questo scopo,
                        determinare se è presente o meno un disturbo. </div>
                      <div><span><br>
                        </span>
                        <div>
                          <div><br>
                            <blockquote type="cite">
                              <div>Il giorno 14 mar 2023, alle ore
                                09:55, Ambulatorio Autismo <a
                                  class="moz-txt-link-rfc2396E"
                                  href="mailto:ambulatorioautismoadulti@gmail.com"
                                  moz-do-not-send="true"><ambulatorioautismoadulti@gmail.com></a>
                                ha scritto:</div>
                              <br class="Apple-interchange-newline">
                              <div>
                                <div><br>
                                  <div>Buon giorno a tutti,</div>
                                  <div>mi fa piacere che il Sig. Fagni
                                    condivida anche lui che l’autismo 0
                                    non esiste, quindi penso che
                                    possiamo  bandire per sempre dai
                                    nostri discorsi  questa definizione
                                     sbagliata che può fuorviare chi non
                                    ha le giuste conoscenze.</div>
                                  <div><br>
                                    <div>Posso comprendere le sue
                                      perplessità e i suoi dubbi ma vedo
                                      che la sua mail è piena di
                                      criticità e sfiducia verso
                                      l’operato dei clinici.
                                      Naturalmente fra gli esseri umani
                                      ci sono delinquenti di tutti i
                                      tipi, persone poco professionali e
                                      persone che cerano di approfittare
                                      economicamente della loro
                                      posizione. Credo che questo tipo
                                      di persona sia ben distribuita in
                                      tutte le professioni, i tutti i
                                      contesti sociali e in qualsiasi
                                      tipo di funzionamento umano.
                                      Quindi ce ne sono sicuramente
                                      anche fra psicologi psichiatri e
                                      neuropsichiatri. Ma questa
                                      considerazione non dovrebbe a mio
                                      modo di vedere portarci a una
                                      sfiducia così grande come quella
                                      che traspare dai suoi commenti.
                                      Comprendo i suoi dubbi ma
                                       francamente trovo difficile
                                      interloquire su una posizione così
                                      general generica che riguarda
                                      l’umanità tutta.</div>
                                    <div><br>
                                    </div>
                                    <div> Su tre cose non sono invece
                                      assolutamente d’accordo con il
                                      Sig. Fagni:</div>
                                    <div>1. dire che se "uno ha sempre
                                      avuto le capacità di superare le
                                      sue difficoltà, senza fare nessun
                                      tipo di terapia ed avere nessun
                                      tipo di supporto, significa che il
                                      criterio D non è soddisfatto” è
                                      proprio sbagliato. La sofferenza
                                      psichica lascia sempre una traccia
                                      che il clinico deve saper valutare
                                      e comunque è sempre necessario che
                                      si chieda come sta e quanta fatica
                                      faccia la persona nel presente. A
                                      parte il fatto che in genere le
                                      persone adulte che arrivano al
                                      percorso diagnostico hanno già
                                      fatto prima percorsi di supporto
                                      psicologico di cui non sono
                                      soddisfatte, ci possono essere
                                      innumerevoli  motivi per cui una
                                      persona non ha richiesto aiuto, da
                                      quello economico alla sfiducia nel
                                      lavoro psicologico, dall’orgoglio
                                      a forme di malessere tanto forte
                                      da impedire di attivarsi, dal non
                                      vedere riconosciuto il proprio
                                      bisogno al sentirsi dire che non
                                      c'è necessità di terapia. E
                                      sicuramente ce ne sono tantissimi
                                      altri. Non è detto che non avere o
                                      non aver avuto una terapia  sia
                                      indice di mancanza di bisogno. È
                                      compito del clinico valutare la
                                      sofferenza e il bisogno ed è suo
                                      compito dotarsi delle capacità,
                                      della formazione e degli strumenti
                                      per saperla riconoscere e saperla
                                      comprendere. Posso capire la
                                      sfiducia nella capacità dei
                                      clinici di fare valutazioni di
                                      questo tipo ma trovo sbagliato
                                      fare una generalizzazione così
                                      negativa. </div>
                                    <div>Negli anni ’90 c’erano
                                      pochissimi clinici capaci di
                                      diagnosticare l’autismo, oggi
                                      proliferano i servizi e
                                      naturalmente è difficile scegliere
                                      e può essere difficile valutare la
                                      competenza di un clinico. Ma io
                                      sono contenta che i servizi
                                      prolifichino perchè questo stimola
                                      la crescita professionale. </div>
                                    <div>E inoltre naturalmente  ogni
                                      adulto che si deve occupare della
                                      salute dei suoi cari deve
                                      impegnarsi a ricercare il clinico
                                      migliore. Non è una cosa che
                                      riguardi solo l’autismo.</div>
                                    <div><br>
                                    </div>
                                    <div>2. Lo stesso vale per quando
                                      scrive “ E  i vari test sono
                                      facili da  indirizzare. Io posso
                                      decidere il punteggio che voglio
                                      avere in un test  che voglia
                                      "misurare" i miei sintomi
                                      autistici, ma se si vuole valutare
                                      il mio autismo sul presente un
                                      clinico non potrebbe mai darmi una
                                      diagnosi…”. Il Sig. Fagni, come
                                      del resto chiunque,  può al
                                      massimo scaricare i test
                                      autosomministrati e se vuole
                                      manipolarli  basta che scarichi i
                                      punteggi o li cerchi nei libri in
                                      cui sono pubblicati.  Così
                                      certamente si,  potrebbe
                                      manipolarli. Ma un clinico serio
                                      non farebbe mai la diagnosi  solo
                                      ed esclusivamente su quel tipo di
                                      test, proprio perchè essendo
                                      facilmente reperibili sono anche
                                      facilmente manipolabili.
                                      Nonostante questo le ricerche
                                      scientifiche ci dicono che
                                      comunque alcuni di questi test,
                                      come la RAADS-R, per esempio, sono
                                      molto forti ma naturalmente si
                                      parte dall’assunto che chi compila
                                      lo faccia rispondendo in modo
                                      onesto. Per fortuna non abbiamo a
                                      disposizione solo test
                                      autosomminstrati, questi non sono
                                      gli  unici test disponibili. Un
                                      clinico competente dovrebbe sapere
                                       che ci sono test che raccolgono
                                      altri tipi di informazioni che non
                                      sono soggette a punteggi tipo
                                      “risposta giusta o sbagliata” o
                                      con i criteri dei test disponibili
                                      on line. Ci sono interviste alle
                                      famiglie, interviste ad altri
                                      operatori e test che riflettono il
                                      parere del clinico. È l’insieme
                                      dei risultati di questi test che
                                      un clinico esperto dovrebbe saper
                                      valutare. In ogni caso mi pare
                                      evidente che si continui a
                                      sottovalutare il fatto  che la
                                      diagnosi è sempre clinica perché
                                      non esiste un test che possa
                                      considerarsi completamente sicuro
                                      al 100%. Questa cosa è ampiamente
                                      dichiarata e documentata anche
                                      scientificamente ovunque.  I test
                                      possono sostenere il giudizio
                                      diagnostico ma questo è, alla
                                      fine, sempre e solo del clinico.
                                      Questo significa che  la diagnosi
                                      riflette sempre  il parere
                                      professionale del professionista,
                                      anche indipendentemente dall’esito
                                      dei test. Questo da una maggiore
                                      responsabilità al clinico che
                                      dovrebbe quindi essere molto
                                      attento. Naturalmente il Sig.
                                      Fagni non è un professionista e
                                      quindi non conosce i test e non sa
                                      quale tipo di lavoro deve fare il
                                      clinico quando li somministra. Ma
                                      proprio per questo trovo che sia
                                      fuorviante che faccia affermazioni
                                      di questo tipo con tanta sicurezza
                                      invece, magari, di chiedere
                                      qualche informazione in più.</div>
                                    <div>Vorrei anche sottolineare che
                                      se una persona che richiede un
                                      parere diagnostico mente, la
                                      responsabilità primaria è sua
                                      perché così facendo distrugge la
                                      relazione con il clinico. Ci
                                      possono essere innumerevoli motivi
                                      per cui una persona mente oltre a
                                      quelli che il Sig. Fagnmi descrive
                                      nella sua mail e ci sono anche
                                      tante persone che cercano in tutti
                                      i modi di farsi togliere la
                                      diagnosi di autismo cercando in
                                      tutti i modi di apparire
                                      neurotipiche.  In ogni caso,
                                      poiché non esiste un test
                                      incontrastabile, come potrebbe
                                      essere un test genetico, se un
                                      paziente mente bene potrebbe
                                      comunque indurre un parere
                                      sbagliato nel clinico. I clinici
                                      devono stare attenti e dotarsi di
                                      strumenti, della formazione e
                                      della supervisione che serve per
                                      contenere questi problemi ma
                                      naturalmente potrebbero comunque
                                      cadere vittima dell’imbroglio. Ma
                                      se è imbrogliato il clinico è la
                                      vittima e non il responsabile
                                      della menzogna. Chi mente è
                                      responsabile.</div>
                                    <div><br>
                                    </div>
                                    <div>3. Infine quando dice che non è
                                      mutata la diagnosi di autismo per
                                      i vari manuali. In realtà il DSM-5
                                      segna un cambiamento epocale
                                      perché definisce i Disturbi del
                                      Neurosviluppo, che prima non erano
                                      definiti, e pone le basi per
                                      un’unica diagnosi di autismo
                                      escludendo in modo definitivo la
                                      disabilità intellettiva e il
                                      disturbo del linguaggio dai
                                      sintomi di autismo. Un grande
                                      cambiamento che suscita ancora
                                      molte discussioni come del resto
                                      si evince dallo scambio nato dalla
                                      mail di Carlo Hanau.</div>
                                    <div><br>
                                    </div>
                                    <div><br>
                                    </div>
                                    <div>Per quanto riguarda
                                      Neuropeculiar: il Sig. Fagni si
                                      sbaglia, io non ho sollevato
                                      nessun discorso né punto nè
                                      domanda su questa associazione né
                                      sui suoi soci in questa sede né in
                                      altre e non ho posto alcuna
                                      domanda per cui lui, o chiunque
                                      altro, mi debba risposte. </div>
                                    <div>Non ho mai preso  le loro
                                      difese perché non ho mai pensato
                                      che ne abbiano bisogno. Sono
                                      persone adulte autonome e
                                      autodeterminate, responsabili
                                      delle loro scelte e delle loro
                                      posizioni.  </div>
                                    <div>Preciso che,  insieme ad altri
                                      colleghi, faccio parte del
                                      Comitato Scientifico
                                      dell’Associazione. Io mi confronto
                                      spesso con loro  e non ho mai
                                      avuto problemi a trovare un piano
                                      di confronto rispettoso delle
                                      posizioni personali, anche quando
                                      non siamo d’accordo. Ritengo
                                      quindi che chiunque possa trovarlo
                                      se lo desidera. Mi pare però poco
                                      corretto porre queste critiche in
                                      una sede dove nessuno di loro è
                                      presente non permettendo nessun
                                      tipo di confronto che consenta
                                      alle altre persone della lista di
                                      conoscerli e di poter fare le
                                      proprie valutazioni.</div>
                                    <div><br>
                                    </div>
                                    <div>Infine vorrei dire a Carlo che
                                       trovo grave questa scollatura fra
                                      genitori e persone autistiche,
                                      saper accettare che ci siano
                                      diversi livelli di ricaduta sulla
                                      qualità di vita dovrebbe
                                      rassicurare sul fatto che non
                                      verranno trascurate le persone che
                                      hanno dalla loro condizione gravi
                                      ripercussioni sulla qualità di
                                      vita e sull’indipendenza e
                                      l'autonomia, ma per garantire che
                                      ciò accada non serve litigare,
                                      servirebbe invece promuovere la
                                      formazione dei clinici. Perché è
                                      da loro che dipende la valutazione
                                      della ricaduta sulla qualità di
                                      vita e sono loro che dovrebbero
                                      saper spiegare chi quando e perché
                                      ha bisogno di incerto tipo di
                                      aiuto. Card si possa trovare un
                                      giusto equilibrio fra ascoltare i
                                      clinici e ascoltare le persone
                                      autistiche e ascoltare i genitori.
                                      Ma anche ascoltare chiunque avario
                                      titolo voglia zarlaredi autismo.
                                      Paleseante nessuno può parlare per
                                      tutti e forse tutti dovrebbero
                                      parlare. Per sé o per le proprie
                                      associazionni o gruppi.</div>
                                    <div><br>
                                    </div>
                                    <div>Io credo che i clinici possano
                                      definirsi davvero competenti di
                                      autismo se lo conoscono in tutte
                                      le sue declinazioni, stili di
                                      funzionamento cognitivo, se lo
                                      conoscono nei bambini così come
                                      negli adulti, se hanno potuto
                                      interagire in diversi contesti non
                                      solo in quello clinico.</div>
                                    <div><br>
                                    </div>
                                    <div>Quando sono stata alla Divison
                                      TEACCH alla fine degli anni ’90 ho
                                      capito che l’autismo era qualcosa
                                      di molto più vasto e complesso di
                                      quello che noi percepivamo in
                                      Italia e ho capito che non avevamo
                                      alcuna idea di cosa fosse quello
                                      che allora chiamavamo autismo HF
                                      (High Functioning). Alla Division
                                      TEACCH già da almeno un decennio
                                       avevano servizi differenziati
                                      anche in base alla ricaduta sulla
                                      qualità di vita e sull’autonomia,
                                      avevano gruppi diversificati per
                                      stile di funzionamentocognitivo e
                                      collaboravano non solo con i
                                      genitori ma anche con le persone
                                      autistiche, io stessa sono stata
                                      parecchio tempo con persone
                                      autistiche che mi hanno  spiegato
                                      il loro stile di funzionamento e
                                      il lavoro clinico di cui godevano.
                                      Era la prima volta che mi accadeva
                                      d è stata un’esperienza che ha
                                      segnato le mie scelte.</div>
                                    <div>Proprio allora ho fatto alcune
                                      scelte professionali che hanno
                                      dato una direzione al mio lavoro:
                                      ho scelto di tradurre con altri
                                      colleghi i test gold standard in
                                      Italiano, di  promuovere la
                                      formazione su come fare la
                                      diagnosi, e ho scelto di
                                      approfondire la diagnosi nelle
                                      direzioni più complesse: nei
                                      bambini molto piccoli e negli
                                      adulti senza disabilità cognitiva.
                                      Proprio grazie a queste scelte,
                                      posso  affermare di essere
                                       certamente stata uno dei primi
                                      clinici italiani a fare al
                                      diagnosi ad adulti senza
                                      compromissione cognitiva che si
                                      chiedevano se potevano essere
                                      autistici. Ma prima di allora
                                      avevo lavorato per moltissimi anni
                                      solo con persone autistiche
                                       disabili intellettive e lavoro
                                      con loro tantissimo ancora oggi.
                                      Io so bene che è proprio perché ho
                                      lavorato tanto con loro che ho
                                      imparato molte cose che mi sono
                                      state molto utili per comprendere
                                      meglio le persone autistiche senza
                                      compromissione cognitiva. Allo
                                      stesso modo poter  ascoltare
                                      persone che possono descrivere il
                                      proprio mondo interno mi ha
                                      permesso di imparare  cose
                                      utilissime anche per le persone
                                      con disabilità intellettiva. </div>
                                    <div><br>
                                    </div>
                                    <div>Io ho fatto scelte su cui ho
                                      sempre messo la faccia e ancora
                                      oggi mi impegno al meglio che
                                      posso per tenere aperto uno
                                      stabile confronto con le persone
                                      autistiche che si occupano di
                                      advocacy così come con moltissime
                                      altre persone autistiche molto
                                      meno presenti sui social, così
                                      come con tanti genitori con cui
                                      lavoro quotidianamente e, anche se
                                      indirettamente, osservando i
                                      bambini e tutte quelle persone
                                      autistiche di ogni età e stile di
                                      funzionamento che non possono
                                      descriverci il loro mondo interno
                                      ma ci mostrano come agiscono. Mi
                                      confronto con colleghi di tutti i
                                      tipi, leggo i loro libri, anche
                                      quelli dei professionisti
                                      psicodinamici. </div>
                                    <div>Ascoltare, leggere e
                                      confrontarsi  sono per me
                                      strumenti di conoscenza.
                                      Naturalmente rivendico
                                      l’originalità del mio pensiero e
                                      rifiuto assolutamente di prendermi
                                      la responsabilità di cose che non
                                      ho mai detto né affermato.  Se
                                      promuovo qualcosa che dice
                                      un’altra persona, sia essa un
                                      clinico, un genitore o una persona
                                      autistica vuol dire che quel
                                      contenuto mi è piaciuto e che l'ho
                                      trovato stimolante. Solo di quello
                                      che condivido e di ciò che dico
                                      personalmente mi prendo la
                                      responsabilità.</div>
                                    <div>Ritengo che soprattutto in
                                      questo momento storico in cui i
                                      criteri diagnostici si son tanto
                                      allargati, sia importantissimo,
                                      anche essenziale, per clinici
                                       osservare e ascoltare per
                                      imparare.</div>
                                    <div>Ma andrebbe ricordato che
                                      osservare e ascoltare non
                                      significa aderire a qualsiasi
                                      cosa, significa raccogliere
                                      elementi per poter pensare e fare
                                      le proprie riflessioni e le
                                      proprie scelte in una visione più
                                      ampia.</div>
                                    <div>Giudicare senza un confronto
                                      induce sempre e solo a grandi
                                      tensioni.</div>
                                    <div><br>
                                    </div>
                                    <div>Buona giornata a tutti</div>
                                    <div>Raffaella Faggioli </div>
                                    <div><br>
                                    </div>
                                    <div><br>
                                    </div>
                                    <div>
                                      <div><br>
                                        <blockquote type="cite">
                                          <div>Il giorno 9 mar 2023,
                                            alle ore 11:24, <a
                                              href="mailto:albertofagni@libero.it"
class="moz-txt-link-freetext" moz-do-not-send="true">albertofagni@libero.it</a>
                                            ha scritto:</div>
                                          <br
                                            class="Apple-interchange-newline">
                                          <div>
                                            <div>
                                              <p>Dottoressa Faggioli, <br>
                                                <br>
                                                io sono d'accordo con
                                                lei quando dice che NON
                                                esiste l'autismo di
                                                livello ZERO , termine
                                                che probabilmente ho
                                                iniziato ad sare io, per
                                                spiegare come ci siano
                                                troppi autistici o
                                                comunque persone che si
                                                dichiarano tali, ma che
                                                non rientrano nei
                                                criteri della diagnosi. <br>
                                                E come lei sono
                                                dell'idea che non si
                                                possa usare il termine
                                                autistico come semplice
                                                aggettivo al di fuori di
                                                una diagnosi medica.<br>
                                                <br>
                                                Questo punto per me è
                                                basilare perché troppe
                                                volte leggo di diagnosi
                                                "senza disturbo" cioè
                                                senza che il criterio D
                                                sia soddisfatto, nei
                                                tanti gruppi di autismo
                                                e vengono difese dagli
                                                stessi professionisti .<br>
                                                Con Vagni ho avuto una
                                                discussione su questo
                                                punto sul mio profilo
                                                Facebook <br>
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                                                <br>
                                                In quella discussione
                                                David ha difeso la
                                                possibilità di fare
                                                diagnosi psicologiche di
                                                autismo senza disturbo e
                                                di poterle definire
                                                diagnosi e non
                                                valutazioni . Ciò
                                                ovviamente genera
                                                confusione e molti
                                                penseranno di avere una
                                                vera diagnosi e non di
                                                avere solamente dei
                                                tratti autistici e al
                                                limite essere
                                                subclinici. <br>
                                                <br>
                                                Adesso leggo che
                                                entrambi riteniate sia
                                                corretto fare diagnosi
                                                prendendo in
                                                considerazione tutti
                                                quelli che raccontano di
                                                aver affrontato
                                                difficoltà nella vita
                                                per cavarsela ed essere
                                                autonomi, basta che
                                                questa sofferenza sia
                                                dovuta ad alcuni tratti
                                                autistici.<br>
                                                Lei afferma in una sua
                                                risposta che chi cerca
                                                una diagnosi vada
                                                accolto perché cerca
                                                risposte a delle
                                                difficoltà. <br>
                                                Concordo, ma ciò non
                                                significa che tutte
                                                siano da accogliere con
                                                delle diagnosi .<br>
                                                Perché se uno ha sempre
                                                avuto le capacità di
                                                superare le sue
                                                difficoltà, senza fare
                                                nessun tipo di terapia
                                                ed avere nessun tipo di
                                                supporto, significa che
                                                il criterio D non è
                                                soddisfatto. <br>
                                                Perché se la diagnosi
                                                dovesse premiare  tutti
                                                quelli che raccontano
                                                sofferenze e difficoltà
                                                superate, nessuno
                                                sarebbe esente da
                                                diagnosi. <br>
                                                Aggiungo che spesso
                                                queste persone hanno
                                                delle difficoltà che
                                                sono ascrivibili a ben
                                                altre diagnosi dalle
                                                quali provengono, ma che
                                                trovandole più
                                                stigmatizzanti della
                                                diagnosi di autismo (e
                                                meno fighe) cercano di
                                                rifugiarsi in quella di
                                                autismo. <br>
                                                Ora con tutta la fiducia
                                                che posso avere nei
                                                clinici, se la diagnosi
                                                si fa solo sul racconto
                                                di difficoltà superate,
                                                non sarà difficile per
                                                ch conosce lo spettro
                                                avere una diagnosi di
                                                autismo (oramai anche on
                                                line) <br>
                                                E  i vari test sono
                                                facili da  indirizzare.
                                                Io posso decidere il
                                                punteggio che voglio
                                                avere in un test  che
                                                voglia "misurare" i miei
                                                sintomi autistici, ma se
                                                si vuole valutare il mio
                                                autismo sul presente un
                                                clinico non potrebbe mai
                                                darmi una diagnosi , né
                                                io  vorrei mai una
                                                diagnosi che mi limita e
                                                che non mi darebbe alcun
                                                supporto utile, visto
                                                che sono completamente
                                                autonomo. <br>
                                                E se fossi altro , cioè
                                                bipolare, depresso etc
                                                etc , comunque una
                                                diagnosi non pertinente,
                                                per quanto più figa, mi
                                                allontanerebbe dai
                                                supporti e dalle terapie
                                                corrette. <br>
                                                Io temo che oramai chi
                                                ha avuto difficoltà
                                                nella vita legate alla
                                                propria omosessualità,
                                                alla propria depressione
                                                o per qualsiasi altro
                                                motivo, può  spingere
                                                per avere una diagnosi
                                                di autismo . <br>
                                                Senza voler accusare
                                                nessuno mi chiedo e vi
                                                chiedo se non ci sia il
                                                rischio che molti da
                                                clinici si stiano
                                                trasformando (in modo
                                                anche inconsapevole) in
                                                VENDITORI di diagnosi ? <br>
                                                <br>
                                                Altro punto al quale
                                                vorrei rispondere è sul
                                                fatto che lei dottoressa
                                                ha preso le difese dei
                                                vari attivisti , i quali
                                                si lamentano che
                                                qualcuno possa mettere
                                                in dubbio le loro
                                                diagnosi. <br>
                                                Siccome sappiamo
                                                benissimo che la critica
                                                è rivolta soprattutto a
                                                me da parte dei suoi
                                                pazienti di
                                                Neuropeculiar (mi piace
                                                essere molto diretto) ,
                                                faccio notare alcune
                                                cose : <br>
                                                <br>
                                                - Io non metto in dubbio
                                                le loro diagnosi ,ma
                                                come descrivono le
                                                diagnosi, che vorrebbero
                                                slegare dai vari manuali
                                                diagnostici. Sono loro a
                                                metterle in dubbio
                                                casomai. <br>
                                                - Alcuni di quelli che
                                                loro invitano ai loro
                                                convengni e che si
                                                definiscono autistici,
                                                hanno ammesso di non
                                                avere una diagnosi e che
                                                non l'hanno mai cercata
                                                non avendo bisogno di
                                                supporti. <br>
                                                - Visto che usano la
                                                loro diagnosi per
                                                vendersi come formato
                                                come se fosse un titolo
                                                di studio, non vedo
                                                perché non dovrebbero
                                                renderla pubblica ? (
                                                Questa è una mia
                                                provocazione, ma davvero
                                                chi ha una diagnosi può
                                                fare il formatore senza
                                                avrebbe i titoli? )<br>
                                                <br>
                                                - Le stesse persone che
                                                si lamentano che le loro
                                                diagnosi siano messe in
                                                dubbio, sono quelle che
                                                attaccano i genitori,
                                                dicendo loro che un
                                                genitore NON ha alcun
                                                diritto di parlare di
                                                autismo, ma solo loro
                                                possono in quanto
                                                autistici... Come se
                                                loro potessero sapere
                                                come pensa e, cosa pensa
                                                e cosa prova un
                                                autistico non verbale. <br>
                                                <br>
                                                - Sempre loro hanno
                                                creato un clima di
                                                guerra alle definizioni
                                                mediche e corrette ,
                                                tanto che molti
                                                professionisti hanno
                                                smesso di scrivere e non
                                                si espongono per non
                                                essere attaccati
                                                .Proprio durante questa
                                                discussione alcuni
                                                professionisti mi hanno
                                                scritto in privato,
                                                dicendosi d'accordo con
                                                la mia posizione, ma che
                                                non avrebbero scritto
                                                poiché stanchidel clima
                                                di attacco alle
                                                posizioni corrette e mi
                                                hanno anche fatto notare
                                                che sono sempre meno i
                                                professionisti che si
                                                espongono nelle
                                                discussioni su questa
                                                lista . <br>
                                                Non è un caso che a
                                                farlo siate stati
                                                soprattutto in due ,
                                                entrambi molto vicini
                                                alle posizioni di questi
                                                attivisti o comunque li
                                                si voglia definire. <br>
                                                <br>
                                                Quindi non è mutata la
                                                diagnosi di autismo per
                                                i vari manuali, ma sta
                                                mutando perché si è
                                                creato un mercato , si è
                                                creato il bisogno di
                                                ricercare una diagnosi. <br>
                                                <br>
                                                Saluti <br>
                                                Alberto Fagni<br>
                                                (mi scuso per gli
                                                errori, ma preferisco
                                                non rileggere ) </p>
                                              <blockquote type="cite">
                                                <div> Il 08/03/2023
                                                  11:15 Raffaella
                                                  Faggioli <<a
                                                    href="mailto:ambulatorioautismoadulti@gmail.com"
class="moz-txt-link-freetext" moz-do-not-send="true">ambulatorioautismoadulti@gmail.com</a>>
                                                  ha scritto: </div>
                                                <div> <br>
                                                </div>
                                                <div> <br>
                                                </div>
                                                Ciao David, naturalmente
                                                è necessario tenere
                                                conto che abbiamo
                                                professionalità diverse,
                                                 sensibilità diverse e
                                                 responsabilità diverse.
                                                Naturalmente io sono
                                                principalmente un
                                                clinico impegnata
                                                 stabilmente nella
                                                valutazione diagnostica
                                                di persone di tutte le
                                                età e di tutti i
                                                funzionamenti cognitivi
                                                 e solo in seconda
                                                battuta sono una
                                                ricercatrice (nella
                                                pratica quotidiana, io
                                                produco idee di ricerca
                                                e una montagna di dati
                                                che altri leggono)
                                                <div> <br>
                                                </div>
                                                <div> Magari mi sbaglio
                                                  ma mi sembra che anche
                                                  sui i bambini in
                                                  realtà siamo d'accordo
                                                  nel momento stesso in
                                                  cui scrivi: <span>Il
                                                    problema è che tu <strong>sai</strong> che <em>prima
                                                      o poi quel bambino
                                                      cadrà</em>. </span>Ed
                                                  è esattamente per
                                                  questo che non esiste
                                                  il livello 0 nei
                                                  bambini perché noi
                                                  sappiamo che prima
                                                  poi, hai ragione
                                                  spesso ai cambi di
                                                  ciclo scolastico, ci
                                                  sarà qualche cosa che
                                                  lo porterà alla
                                                  sofferenza e a
                                                  sentirsi in dovere di
                                                  mascherarsi, a non
                                                  sentirsi “normale” e a
                                                  percepire una
                                                  diversità che lo farà
                                                   sentire solo al mondo
                                                  (un extraterrestre,
                                                  metafora molto
                                                  significativa, chiara
                                                  e diretta usata da
                                                  moltissime persone
                                                  autistiche) e quindi
                                                  anche poco amato. Non
                                                  basta  questo come
                                                  ricaduta sulla qualità
                                                  di vita? Io direi
                                                  proprio di si. La
                                                  sofferenza
                                                  testimoniata da  tanti
                                                  adulti autistici,
                                                  l’intenso lavorio
                                                  interiore che devono
                                                  fare gli adolescenti,
                                                  che magari non si
                                                  mettono sui social, ma
                                                  che noi terapeuti che
                                                  li seguiamo
                                                  costantemente ben
                                                  conosciamo e che
                                                  conoscono i loro
                                                  genitori, non dovrebbe
                                                  lasciarci
                                                  indifferenti. </div>
                                                <div> <br>
                                                </div>
                                                <div> Naturalmente anche
                                                  per me, con un bambino
                                                  l’approccio clinico è
                                                  molto diverso da
                                                  quello con gli adulti
                                                  ed è naturale che un
                                                  clinico possa avere
                                                  dubbi, io stessa li ho
                                                  e quando li ho mi
                                                  prendo il tempo per
                                                  definire il mio
                                                  giudizio diagnostico.
                                                  Ma la diagnosi a un
                                                  bambino è una
                                                  proiezione in avanti
                                                  che influenzerà tutta
                                                  la sua vita: una volta
                                                  fatta ci aspettiamo e
                                                  anche pretendiamo che
                                                  il mondo intero tenda
                                                  ad  adattarsi al suo
                                                  stile di funzionamento
                                                  e che gli adulti che
                                                  si occupano della sua
                                                  educazione  mettano in
                                                  atto strategie
                                                  educative più mirate,
                                                  strategie di
                                                  conversazione più
                                                  adatte al suo stile di
                                                  funzionamento,
                                                  protezione
                                                  dall’esposizione
                                                  incontrollata e
                                                  costante a stimoli
                                                  sensoriali e sociali
                                                  inadeguati e forieri
                                                  di sofferenza e
                                                  stress. Quanti adulti
                                                  autistici ci dicono
                                                  che quando stanno in
                                                  un gruppo intento in
                                                  una conversazione si
                                                  sentono stabilmente in
                                                  allerta? Vogliamo
                                                  “regalare” questo tipo
                                                  di sensazioni e queste
                                                  fatiche ai bambini?.  
                                                </div>
                                                <div> Sappiamo che
                                                  questo tipo di sforzo
                                                  e di sofferenza porta
                                                  in adolescenza a
                                                  problematiche
                                                  psichiatriche. La
                                                  diagnosi deve quindi a
                                                  mio avviso essere
                                                  pensata anche per
                                                  contenere questa
                                                  inutile devastazione.
                                                  La diagnosi dovrebbe
                                                  proteggerli da
                                                  eccessivi sforzi di
                                                  mascheramento così
                                                  come dal non sentirsi
                                                  accettati per quello
                                                  che si è o dalla
                                                  sensazione di essere
                                                  extraterrestri.
                                                  Dovrebbe permettere
                                                  agli adulti che si
                                                  occupano della loro
                                                  educazione di farli
                                                  crescere il più
                                                  confidenti possibile
                                                  in sè stessi, con meno
                                                  sensazione di
                                                  estraniamento, più
                                                  legittimati. Una
                                                  diagnosi sbagliata nei
                                                  bambini, anche in
                                                  quelli in plus
                                                  dotazione e con un
                                                  linguaggio pienamente
                                                  fluente, avrà una
                                                  ricaduta sulla salute
                                                  psicologica, sulla
                                                  sofferenza psichica e
                                                  sull’esposizione a non
                                                  sentirsi compresi.
                                                  Inoltre avrà una
                                                  ricaduta sulla
                                                  possibilità di
                                                  autodeterminarsi.  </div>
                                                <div> Se esito a fare la
                                                   diagnosi a un bambino
                                                  non è perché lo vedo a
                                                  livello 0, che
                                                  ribadisco non esiste,
                                                  ma perché ci sono
                                                  situazioni in cui i
                                                  sintomi sono difficili
                                                  da decifrare in pochi
                                                  incontri ed è
                                                  necessario conoscerlo
                                                  meglio e in modo più
                                                  profondo. </div>
                                                <div> Ci possono essere
                                                  molti motivi per cui
                                                  il suo stile di
                                                  funzionamento
                                                  autistico non è
                                                  immediatamente
                                                  apprezzabile e la
                                                  conoscenza, stare in
                                                  relazione è, in questi
                                                  casi, l’unica
                                                  strategia che abbiamo
                                                  per capire.  </div>
                                                <div> <br>
                                                </div>
                                                <div> Ma non è mai
                                                  quello che viene
                                                  proposto come il
                                                  livello 0  per gli
                                                  adulti, anzi se mai ci
                                                  sono bambini,
                                                  soprattutto piccoli,
                                                  anche chiaramente
                                                  autistici che non
                                                  hanno una vera e
                                                  propria ricaduta sulla
                                                  qualità di vita al
                                                  momento della
                                                  diagnosi, ma possiamo
                                                  ben prevedere che ne
                                                  avrà e la diagnosi
                                                  dovrebbe servire a
                                                  tutelarli e a dargli
                                                  un mondo sociale più
                                                  capace di capirli e
                                                  più adatto al loro
                                                  stile di
                                                  funzionamento.
                                                  Esattamente come dici
                                                  anche tu. </div>
                                                <div> È un diritto
                                                  inalienabile dei
                                                  bambini che gli adulti
                                                  si muovano in questa
                                                  prospettiva
                                                  protettiva. Quindi io
                                                  non ritengo affatto di
                                                  “forzare” il sistema,
                                                  credo sia giusto porre
                                                  le basi per aiutare il
                                                  bambino a crescere il
                                                  più sereno possibile.
                                                </div>
                                                <div> <br>
                                                </div>
                                                <div> E il criterio D
                                                  non può e non deve
                                                  essere inteso solo
                                                  come “il tuo stile di
                                                  funzionamento
                                                  autistico ti impedisce
                                                  di lavorare e di
                                                  essere autonomo” ma
                                                  anche come ricaduta in
                                                  termini di sofferenza
                                                  e  di disagio
                                                  psichico. D’altronde
                                                  qualche volta la
                                                  sofferenza può essere
                                                  così forte da impedire
                                                  di realizzarsi e di
                                                  diventare autonomi. E
                                                  la sofferenza psichica
                                                  non è sapere
                                                  psichiatrica. </div>
                                                <div> È  ora di
                                                  riconoscere e dare
                                                  valore anche a questo
                                                  aspetto con buona pace
                                                  di chi pensa che
                                                  psicologi e psichiatri
                                                  siano
                                                  (non)professionisti
                                                  facilmente
                                                  abbindolabili e
                                                  incapaci di
                                                  riconoscere la
                                                  sofferenza psicologica
                                                  e la ricaduta che
                                                  questa ha sulla
                                                  qualità di vita e
                                                  sull’autodeterminazione.
                                                </div>
                                                <div> <br>
                                                </div>
                                                <div> Raffaella  </div>
                                                <div> <br>
                                                </div>
                                                <div> <br>
                                                </div>
                                                <div> <br>
                                                </div>
                                                <div>
                                                  <div> <br>
                                                    <blockquote
                                                      type="cite">
                                                      <div> Il giorno 1
                                                        mar 2023, alle
                                                        ore 17:37, David
                                                        Vagni <<a
                                                          href="mailto:david.vagni@gmail.com"
class="moz-txt-link-freetext" moz-do-not-send="true">david.vagni@gmail.com</a>>
                                                        ha scritto: </div>
                                                      <div>
                                                        <div> Cara
                                                          Raffaella,
                                                          <div> a parte
                                                          l’avere idee
                                                          diverse
                                                          sull’unitarietà
                                                          dell’autismo,
                                                          concordo sul
                                                          resto del tuo
                                                          discorso ma
                                                          vorrei
                                                          aggiungere un
                                                          commento alla
                                                          tua ultima
                                                          parte:
                                                          <div> <br>
                                                          </div>
                                                          <div>
                                                          <div>
                                                          <blockquote
                                                          type="cite">
                                                          <div> Inoltre
                                                          dovrebbe farci
                                                          riflettere che
                                                          questo
                                                          problema non
                                                          esiste quando
                                                          parliamo di
                                                          bambini esiste
                                                          solo per
                                                          quanto
                                                          riguarda gli
                                                          adulti. Ma
                                                          questi adulti
                                                          sono stati
                                                          bambini e
                                                          adolescenti
                                                          che
                                                          probabilmente
                                                          hanno sofferto
                                                          per non
                                                          sentirsi né
                                                          capiti né
                                                          integrati e
                                                          per una
                                                          diversità che
                                                          li ha sempre
                                                          fatti sentire
                                                          estranei. </div>
                                                          </blockquote>
                                                          </div>
                                                          <br>
                                                          </div>
                                                          <div> Come sai
                                                          non faccio
                                                          diagnosi
                                                          (ripeto, sono
                                                          un ricercatore
                                                          non un
                                                          clinico) ma
                                                          partecipo a
                                                          tantissime
                                                          valutazioni.
                                                          Devo dire che
                                                          anche se è
                                                          infrequente,
                                                          mi è capitato
                                                          più di una
                                                          volta di
                                                          osservare
                                                          situazioni di
                                                          "autismo si,
                                                          autismo no,
                                                          autismo forse”
                                                          <strong>anche
                                                          nei bambini</strong>,
                                                          relativamente
                                                          al criterio
                                                          del
                                                          “funzionamento”.
                                                          </div>
                                                          </div>
                                                          <div> <br>
                                                          </div>
                                                          <div>
                                                          Purtroppo nei
                                                          bambini,
                                                          ancora più che
                                                          negli adulti,
                                                          è difficile (e
                                                          rischi di
                                                          essere preso
                                                          per pazzo o
                                                          peggio) fare
                                                          diagnosi in
                                                          presenza di un
                                                          buon
                                                          funzionamento,
                                                          perché se sono
                                                          in un ambiente
                                                          “protetto”,
                                                          l’ambiente
                                                          stesso tende a
                                                          mascherare le
                                                          difficoltà
                                                          (genitori
                                                          iper-presenti,
                                                          piccola scuola
                                                          privata,
                                                          etc.). </div>
                                                          <div> <br>
                                                          </div>
                                                          <div> Il
                                                          problema è che
                                                          tu <strong>sai</strong> che
                                                          <em>prima o
                                                          poi quel
                                                          bambino cadrà</em>.
                                                          Perché il
                                                          problema è che
                                                          quando i
                                                          tratti
                                                          autistici ci
                                                          sono, anche in
                                                          presenza di un
                                                          buon
                                                          funzionamento
                                                          (e magari
                                                          momentaneamente
                                                          anche in
                                                          assenza di
                                                          stress
                                                          psicologico),
                                                          prima o poi
                                                          quella cosa
                                                          che ti fa
                                                          crollare la
                                                          trovi. Spesso
                                                          è il passaggio
                                                          da un ciclo
                                                          scolastico
                                                          all’altro o un
                                                          trasloco. </div>
                                                          <div> <span><br>
                                                          </span> </div>
                                                          <div> In
                                                          generale in
                                                          quei casi
                                                          spesso uno
                                                          scrive “ci
                                                          sono marcati
                                                          tratti… ma il
                                                          funzionamento
                                                          al momento….”
                                                          “si consiglia
                                                          di tenere
                                                          sotto
                                                          osservazione”…”si
                                                          consiglia
                                                          ugualmente di
                                                          fare un
                                                          parent-training”,
                                                          etc. </div>
                                                          <div> Ma
                                                          spesso bambini
                                                          nello spettro
                                                          hanno
                                                          genitori,
                                                          almeno con una
                                                          gamba nello
                                                          spettro ed il
                                                          pensiero
                                                          dicotomico la
                                                          fa da padrone
                                                          e viene
                                                          ulteriormente
                                                          incentivato da
                                                          un sistema
                                                          sociosanitario
                                                          pensato per la
cura/assistenza molto più che per la prevenzione.  </div>
                                                          <div> <br>
                                                          </div>
                                                          <div> Il
                                                          risultato è
                                                          che
                                                          frequentemente
                                                          in quei casi
                                                          non fanno
                                                          nulla e poi
                                                          ritornano dopo
                                                          2, 4, 6 anni,
                                                          quando scoppia
                                                          il problema. </div>
                                                          <div> <br>
                                                          </div>
                                                          <div> Questo
                                                          penso dovrebbe
                                                          far ragionare
                                                          su una cosa,
                                                          medici e
                                                          psicologi, di
                                                          cosa si
                                                          occupano?
                                                          Della malattia
                                                          o della
                                                          salute? Perché
                                                          se ci
                                                          occupiamo
                                                          della salute
                                                          dovremmo
                                                          impegnarci <em>primariamente</em><span> nella
                                                          </span><em>prevenzione</em>.
                                                          Ma
                                                          il “sistema”
                                                          non lo
                                                          consente.  </div>
                                                          <div> <br>
                                                          </div>
                                                          <div> Quanto è
                                                          lecito forzare
                                                          il sistema per
                                                          fare
                                                          prevenzione? </div>
                                                          <div> <br>
                                                          </div>
                                                          <div> Questa
                                                          penso sia una
                                                          domanda
                                                          interessante
                                                          da porsi e a
                                                          cui non ho una
                                                          risposta. </div>
                                                        </div>
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                                                        autismo-biologia
                                                        <br>
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                                                    </blockquote>
                                                  </div>
                                                  <br>
                                                </div>
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                                                autismo-biologia <br>
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                                              </blockquote>
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                                        </blockquote>
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                                      <br>
                                    </div>
                                  </div>
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                            </blockquote>
                          </div>
                          <br>
                        </div>
                      </div>
                    </blockquote>
                  </div>
                </blockquote>
              </div>
              <br>
              <fieldset class="moz-mime-attachment-header"></fieldset>
              <pre class="moz-quote-pre" wrap="">_______________________________________________
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            </blockquote>
            <br>
            <span>_______________________________________________</span><br>
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      <pre class="moz-quote-pre" wrap="">_______________________________________________
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