An Overview of Pediatric Approaches to Child with Developmental Delay Especially if There is Suspicion of ASD in First Few Years of Life.

Aneta Demerdzieva, Nada Pop-Jordanova
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Abstract

To be a pediatrician means that one encounters many serious childhood health problems and one finds many ways to help families cope with these problems. Symptoms in children can be discrete, and the responsibility of the pediatrician to distinguish normal development from pathological. We are facing a new era in the developmental assessment of children. A cluster of neurodevelopmental disorders includes ASD (autism spectrum disorder) and ADHD (attention deficit hyperactivity disorder). Parents often do not recognize the problem on time. Generally, their first concern is speech delay, leading to the suspicion of hearing problems. Therefore, it is very important to obtain objective anamnestic information and for the child to undergo a careful physical examination, a neurophysiological assessment, and metabolic and genetic testing. The etiology usually is multifactorial: genetic, epigenetic, and non-genetic factors act in combination through various paths. Most children seem to have typical neurodevelopment during first their year. It was found that approximately one-third of children with ASD lose some skills during the preschool period, usually speech related, but sometimes also non-verbal communication, social or play skills. In conclusion we must say that it is very important to recognize the early signs of ASD and any kind of other developmental delay and to start with early intervention. Clinical pediatricians tend to correlate clinical manifestations and biological underpinnings related to neurodevelopmental disorder, especially ASD. Therefore, better treatment possibilities are needed.

发展迟缓儿童的儿科治疗方法综述,特别是在生命的最初几年有ASD的怀疑。
成为一名儿科医生意味着你会遇到许多严重的儿童健康问题,并找到许多方法来帮助家庭应对这些问题。儿童的症状可以是离散的,儿科医生有责任区分正常发育和病理发育。我们正面临着儿童发展评估的新时代。一系列神经发育障碍包括ASD(自闭症谱系障碍)和ADHD(注意缺陷多动障碍)。父母常常不能及时发现问题。一般来说,他们首先担心的是语言迟缓,从而怀疑听力有问题。因此,获得客观的记忆信息,对儿童进行仔细的体格检查、神经生理评估、代谢和基因检测是非常重要的。病因通常是多因素的:遗传、表观遗传和非遗传因素通过各种途径共同作用。大多数孩子在一岁时似乎有典型的神经发育。研究发现,大约三分之一的自闭症儿童在学龄前期间会失去一些技能,通常是与语言有关的,但有时也会失去非语言沟通、社交或游戏技能。总之,我们必须说,认识到自闭症谱系障碍和任何其他发育迟缓的早期迹象并开始早期干预是非常重要的。临床儿科医生倾向于将临床表现与神经发育障碍,特别是ASD相关的生物学基础联系起来。因此,需要更好的治疗方法。
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