Autism Early Intervention - Progress, Steps Backward, and the Reconciliation of Conflicting Narratives.

IF 5.5 2区 医学 Q1 PSYCHIATRY
Giacomo Vivanti
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引用次数: 0

Abstract

Purpose of review: We review recent research on interventions, services and supports for children on the autism spectrum, examining both advancements and setbacks.

Recent findings: Progress has included an increase in quantity and rigor of intervention science, as well as a broadening of disciplines and perspectives engaged in the examination of early interventions, including their effectiveness, social validity and the contextual determinants of implementation outcomes. Setbacks have included the decrease in research involving children on the autism spectrum who have co-occurring profound intellectual disability, minimal or no spoken language, and who require constant assistance with daily living activities. This trend is alarming because it contributes to the marginalization and unmet needs of children who need intervention the most. Additionally, access to early intervention services is unequal and complicated by the misalignment of policy with the evolving evidence base in the field. The recent growth in the depth and breadth of knowledge related to autism early intervention means that policies, practices, advocacy efforts and research directions can be grounded on a more comprehensive evidence base and societal appraisal of autism. Nevertheless, these indisputable markers of success co-exist with conflicting narratives that hinder the establishment of a cohesive agenda to tackle inequities experienced by marginalized subgroups. Reconciliation of conflicting narratives requires a nuanced and compassionate appraisal of sources of tensions and heterogeneity of needs within the autism spectrum.

自闭症早期干预--进步、退步以及矛盾叙事的调和。
综述目的:我们回顾了针对自闭症谱系儿童的干预、服务和支持的最新研究,审视了研究的进展和挫折:进展包括干预科学的数量和严谨性的增加,以及参与早期干预研究的学科和视角的拓宽,包括干预的有效性、社会有效性和实施结果的背景决定因素。挫折包括涉及自闭症谱系儿童的研究有所减少,这些儿童同时伴有严重的智力障碍,语言能力极差或完全不会说话,日常生活活动需要不断的帮助。这一趋势令人担忧,因为它导致最需要干预的儿童被边缘化,他们的需求得不到满足。此外,获得早期干预服务的机会是不平等的,并且由于政策与该领域不断发展的证据基础不一致而变得更加复杂。最近,有关自闭症早期干预的知识在深度和广度上都有所增长,这意味着政策、实践、宣传工作和研究方向可以建立在更全面的证据基础和社会对自闭症的评价之上。然而,这些毋庸置疑的成功标志与相互矛盾的说法并存,阻碍了制定一个有凝聚力的议程来解决边缘化亚群体所经历的不平等问题。要调和相互冲突的说法,就需要对自闭症谱系中的紧张关系和不同需求的根源进行细致入微和富有同情心的评估。
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来源期刊
CiteScore
11.30
自引率
3.00%
发文量
68
审稿时长
6-12 weeks
期刊介绍: This journal aims to review the most important, recently published research in psychiatry. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by psychiatric disorders. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as anxiety, medicopsychiatric disorders, and schizophrenia and other related psychotic disorders. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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