通过改变诊断程序的设计改进自闭症谱系障碍的干预策略

Short Communication, R. E. Seymour
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摘要

自 Leo Kanner 博士和 Hans Asperger 博士分别于 1943 年和 1944 年发现儿童自闭症以来,我们对这种疾病的认识一直在不断发展。起初,自闭症被描述为一种依恋障碍,后来又被描述为一种心理-社会-教育障碍。这种想法决定了所采用的干预措施。医生、家长或教育工作者几乎不期望 ASD 有明显的好转。家长们普遍反映,在确诊后,除了把孩子送进特殊学校和开始言语治疗外,他们没有得到任何真正的建议。ASD 的发病率越来越高(每 44 个新生儿中就有 1 个:疾病预防控制中心),这意味着服务提供者所面临的压力越来越大,难以承受。然而,思想的变化带来了一些光明的前景。例如,自 20 世纪 90 年代以来,人们越来越认识到生物群落的作用,有报告称,新陈代谢干预措施取得了积极成果。这些方法带来了积极的结果,也让人们对自闭症的本质有了更深入的了解。本讲座建议改变诊断方案的执行方式,以符合对 ASD 更为普遍的看法。我们需要一种与研究和新发展相一致的新方法,以便家长在诊断时就能获得对孩子大有裨益的行动指南,因为所有人都认为早期干预能带来更好的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improving Intervention Strategies for Autism Spectrum Disorders by Altering the Design of the Diagnostic Procedure
Since the identification of the childhood disorder Autism by Dr Leo Kanner in 1943 and Dr Hans Asperger in 1944, our understanding of this condition has evolved. At first it was described as an attachment disorder, then it was described as a psycho-social-educational disorder, which is largely where our thinking on the topic has remained. This thinking determines the interventions applied. There is little expectation by physicians, parents or educators of significant emergence from ASD. It is common for parents to report that they receive no real advice as to what to do after the diagnosis other than placement of the child in a special school and to start Speech Therapy. The increasing incidence of ASD (1 in 44 births: CDC) means the mounting pressure on service providers is unmanageable. However there have been changes in thinking that brought some promise of brighter outcomes. For example since the 1990’s there has been increasing appreciation of the role of the biome, with reports of positive outcomes following metabolic interventions. Approaches have arisen that offer positive outcomes and have brought a greater understanding of the nature of ASD. This presentation proposes a change to the way the diagnostic protocol is executed in keeping with a more pervasive view of ASD. A new approach is needed in line with research and new developments, so that at the time of diagnosis parents get pointers for actions to follow that can greatly benefit the child, since all agree that early intervention brings better outcomes.
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