Scahill Lawrence
Yale University School of Medicine, New Haven, CT, USA.
J Clin Psychiatry. 2005;66 Suppl 10:19-25.
Accurate diagnosis and appropriate treatment of pervasive developmental disorders (PDDs), including autistic disorder, Asperger's disorder, and pervasive developmental disorder not otherwise specified, are necessary to ensure the best possible outcomes for children with these disorders. In the past, it was not uncommon for children with PDDs to wait several years from the time of parental recognition of developmental delay to the determination of the correct diagnosis and initiation of treatment. Increased awareness of PDDs and the availability of better assessment tools have improved the detection of these conditions in children. A wide variety of standardized diagnostic checklists, interviews, and observational measures are available to assist the clinician in making an accurate PDD diagnosis. A comprehensive evaluation also establishes a baseline of adaptive functioning and problematic behavior, which is essential for subsequent assessment of progress. This article discusses the differential diagnosis and evaluation of PDDs, focusing on the various assessment tools. The elements of a contemporary diagnostic evaluation and behavioral assessment are presented. The application of discretionary evaluations for special situations are also introduced.
准确诊断和恰当治疗广泛性发育障碍(PDDs),包括自闭症谱系障碍、阿斯伯格综合征以及未特定的广泛性发育障碍,对于确保患有这些障碍的儿童获得最佳预后至关重要。过去,患有PDDs的儿童从父母意识到发育迟缓到确定正确诊断并开始治疗,往往要等待数年时间。对PDDs的认识提高以及更好评估工具的出现,改善了对儿童这些病症的检测。有各种各样的标准化诊断清单、访谈和观察措施可协助临床医生做出准确的PDD诊断。全面评估还能确立适应性功能和问题行为的基线,这对于后续评估进展至关重要。本文讨论PDDs的鉴别诊断和评估,重点关注各种评估工具。介绍了当代诊断评估和行为评估的要素。还介绍了特殊情况的酌情评估应用。