Aman Michael G
The Nisonger Center, Ohio State University, Columbus, Ohio 43210-1296, USA.
J Clin Psychiatry. 2005;66 Suppl 10:38-45.
Patients with autism spectrum disorders (ASDs) can present with extremely heterogeneous issues, and, therefore, their treatment can be very challenging. Most patients with ASDs will benefit from contact with a multitude of disciplines. In this article, treatment planning is structured in terms of the patient's life stages. Early on, assessment of developmental milestones, metabolic conditions, and hearing; making the diagnosis of ASD; and providing genetic counseling are salient. As the child grows, speech and language therapy, early intensive intervention, special education, parent training, and neurologic assessment become important. With greater age, behavior therapy, pharmacotherapy, occupational therapy, and sexuality issues are often in ascendancy. As the patient approaches and proceeds through adulthood, transition training, housing options, and guardianship issues may be priorities. Advocacy is relevant throughout the life span. Professionals have an obligation to familiarize parents with interventions likely to be fruitful or unhelpful. There is growing evidence that early intensive behavior intervention, though expensive, may produce lifelong gains in functioning. A variety of experimental and/or unproven treatments are identified; mental health professionals can help families with members who have ASDs by guiding them toward effective treatments and away from therapies of unknown value but with potential risks and/or costs.
自闭症谱系障碍（ASD）患者可能会出现极其多样化的问题，因此，对他们的治疗极具挑战性。大多数ASD患者将受益于与多个学科的接触。在本文中，治疗计划是根据患者的生命阶段来构建的。早期，发育里程碑、代谢状况和听力评估、ASD的诊断以及遗传咨询是重点。随着孩子的成长，言语和语言治疗、早期强化干预、特殊教育、家长培训以及神经学评估变得重要起来。随着年龄的增长，行为治疗、药物治疗、职业治疗以及性取向问题通常变得更加突出。当患者接近成年并步入成年期时，过渡培训、住房选择以及监护问题可能成为优先事项。在整个生命周期中，自我维权都很重要。专业人员有义务让家长了解哪些干预措施可能有效或无效。越来越多的证据表明，早期强化行为干预虽然昂贵，但可能会给患者的功能带来终身改善。文中还指出了各种实验性和/或未经证实的治疗方法；心理健康专业人员可以通过引导患有ASD的家庭成员接受有效治疗，远离那些价值不明但有潜在风险和/或成本的疗法，来帮助这些家庭。
