Szatmari P
Department of Psychiatry, McMaster University Hospital, Hamilton, Ontario, Canada.
Psychiatr Clin North Am. 1991 Mar;14(1):81-93.
Should Asperger's syndrome be distinguished as a separate clinical entity? Unfortunately, relatively little empiric information is available on this issue. The data suggest, however, that even compared to high-functioning autistic children of equivalent IQ, Asperger's syndrome children have better social and language skills. Anecdotal evidence also suggests that they have a different outcome, although this needs to be confirmed in proper, controlled follow-up studies. Although some differences in etiology between autism and Asperger's syndrome have been identified, these are of uncertain clinical significance. It may be that, for purposes of recognition and research, Asperger's syndrome should be considered a separate entity. This ensures that such children are identified for treatment and included in research protocols. This, in itself, would be of considerable benefit, even if it is acknowledged that Asperger's syndrome and autism probably represent different endpoints of a similar pathogenic mechanism. Asperger's syndrome represents a type of developmental disability that profoundly limits a child's participation in the process of growing up. After all, childhood is a time of play and of learning how to communicate with others. As clinicians, we need to understand these limitations and not put up artificial barriers to appropriate diagnostic and treatment services. It is hoped that the growing recognition of the predicament of these children will stimulate greater interest in research and treatment. Not only will children with Asperger's syndrome benefit from this, but, by extension, so will all children with developmental disabilities.
阿斯伯格综合征是否应被区分为一个独立的临床实体？遗憾的是，关于这个问题可获得的实证信息相对较少。然而，数据表明，即便与智商相当的高功能自闭症儿童相比，阿斯伯格综合征儿童也具备更好的社交和语言技能。轶事证据还表明他们有不同的预后情况，不过这需要在适当的对照随访研究中得到证实。虽然已确定自闭症和阿斯伯格综合征在病因方面存在一些差异，但这些差异的临床意义尚不确定。或许，出于识别和研究的目的，阿斯伯格综合征应被视为一个独立的实体。这能确保识别出此类儿童以便进行治疗，并将他们纳入研究方案。即便承认阿斯伯格综合征和自闭症可能代表相似致病机制的不同终点，这本身也会带来相当大的益处。阿斯伯格综合征代表一种发育障碍，它严重限制儿童参与成长过程。毕竟，童年是玩耍以及学习如何与他人交流的时期。作为临床医生，我们需要了解这些限制，并且不要为适当的诊断和治疗服务设置人为障碍。希望对这些儿童困境的日益认识将激发对研究和治疗的更大兴趣。不仅阿斯伯格综合征患儿会从中受益，而且所有发育障碍儿童也会因此受益。
