Allely Clare S, Wilson Philip
Institute of Health and Wellbeing, University of Glasgow, RHSC Yorkhill, Glasgow.
Practitioner. 2011 Nov;255(1745):27-30, 3.
Autism is a disorder of social communication, originally described as a triad of impaired social interaction, communication, and imagination, associated with a rigid, repetitive pattern of behaviour. More recently the core deficit has been described as a lack of social instinct. The term autism spectrum disorder (ASD) includes autism, atypical autism and Asperger's syndrome. According to NICE, diagnostic assessment should start within three months of referral. The decision to refer should be made on the basis of signs or symptoms. Information from all sources (i.e. medical history, parental concerns, clinical judgement) should be used to diagnose ASD based on ICD-10 or DSM-IV criteria. Clinicians should not rely on any one autism-specific diagnostic tool alone to diagnose ASD. Diagnosis is based primarily on the recognition and interpretation of behavioural symptoms. CHAT or the modified version (M-CHAT) are simple checklists that can be used for the assessment of young children in primary care when ASD is suspected. They can identify clinical features indicative of increased risk but should not be used to rule out ASD.
自闭症是一种社会交往障碍，最初被描述为社交互动、沟通和想象力受损的三联征，伴有刻板、重复的行为模式。最近，核心缺陷被描述为缺乏社交本能。自闭症谱系障碍（ASD）这一术语包括自闭症、非典型自闭症和阿斯伯格综合征。根据英国国家卫生与临床优化研究所（NICE）的建议，诊断评估应在转诊后三个月内开始。转诊决定应基于体征或症状做出。应综合所有来源的信息（即病史、家长担忧、临床判断），依据国际疾病分类第10版（ICD - 10）或精神疾病诊断与统计手册第4版（DSM - IV）标准来诊断ASD。临床医生不应仅依赖任何一种特定的自闭症诊断工具来诊断ASD。诊断主要基于对行为症状的识别和解读。CHAT或其修订版（M - CHAT）是简单的筛查清单，当怀疑患有ASD时，可用于基层医疗中对幼儿的评估。它们能够识别出表明风险增加的临床特征，但不应被用于排除ASD。
