Columbia University, New York, New York, USA.
Curr Opin Pediatr. 2013 Feb;25(1):130-44. doi: 10.1097/MOP.0b013e32835c2b70.
To provide an updated overview of autism spectrum disorders (ASDs), with particular attention to the pediatrician's role in assessing and managing patients with ASDs.
Clinical perspectives on ASDs continue to evolve. The prevalence of ASDs in the United States continues to rise, and pediatricians are being tasked with the responsibility for universal screening. Further changes in its epidemiology will undoubtedly result from anticipated changes in the diagnostic criteria put forth in the upcoming revision to the Diagnostic and Statistical Manual (5th edition). Although there have been considerable advances in identifying a genetic cause in many more cases, the cause remains elusive in most cases. Recent studies of concordant twins suggest there is a stronger environmental component than previously believed. Research suggests earlier diagnosis may be feasible in some cases, and a new treatment approach has been shown to be effective in very young children. Although there have not been any large-scale advances in the medical treatment, some isolated successes have been reported and other promising therapies are now being investigated.
Clinical guidelines for ASDs are evolving, with updated diagnostic criteria expected and revised recommendations for evaluation also imminent. This article provides pediatricians with a clinical overview of ASD - with an emphasis on the clinical considerations relating to screening, evaluation, and management.
提供自闭症谱系障碍(ASD)的最新概述,特别关注儿科医生在评估和管理 ASD 患者方面的作用。
对 ASD 的临床观点仍在不断发展。美国 ASD 的患病率持续上升,儿科医生承担着进行普遍筛查的责任。即将对《诊断与统计手册》(第 5 版)提出的诊断标准进行修订,预计其流行病学将发生进一步变化。尽管在许多情况下已经在确定遗传原因方面取得了相当大的进展,但在大多数情况下,原因仍然难以捉摸。最近对同卵双胞胎的研究表明,环境因素比以前认为的更强。研究表明,在某些情况下可能实现更早的诊断,并且一种新的治疗方法已被证明对非常年幼的儿童有效。尽管在医学治疗方面没有取得任何重大进展,但已经有一些孤立的成功案例报告,并且现在正在研究其他有前途的治疗方法。
ASD 的临床指南正在不断发展,预计将更新诊断标准,并且即将对评估提出修订建议。本文为儿科医生提供了 ASD 的临床概述,重点介绍了与筛查、评估和管理相关的临床注意事项。