Webb Sara Jane, Jones Emily J H
Department of Psychiatry and Behavioral Sciences, University of Washington Autism Center, University of Washington, Seattle.
Infants Young Child. 2009 Apr-Jun;22(2):100-118. doi: 10.1097/IYC.0b013e3181a02f7f.
In the first year of life, infants who later go on to develop autistic spectrum disorders (ASD) may exhibit subtle disruptions in social interest and attention, communication, temperament, and head circumference growth that occur prior to the onset of clinical symptoms. These disruptions may reflect the early course of ASD development and may also contribute to the later development of clinical symptoms through alterations in the child's experience of his or her environment. By age 2, developmental precursors of autism symptoms can be used to diagnose children reliably, and by age 3, the diagnosis is thought to be relatively stable. The downward extension of the autism diagnosis poses important questions for therapists in designing interventions that are applicable for infants who demonstrate early risk factors. We review current knowledge of the early signs of ASD in the infancy period (0-12 months) and the manifestation of symptoms in toddlerhood (12- 36 months), noting the importance of considering the variability in onset and trajectory of ASD. Finally, we consider the implications of this emerging research for those who work or interact with young children, including the importance of early monitoring and the development and evaluation of age-appropriate interventions.
在生命的第一年，那些后来发展为自闭症谱系障碍（ASD）的婴儿可能在临床症状出现之前，就表现出社交兴趣和注意力、沟通、气质以及头围生长方面的细微紊乱。这些紊乱可能反映了ASD发展的早期过程，也可能通过改变儿童对其环境的体验，导致临床症状的后期发展。到2岁时，自闭症症状的发育先兆可用于可靠地诊断儿童，到3岁时，诊断结果被认为相对稳定。自闭症诊断范围的向下延伸，给治疗师在设计适用于表现出早期风险因素的婴儿的干预措施时带来了重要问题。我们回顾了婴儿期（0 - 12个月）ASD早期迹象以及幼儿期（12 - 36个月）症状表现的现有知识，指出了考虑ASD发病和发展轨迹变异性的重要性。最后，我们考虑了这项新研究对那些与幼儿一起工作或互动的人的影响，包括早期监测的重要性以及适合不同年龄段干预措施的开发和评估。
