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成年自闭症:采用新型多步网络模型分析的五百名自闭症患者队列的临床和人口统计学特征

Autism in Adulthood: Clinical and Demographic Characteristics of a Cohort of Five Hundred Persons with Autism Analyzed by a Novel Multistep Network Model.

作者信息

Keller Roberto, Chieregato Silvia, Bari Stefania, Castaldo Romina, Rutto Filippo, Chiocchetti Annalisa, Dianzani Umberto

机构信息

Adult Autism Center, Mental Health Department, Health Unit ASL Città di Torino, 10138 Turin, Italy.

Department of Psychology, University of Turin, 10100 Turin, Italy.

出版信息

Brain Sci. 2020 Jul 1;10(7):416. doi: 10.3390/brainsci10070416.

Abstract

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in communication and relational skills, associated with repetitive verbal and motor behaviors, restricted patterns of interest, need for a predictable and stable environment, and hypo- or hypersensitivity to sensory inputs. Due to the challenging diagnosis and the paucity of specific interventions, persons with autism (PWA) reaching the adult age often display a severe functional regression. In this scenario, the Regional Center for Autism in Adulthood in Turin seeks to develop a personalized rehabilitation and enablement program for PWA who received a diagnosis of autism in childhood/adolescence or for individuals with suspected adulthood ASD. This program is based on a Multistep Network Model involving PWA, family members, social workers, teachers, and clinicians. Our initial analysis of 500 PWA shows that delayed autism diagnosis and a lack of specific interventions at a young age are largely responsible for the creation of a "lost generation" of adults with ASD, now in dire need of effective psychosocial interventions. As PWA often present with psychopathological co-occurrences or challenging behaviors associated with lack of adequate communication and relational skills, interventions for such individuals should be mainly aimed to improve their self-reliance and social attitude. In particular, preparing PWA for employment, whenever possible, should be regarded as an essential part of the intervention program given the social value of work. Overall, our findings indicate that the development of public centers specialized in assisting and treating PWA can improve the accuracy of ASD diagnosis in adulthood and foster specific habilitative interventions aimed to improve the quality of life of both PWA and their families.

摘要

自闭症谱系障碍(ASD)是一种神经发育障碍,其特征在于沟通和社交技能缺陷,伴有重复性言语和运动行为、兴趣模式受限、对可预测和稳定环境的需求以及对感觉输入的低敏或高敏反应。由于诊断具有挑战性且缺乏特定干预措施,成年自闭症患者(PWA)往往会出现严重的功能衰退。在这种情况下,都灵成年自闭症区域中心旨在为童年/青少年期被诊断为自闭症的PWA或疑似成年期ASD的个体制定个性化的康复与赋能计划。该计划基于一个多步骤网络模型,涉及PWA、家庭成员、社会工作者、教师和临床医生。我们对500名PWA的初步分析表明,自闭症诊断延迟以及年轻时缺乏特定干预措施在很大程度上导致了一代患有ASD的成年“迷失者”的产生,他们现在迫切需要有效的心理社会干预。由于PWA常常伴有精神病理学共病或与缺乏足够沟通和社交技能相关的挑战性行为,针对这类个体的干预应主要旨在提高他们的自立能力和社交态度。特别是,只要有可能,为PWA做好就业准备应被视为干预计划的重要组成部分,因为工作具有社会价值。总体而言,我们的研究结果表明,专门协助和治疗PWA的公共中心的发展可以提高成年期ASD诊断的准确性,并促进旨在改善PWA及其家庭生活质量的特定康复干预措施。

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