Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Region Stockholm, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden.
Child and Adolescent Psychiatry, Region Stockholm, Stockholm Health Care Services, Stockholm, Sweden.
Bioessays. 2021 Sep;43(9):e2000254. doi: 10.1002/bies.202000254. Epub 2021 Apr 1.
Neurodevelopmental disorders (NDDs), such as autism and ADHD, are behaviorally defined adaptive functioning difficulties arising from variations, alterations and atypical maturation of the brain. While it is widely agreed that NDDs are complex conditions with their presentation and functional impact underpinned by diverse genetic and environmental factors, contemporary and polarizing debate has focused on the appropriateness of the biomedical as opposed to the neurodiverse paradigm in framing conceptions of these conditions. Despite being largely overlooked by both research and practice, the International Classification of Functioning Disability and Health (ICF) endorsed by the World Health Organization in 2001 views functioning dynamically, offering a framework for investigating, assessing and treating NDDs holistically. Exemplified by autism and ADHD, we argue that the ICF provides not only a multitude of opportunities in accounting for the environmental determinants in researching and clinically managing NDDs, but opportunities for harmonizing the seemingly irreconcilable biomedical and neurodiverse paradigms. Also see the video abstract here: https://youtu.be/YwuWPDUOs5k.
神经发育障碍（NDDs），如自闭症和注意缺陷多动障碍（ADHD），是指大脑的变异、改变和非典型成熟导致的行为定义的适应功能障碍。虽然人们普遍认为 NDDs 是复杂的疾病，其表现和功能影响由多种遗传和环境因素决定，但当前存在着两极分化的争论，焦点是在构建这些疾病的概念时，生物医学范式与神经多样性范式是否合适。尽管在研究和实践中都在很大程度上被忽视，但世界卫生组织（WHO）在 2001 年认可的《国际功能、残疾和健康分类》（ICF）从动态的角度看待功能，为全面研究、评估和治疗 NDDs 提供了一个框架。以自闭症和 ADHD 为例，我们认为 ICF 不仅为研究和临床管理 NDDs 中环境决定因素提供了多种机会，而且为协调看似不可调和的生物医学和神经多样性范式提供了机会。也可在此处查看视频摘要：https://youtu.be/YwuWPDUOs5k。
