MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.
Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands.
J Child Psychol Psychiatry. 2022 Apr;63(4):397-417. doi: 10.1111/jcpp.13481. Epub 2021 Jul 23.
Practitioners frequently use diagnostic criteria to identify children with neurodevelopmental disorders and to guide intervention decisions. These criteria also provide the organising framework for much of the research focussing on these disorders. Study design, recruitment, analysis and theory are largely built on the assumption that diagnostic criteria reflect an underlying reality. However, there is growing concern that this assumption may not be a valid and that an alternative transdiagnostic approach may better serve our understanding of this large heterogeneous population of young people. This review draws on important developments over the past decade that have set the stage for much-needed breakthroughs in understanding neurodevelopmental disorders. We evaluate contemporary approaches to study design and recruitment, review the use of data-driven methods to characterise cognition, behaviour and neurobiology, and consider what alternative transdiagnostic models could mean for children and families. This review concludes that an overreliance on ill-fitting diagnostic criteria is impeding progress towards identifying the barriers that children encounter, understanding underpinning mechanisms and finding the best route to supporting them.
从业者经常使用诊断标准来识别患有神经发育障碍的儿童，并指导干预决策。这些标准也为关注这些障碍的大部分研究提供了组织框架。研究设计、招募、分析和理论在很大程度上基于这样一种假设，即诊断标准反映了潜在的现实。然而，人们越来越担心这种假设可能不成立，而一种替代的跨诊断方法可能会更好地帮助我们理解这个年轻人的大型异质群体。这篇综述借鉴了过去十年中的重要发展，为理解神经发育障碍方面的突破奠定了基础。我们评估了当代的研究设计和招募方法，回顾了用于描述认知、行为和神经生物学的基于数据的方法，并考虑了替代的跨诊断模型对儿童和家庭意味着什么。这篇综述得出的结论是，过度依赖不合适的诊断标准阻碍了识别儿童遇到的障碍、理解潜在机制以及找到支持他们的最佳途径的进展。
