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考虑在视力或听力受损的儿童中识别自闭症谱系障碍:对文献的批判性回顾和对实践的建议。

Considerations for the identification of autism spectrum disorder in children with vision or hearing impairment: A critical review of the literature and recommendations for practice.

机构信息

Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA.

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

Clin Neuropsychol. 2022 Jul;36(5):1049-1068. doi: 10.1080/13854046.2021.2002933. Epub 2021 Dec 10.

Abstract

OBJECTIVE

There is higher risk for autism spectrum disorder (ASD) across many pediatric neurological conditions characterized by vision impairment or hearing loss. Early and accurate identification of ASD is imperative in promoting access to appropriate and early evidenced-based intervention; however, differential diagnosis can be particularly challenging in children with sensory impairment given the heterogeneity of ASD combined with the impact of vision impairment or hearing loss/deafness on development and behavior. A neuropsychologist's unique expertise and appreciation of the interplay between sensory and behavioral manifestations can be valuable for making an early and accurate ASD diagnosis in children who are blind/visually impaired or deaf/hard-of-hearing. This article highlights clinical considerations when identifying ASD within the context of vision impairment or hearing loss/deafness.

METHOD

We discuss clinical considerations for the early identification of ASD in children who are blind/visually impaired and deaf/hard-of-hearing. Information presented in the article is based on a critical review of the literature and the expertise of the author group.

CONCLUSION

Ongoing development of clinical expertise and evidence-based assessment methods are important when informing the early differential diagnosis of ASD in individuals with sensory impairment. Accurate identification is also vital for the development of targeted interventions across the lifespan.

摘要

目的

许多儿科神经疾病都会导致自闭症谱系障碍(ASD)的风险增加,这些疾病的特征是视力障碍或听力损失。早期准确识别 ASD 对于促进获得适当和早期的循证干预至关重要;然而,对于有感官障碍的儿童,由于 ASD 的异质性以及视力障碍或听力损失/耳聋对发育和行为的影响,鉴别诊断可能特别具有挑战性。神经心理学家在识别视力障碍或听力损失/耳聋的儿童中的 ASD 时,具有独特的专业知识和对感官和行为表现相互作用的理解,可以为早期和准确的 ASD 诊断提供有价值的信息。本文重点介绍了在视力障碍或听力损失/耳聋的背景下识别 ASD 时的临床注意事项。

方法

我们讨论了在盲/视力障碍和聋/重听儿童中早期识别 ASD 的临床注意事项。本文中介绍的信息是基于对文献的批判性回顾和作者小组的专业知识。

结论

在告知有感官障碍的个体进行 ASD 的早期鉴别诊断时,不断发展的临床专业知识和基于证据的评估方法很重要。准确识别对于在整个生命周期中制定有针对性的干预措施也至关重要。

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