Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
University Hospital, Ribeirão Preto Medical School, University of São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil.
World J Pediatr. 2023 Aug;19(8):715-726. doi: 10.1007/s12519-022-00629-y. Epub 2022 Oct 25.
Neurodevelopmental disorders are a heterogeneous group of conditions that manifest as delays or deviations in the acquisition of expected developmental milestones and behavioral changes. Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in communication and social interaction and by repetitive and restricted patterns of behavior, interests and activities. The aim of this review is to discuss the clinical features of the differential diagnoses of ASD that are prevalent among preschoolers, focusing on their similarities and disparities.
The international medical literature search was conducted using PubMed and was revised regarding the subject using single and/or combined keywords as follows: differential diagnosis, preschoolers, diagnostic challenge, attention deficit hyperactivity disorder, intellectual disability, high abilities/giftedness, childhood apraxia of speech, social communication disorder, Landau-Kleffner syndrome, stereotyped movement disorder and excessive screen time.
We describe conditions commonly found in clinical practice, taking ASD as a reference. We addressed converging and divergent aspects of behavior, cognition, communication, language, speech, socialization, and stereotypes for the diagnosis of ASD and other disorders identified as potential differential or comorbid diagnoses.
The ranking and characterization of symptoms appear to be essential for better understanding the underlying common ground between children with developmental disorders and children with ASD, thus properly diagnosing and directing social, professional, or medication interventions. This detailed discussion adds to the literature since, although ASD differential diagnoses are frequently mentioned and discussed in textbooks and journal articles, they rarely occupy a prominent place as we aimed herein.
神经发育障碍是一组表现为预期发育里程碑延迟或偏离以及行为变化的异质性疾病。自闭症谱系障碍（ASD）是一种神经发育障碍，其特征是在沟通和社交互动方面存在缺陷，以及行为、兴趣和活动方面存在重复和受限的模式。本综述的目的是讨论在学龄前儿童中常见的 ASD 鉴别诊断的临床特征，重点关注它们的相似之处和差异。
使用 PubMed 进行了国际医学文献检索，并使用单个和/或组合关键词对其进行了修订，如下所示：鉴别诊断、学龄前儿童、诊断挑战、注意缺陷多动障碍、智力障碍、高能力/天赋、儿童言语失用症、社交沟通障碍、 Landau-Kleffner 综合征、刻板运动障碍和过度屏幕时间。
我们描述了在临床实践中常见的情况，以 ASD 为参考。我们讨论了行为、认知、沟通、语言、言语、社交和刻板印象方面的趋同和发散方面，以诊断 ASD 和其他被确定为潜在鉴别或共病诊断的障碍。
症状的排序和特征似乎对于更好地理解发育障碍儿童和 ASD 儿童之间的潜在共同点至关重要，从而正确诊断和指导社会、专业或药物干预。由于 ASD 鉴别诊断在教科书中经常被提及和讨论，尽管在本文中很少占据突出位置，但这种详细讨论增加了文献内容。
