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孤独症谱系障碍管理的实践要点——儿科医生应了解的内容。

Practical Aspects of ASD Management-What Pediatricians Should Know.

作者信息

Juneja Monica, Sairam Smitha, Jain Ridhimaa, Gupta Arpita

机构信息

Department of Pediatrics, Maulana Azad Medical College and associated Lok Nayak Hospital, 2, Bahadur Shah Zafar Marg, New Delhi, 110002, India.

Center of Excellence-Early Intervention Center, Lok Nayak Hospital, New Delhi, India.

出版信息

Indian J Pediatr. 2023 Apr;90(4):369-376. doi: 10.1007/s12098-023-04476-1. Epub 2023 Feb 16.

DOI:10.1007/s12098-023-04476-1
PMID:36795273
Abstract

The increasing prevalence of autism spectrum disorder (ASD) warrants higher levels of clinical attention to optimally manage children with ASD. There is mounting evidence that early intervention programs can help improve developmental functioning, maladaptive behaviors, and core ASD symptoms. The most thoroughly investigated and evidence-based therapies have been developmental, behavioral, and educational interventions mediated by either professionals or parents. Other commonly available interventions include speech and language therapy, occupational therapy, and social skills training. Pharmacological interventions, where needed, are used as an adjunct to treat severe problem behaviors and manage medical and psychiatric comorbidities. Complementary or alternative medicine (CAM) approaches have not proven to be of any benefit, and some of them may be harmful to the child. As the child's first point of contact, the pediatrician is well-positioned to effectively guide the families to therapies that are evidence-based and safe and also collaborate with various specialists to provide seamless, coordinated care for these children so as to improve their developmental outcomes and social functioning.

摘要

自闭症谱系障碍(ASD)患病率的不断上升,需要更高水平的临床关注,以便对自闭症谱系障碍儿童进行最佳管理。越来越多的证据表明,早期干预项目有助于改善发育功能、适应不良行为和自闭症谱系障碍的核心症状。研究最为深入且有循证依据的疗法是由专业人员或家长介导的发育、行为和教育干预。其他常见的干预措施包括言语和语言治疗、职业治疗以及社交技能训练。在必要时,药物干预可作为辅助手段,用于治疗严重的问题行为以及处理医学和精神方面的共病情况。补充或替代医学(CAM)方法尚未被证明有任何益处,其中一些方法可能对儿童有害。作为儿童的首要接触点,儿科医生有能力有效地指导家庭采用循证且安全的疗法,并与各类专科医生合作,为这些儿童提供无缝、协调的护理,从而改善他们的发育结果和社会功能。

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本文引用的文献

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An Update on Psychopharmacological Treatment of Autism Spectrum Disorder.自闭症谱系障碍的精神药理学治疗进展。
Neurotherapeutics. 2022 Jan;19(1):248-262. doi: 10.1007/s13311-022-01183-1. Epub 2022 Jan 14.
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The Lancet Commission on the future of care and clinical research in autism.《柳叶刀》自闭症护理与临床研究未来委员会
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A Systematic Review and Meta-analysis of Parent Training for Disruptive Behavior in Children with Autism Spectrum Disorder.系统评价和荟萃分析:自闭症谱系障碍儿童的破坏性行为的父母培训。
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J Neurodev Disord. 2016 Apr 14;8:15. doi: 10.1186/s11689-016-9149-6. eCollection 2016.
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Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder: A Comprehensive Review.针对患有自闭症谱系障碍的儿童、青少年和青年的循证实践:一项全面综述。
J Autism Dev Disord. 2015 Jul;45(7):1951-66. doi: 10.1007/s10803-014-2351-z.
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Parent-mediated early intervention for young children with autism spectrum disorders (ASD).针对自闭症谱系障碍(ASD)幼儿的家长介导早期干预。
Cochrane Database Syst Rev. 2013 Apr 30;2013(4):CD009774. doi: 10.1002/14651858.CD009774.pub2.
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Developmental meta-analysis of the functional neural correlates of autism spectrum disorders.自闭症谱系障碍的功能神经关联的发展元分析。
J Am Acad Child Adolesc Psychiatry. 2013 Mar;52(3):279-289.e16. doi: 10.1016/j.jaac.2012.12.012.
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