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会议录:自闭症、遗传神经发育障碍和消化系统疾病联盟成立大会。

Conference proceedings: Inaugural meeting of the consortium for autism, genetic neurodevelopmental disorders, and digestive diseases.

机构信息

Autism Science Foundation, New York, New York, USA.

Rutgers University, New Brunswick, New Jersey, USA.

出版信息

J Pediatr Gastroenterol Nutr. 2024 Nov;79(5):1062-1070. doi: 10.1002/jpn3.12360. Epub 2024 Sep 11.

Abstract

OBJECTIVES

Individuals with neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD), often experience a higher prevalence of gastrointestinal (GI) symptoms but have complex medical and behavioral comorbidities that make diagnosis and treatment difficult. A multi-stakeholder conference was convened to (a) determine patient and family experiences related to GI symptoms in NDDs, (b) review the clinicians' and researchers' perspectives, and (c) determine actionable steps for future research.

METHODS

The Consortium for Autism, Neurodevelopmental Disorders and Digestive Diseases (CANDID; www.candidgi.com) virtually over 2 days in 2022 and consisted of four key activities: (1) an electronic family survey to assess underlying NDDs and GI symptoms, (2) a session focused on family perspectives, (3) review current clinical care and research, and (4) discussion to identify key next steps. Survey results were obtained electronically via the REDCap platform, and descriptive statistics were generated. The sessions were recorded, and themes were identified.

RESULTS

The pre-conference survey ran for ~2 months and 739 families provided responses, with 634 completing all items. 83% had a child with an NDD under age 18, and most patients were White (85%) and non-Hispanic (87%). Constipation (80%), GI reflux disease (51%), and bloating (49%) were the most frequently reported symptoms. Families gave unstructured feedback that the measures used in the surveys were often difficult to answer for patients with NDDs or who were nonspeaking. Family and clinical/scientific sessions identified several common themes, including (1) the need for less invasive diagnostic modalities, (2) the need to validate or adapt existing diagnostic measures (e.g., the Rome IV criteria) and outcome assessments, and (3) the need for enhanced attention to parent and caregiver input in treatment plans.

CONCLUSIONS

Those providing care to children with NDDs, especially those with communication and cognitive challenges, should be aware of the differing needs in this community and consider family perspectives in managing, treating, and measuring GI issues. Future research should focus on adapting or creating diagnostic and research measures for those with NDDs, developing new diagnostic methods to account for diversity in neurodevelopment and communication, and improving methods for family and caregiver engagement in the care of GI disorders.

摘要

目的

患有神经发育障碍(NDD)的个体,包括自闭症谱系障碍(ASD),通常会出现更高比例的胃肠道(GI)症状,但存在复杂的医疗和行为共病,这使得诊断和治疗变得困难。为此召开了一次多利益相关者会议,旨在:(a)确定与 NDD 相关的胃肠道症状的患者和家属体验,(b)回顾临床医生和研究人员的观点,(c)确定未来研究的可行步骤。

方法

自闭症、神经发育障碍和消化系统疾病联盟(CANDID;www.candidgi.com)于 2022 年分两天以虚拟方式进行,包括四项关键活动:(1)电子家庭调查,以评估潜在的 NDD 和胃肠道症状,(2)关注家庭观点的会议,(3)审查当前的临床护理和研究,以及(4)讨论确定关键的下一步。调查结果通过 REDCap 平台以电子方式获得,并生成描述性统计数据。会议进行了记录,并确定了主题。

结果

会前调查进行了大约 2 个月,有 739 个家庭做出了回应,其中 634 个家庭完成了所有项目。83%的家庭有一个年龄在 18 岁以下的 NDD 儿童,大多数患者为白人(85%)和非西班牙裔(87%)。最常报告的症状是便秘(80%)、胃食管反流病(51%)和腹胀(49%)。家庭提出了非结构化的反馈,称用于调查的措施对于患有 NDD 或无法说话的患者来说往往难以回答。家庭和临床/科学会议确定了几个共同的主题,包括(1)需要使用侵入性较小的诊断方式,(2)需要验证或调整现有的诊断措施(例如,罗马 IV 标准)和结果评估,以及(3)需要更加关注家长和照顾者在治疗计划中的投入。

结论

为 NDD 儿童提供护理的人员,特别是那些存在沟通和认知挑战的儿童,应了解这一群体的不同需求,并在管理、治疗和评估胃肠道问题时考虑家庭的观点。未来的研究应侧重于为 NDD 患者开发或调整诊断和研究措施,开发新的诊断方法以考虑神经发育和沟通的多样性,并改进家庭和照顾者参与胃肠道疾病护理的方法。

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