Vivanti Giacomo
A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA.
Curr Psychiatry Rep. 2024 Dec;26(12):753-760. doi: 10.1007/s11920-024-01552-x. Epub 2024 Oct 25.
We review recent research on interventions, services and supports for children on the autism spectrum, examining both advancements and setbacks.
Progress has included an increase in quantity and rigor of intervention science, as well as a broadening of disciplines and perspectives engaged in the examination of early interventions, including their effectiveness, social validity and the contextual determinants of implementation outcomes. Setbacks have included the decrease in research involving children on the autism spectrum who have co-occurring profound intellectual disability, minimal or no spoken language, and who require constant assistance with daily living activities. This trend is alarming because it contributes to the marginalization and unmet needs of children who need intervention the most. Additionally, access to early intervention services is unequal and complicated by the misalignment of policy with the evolving evidence base in the field. The recent growth in the depth and breadth of knowledge related to autism early intervention means that policies, practices, advocacy efforts and research directions can be grounded on a more comprehensive evidence base and societal appraisal of autism. Nevertheless, these indisputable markers of success co-exist with conflicting narratives that hinder the establishment of a cohesive agenda to tackle inequities experienced by marginalized subgroups. Reconciliation of conflicting narratives requires a nuanced and compassionate appraisal of sources of tensions and heterogeneity of needs within the autism spectrum.
我们回顾了近期关于为自闭症谱系儿童提供干预、服务和支持的研究，审视了进展与挫折。
进展包括干预科学在数量和严谨性上有所增加，以及参与早期干预研究的学科和视角有所拓宽，涵盖了早期干预的有效性、社会效度以及实施结果的背景决定因素。挫折包括涉及患有重度智力障碍、极少或没有口语能力且日常生活需要持续协助的自闭症谱系儿童的研究减少。这一趋势令人担忧，因为它导致了最需要干预的儿童被边缘化且需求未得到满足。此外，早期干预服务的可及性不平等，且政策与该领域不断演变的证据基础不一致，使情况变得复杂。近期自闭症早期干预相关知识在深度和广度上的增长意味着，政策、实践、宣传努力和研究方向可以基于更全面的自闭症证据基础和社会评估。然而，这些无可争议的成功标志与相互矛盾的观点并存，这些观点阻碍了制定一个连贯的议程来解决边缘化亚群体所经历的不平等问题。调和相互矛盾的观点需要对自闭症谱系中紧张关系的根源和需求的异质性进行细致入微且富有同情心的评估。
