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《儿童自闭症综述:十年研究》

Infantile autism reviewed: a decade of research.

作者信息

DeMyer M K, Hingtgen J N, Jackson R K

出版信息

Schizophr Bull. 1981;7(3):388-451. doi: 10.1093/schbul/7.3.388.

Abstract

Progress in the study of infantile autism over the past 10 years was reviewed in terms of classification and diagnosis, relation to other disorders, demographics, parental characteristics, genetics, intelligence, language, perceptual processes, behavioral characteristics, neurobiological, biochemical and pharmacological aspects, behavioral/educational treatment methodologies, prognosis, and theoretical considerations. This decade's research led to the now generally accepted position that infantile autism is a type of developmental disorder accompanied by severe and, to a large extent, permanent intellectual/behavioral deficits. However, its relationship to other forms of developmental disorders and to mental retardation remains to be delineated. Perceptual/cognitive/language defects appear central to the autistic syndrome, but the specific underlying mechanisms are unknown. Most studies indicate that autistic children have more signs of brain dysfunction than do normal children and about the same number as mentally retarded children. The overwhelming evidence suggests that te treatment of choice for maximal benefit to autistic children is a systematic, intrusive behavioral/educational approach. Yet, in spite of significant gains in almost all children treated, the typical prognostic picture is poor in terms of achieving self-supportive adulthood. The parents of autistic children have been found to be essentially similar to parents of children with organic brain disorders, and manifest no psychopathology which conceivably could induce the disorder. The vast majority of theoretical articles appearing in the 1970s proposed some from of neurobiological defect as the causative factor in autism. One of the major goals for future research is to undertake more extensive comparative studies on nonautistic brain dysfunctional children and autistic children that could yield cleared differential behavioral profiles and testable neurobiological hypotheses.

摘要

本文从分类与诊断、与其他疾病的关系、人口统计学、父母特征、遗传学、智力、语言、感知过程、行为特征、神经生物学、生物化学和药理学方面、行为/教育治疗方法、预后以及理论思考等角度,回顾了过去10年婴儿自闭症的研究进展。这十年的研究得出了目前普遍认可的观点,即婴儿自闭症是一种发育障碍,伴有严重且在很大程度上永久性的智力/行为缺陷。然而,它与其他形式的发育障碍以及智力迟钝的关系仍有待明确。感知/认知/语言缺陷似乎是自闭症综合征的核心,但具体的潜在机制尚不清楚。大多数研究表明,自闭症儿童比正常儿童有更多的脑功能障碍迹象,与智力迟钝儿童的迹象数量大致相同。压倒性的证据表明,对自闭症儿童最有益的治疗选择是系统的、侵入性的行为/教育方法。然而,尽管几乎所有接受治疗的儿童都取得了显著进展,但从实现自立成年的角度来看,典型的预后情况仍然不佳。已发现自闭症儿童的父母与患有器质性脑障碍儿童的父母基本相似,且未表现出可想象会诱发该疾病的精神病理学特征。20世纪70年代出现的绝大多数理论文章都提出某种形式的神经生物学缺陷是自闭症的致病因素。未来研究的主要目标之一是对非自闭症脑功能障碍儿童和自闭症儿童进行更广泛的比较研究,这可能会产生清晰的差异行为特征和可检验的神经生物学假设。

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