Affording autism an early brain development re-definition.
Affording autism an early brain development re-definition.
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DOI：
10.1017/s0954579420000802
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发表时间：
2020-10
影响因子：
3.3
通讯作者：
Jones W
中科院分区：
文献类型：
--
作者：
Klin A;Micheletti M;Klaiman C;Shultz S;Constantino JN;Jones W
国家优先考虑推进自闭症谱系障碍（ASD）儿童的早期检测和干预，并没有减少美国连续几个CDC监测队列中ASD诊断的晚期年龄，传统上服务不足的人群更晚获得诊断。在这篇综述中，我们探讨了一个潜在的感知障碍，这个企业认为ASD的条款，是矛盾的，目前的科学，这可能有其起源，在目前的定义的条件，并在其历史协会。为了解决这一感知障碍，我们提出了一个重新定义的ASD在早期大脑发育方面，以期重新审视当前科学提供的机会，以优化儿童的结果，尽管他们与生俱来的风险。在此提出这一观点是为了反驳过时的观念，即在儿童出生的那一刻就确定了潜在的毁灭性残疾，这些负担是不可避免的，改善的机会仅限于缓解症状或适应技能的有限改善。这篇文章的动力是担心这种对复杂神经发育状况（如ASD）的看法可能会成为自我实现的科学和政策，其方式与我们目前所知的完全相反，并且每天都在学习，遗传风险如何成为或不成为终身残疾。
The national priority to advance early detection and intervention for children with autism spectrum disorder (ASD) has not reduced the late age of ASD diagnosis in the US over several consecutive CDC surveillance cohorts, with traditionally under-served populations accessing diagnosis later still. In this review, we explore a potential perceptual barrier to this enterprise which views ASD in terms that are contradicted by current science, and which may have its origins in the current definition of the condition and in its historical associations. To address this perceptual barrier, we propose a re-definition of ASD in early brain development terms, with a view to revisit the world of opportunities afforded by current science to optimize children’s outcomes despite the risks that they are born with. This view is presented here to counter outdated notions that potentially devastating disability is determined the moment a child is born, and that these burdens are inevitable, with opportunities for improvement being constrained to only alleviation of symptoms or limited improvements in adaptive skills. The impetus for this piece is the concern that such views of complex neurodevelopmental conditions, such as ASD, can become self-fulfilling science and policy, in ways that are diametrically opposed to what we currently know, and are learning every day, of how genetic risk becomes, or not, instantiated as lifetime disabilities.