Early diagnosis of autism and impact on prognosis: a narrative review.
Early diagnosis of autism and impact on prognosis: a narrative review.
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DOI：
10.2147/clep.s41714
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发表时间：
2013
影响因子：
3.9
通讯作者：
Gillberg C
中科院分区：
文献类型：
--
作者：
Fernell E;Eriksson MA;Gillberg C
自闭症谱系障碍包括一系列临床表型，这些表型反映了早期发病的神经发育偏差，其核心症状可能与社交本能的缺乏有关。认知障碍的基础是由大量医学因素引起的生理性脑问题。本文对过去5年（2008-2012）的系统综述和荟萃分析进行了叙述性回顾，介绍了自闭症谱系障碍研究的许多方面，特别关注早期干预及其对预后的影响。讨论的其他主要领域包括流行病学、早期症状和筛查、早期诊断、神经心理学、医学因素和合并症的存在。有有限的证据表明，任何一个宽带“早期干预”项目都能有效地改变许多早期诊断为自闭症的个体的自然长期结果。然而，有一些证据表明，早期强化行为干预（EIBI）是一种有效的治疗自闭症儿童的方法。尽管如此，人们逐渐达成共识，即需要早期诊断和信息，以便在受影响的个体周围“创造”一个对自闭症友好的环境。
Autism spectrum disorders involve a set of clinical phenotypes that mirror an early onset of neurodevelopmental deviations, with core symptoms that can probably be related to a deficiency in the social instinct. Underlying the cognitive impairments there are physiological brain problems, caused by a large number of medical factors. This narrative review of systematic reviews and meta-analyses from the last 5 years (2008–2012) presents aspects from many areas in autism spectrum disorder research, with a particular focus on early intervention and the subsequent impact on prognosis. Other major areas discussed are epidemiology, early symptoms and screening, early diagnosis, neuropsychology, medical factors, and the existence of comorbidities. There is limited evidence that any of the broadband “early intervention” programs are effective in changing the natural long-term outcome for many individuals with an early diagnosis of autism. However, there is some evidence that Early Intensive Behavioral Intervention (EIBI) is an effective treatment for some children with ASD. Nevertheless, there is emerging consensus that early diagnosis and information are needed in order that an autism-friendly environment be “created” around affected individuals.