Identification, Evaluation, and Management of Children With Autism Spectrum Disorder
Identification, Evaluation, and Management of Children With Autism Spectrum Disorder
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DOI：
10.1542/peds.2019-3447
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发表时间：
2020-01-01
期刊：
影响因子：
8
通讯作者：
Bridgemohan, Carolyn
中科院分区：
文献类型：
--
作者：
Hyman, Susan L.;Levy, Susan E.;Bridgemohan, Carolyn
自闭症谱系障碍（ASD）是一种常见的神经发育障碍，据报道，在美国，每59名儿童中就有1名（约1.7%）。核心缺陷主要体现在两个领域：社会沟通/互动和限制性、重复性行为模式。患有自闭症的儿童和青少年在行为、教育、健康、休闲、家庭支持和其他领域都有服务需求。在18和24个月大的时候对ASD进行标准化筛查，并进行持续的发育监测，这在初级保健中仍然被推荐（尽管在其他环境中也可以进行），因为ASD很常见，可以在18个月大的时候被诊断出来，并且有基于证据的干预措施可以改善功能。需要更准确和具有文化敏感性的筛查方法。初级保健提供者应熟悉ASD的诊断标准，适当的病因评估，以及影响儿童功能和生活质量的共同发生的医学和行为状况（如睡眠和喂养障碍，胃肠道症状，肥胖，癫痫发作，注意力缺陷/多动障碍，焦虑和徘徊）。越来越多的证据支持针对特定技能和症状采取行为和其他干预措施。共同决策要求在评价和选择干预措施方面与家庭合作。这份单一的临床报告更新了2007年美国儿科学会关于ASD评估和治疗的临床报告，并通过美国儿科学会门户网站提供了在线目录和章节视图，以帮助读者识别报告中的主题领域。
Autism spectrum disorder (ASD) is a common neurodevelopmental disorder with reported prevalence in the United States of 1 in 59 children (approximately 1.7%). Core deficits are identified in 2 domains: social communication/interaction and restrictive, repetitive patterns of behavior. Children and youth with ASD have service needs in behavioral, educational, health, leisure, family support, and other areas. Standardized screening for ASD at 18 and 24 months of age with ongoing developmental surveillance continues to be recommended in primary care (although it may be performed in other settings), because ASD is common, can be diagnosed as young as 18 months of age, and has evidenced-based interventions that may improve function. More accurate and culturally sensitive screening approaches are needed. Primary care providers should be familiar with the diagnostic criteria for ASD, appropriate etiologic evaluation, and co-occurring medical and behavioral conditions (such as disorders of sleep and feeding, gastrointestinal tract symptoms, obesity, seizures, attention-deficit/hyperactivity disorder, anxiety, and wandering) that affect the child's function and quality of life. There is an increasing evidence base to support behavioral and other interventions to address specific skills and symptoms. Shared decision making calls for collaboration with families in evaluation and choice of interventions. This single clinical report updates the 2007 American Academy of Pediatrics clinical reports on the evaluation and treatment of ASD in one publication with an online table of contents and section view available through the American Academy of Pediatrics Gateway to help the reader identify topic areas within the report.