多样性，你知道，是对人性范围的描述. Having the specific label of ASD will not necessarily guide us in terms of treatment. 的 more important thing is to look at what specifically is hard and how to address that.
Nina-Sand Loud, MD你是否担心你的孩子可能患有自闭症谱系障碍(ASD)?
自闭症谱系障碍的诊断数量正在增加. 但是有社交、沟通和互动障碍的孩子—甚至 限制性重复行为 比如拍手或专注于特定兴趣的运动—不一定有障碍.
“Just because they have some of those difficulties doesn't mean they have ASD or that they will get the treatment they need,解释说 Nina Sand-Loud, MD十大正规博彩网站评级正规博彩平台希区柯克医疗中心的发育和行为儿科医生.
“而不是专注于诊断或标签, 注意长处和难点，以便有针对性的支持,她建议家长们. “Sometimes people think, oh, to get any support, I need a diagnosis, but that's not true.”
各种各样的挑战
自闭症谱系障碍的治疗从来都不是一刀切的. 这种障碍有一系列跨越谱系的挑战.
That spectrum widened in 2013 when the American Psychiatric Association removed Asperger's Disorder along with Pervasive Developmental Disorder, 未另有说明, from the new edition of the Diagnostic and Statistical Manual of Mental Disorders (需求侧管理).
新的总体需求侧管理-5诊断变成 自闭症谱系障碍 阿斯伯格症也不再是一个单独的诊断.
“的y were trying to make it clearer and I think in their attempts to make it clearer, 他们说得不那么清楚了, 这种情况有时会发生,大声沙说.
更多诊断的好处和坏处
Since then, the Centers for Disease Control and Prevention has reported a spike in diagnosis, with 每36个孩子中就有一个 在2023年患有这种疾病，相比之下 八岁儿童中每68人中就有一人 in 2012.
非营利倡导组织 “孤独症代言人” 他说，这一增长反映了外展活动的改善, 筛选, 以及在少数群体中对自闭症诊断的去污名化.
But some warn that children who struggle most are now at risk of not receiving the level of services they need.
“As the diagnosis has expanded some with more profound challenges have been somewhat pushed to the corner. That is unfortunate because those are often families that really need a lot of support,大声沙说.
除了, 她说, those tasked with diagnosing the disorder can struggle to keep up with the growing demand.
“Things have become very challenging because of the numbers seeking out evaluations,大声沙说.
上涨的背后还有什么
对于这种增长的原因众说纷纭.
自闭症的人数实际上已经上升了一段时间. 疾控中心报告说，2000年 儿童自闭症发病率仅为150分之一，远低于目前的数字. 环境因素, 改进的推广, 提高对自闭症的认识是导致这种激增的理论之一.
Sand-Loud observes: “Something has happened in terms of ASD starting to become a bit of an identity.”
保险也可能在父母推动孩子接受诊断方面发挥作用. Most states require that insurers provide coverage for the treatment of ASD and insurers often demand that a child have a diagnosis to get coverage for Applied Behavior Analysis (ABA), a mostly one-on-one treatment approach based on understanding 行为s and how they are affected by the environment.
But Sand-Loud stresses that a child without an ASD diagnosis still can get support through schools or early intervention programs based on their specific areas of need.
“人们有点过于关注标签了，”她说. “每个人都可以有自己的不同. 当这些差异引起问题时，我们需要更多地关注它们.”
事实上, 如果大声沙能挥动魔杖的话, she would do away with labels and focus efforts instead on treating specific challenges.
“儿童不需要诊断就能得到支持，”她说. “And just because you have a diagnosis of ASD doesn't automatically mean that the school needs to provide support. 你必须有一个特定的弱点. If, for example, a child has some language delays, schools can provide speech and language therapy. 或者他们可以在专门的学前教育项目中获得服务.”
从哪里开始
如果你担心你的孩子可能患有自闭症, Sand-Loud建议你从确定孩子的挑战开始.
Ask yourself what specifically in your child’s development and 行为 concerns you and what you have observed. 然后，向你孩子的儿科医生或初级保健临床医生提出这些担忧.
Also talk with your child’s school or an early intervention program (if your child is before preschool age) to get an evaluation.
事实上, developmental and 行为al pediatricians such as Sand-Loud ask that children get these evaluations before they assess a child. 这是因为这些信息有助于理解孩子的需求.
Initiating a school or early intervention program evaluation also means a child may be able to start treatment during the wait for an appointment.
“We don't want a two-and-a-half-year-old waiting six months to see me before they get services. 那是在浪费宝贵的时间. We know that 0 to 5 the brain is ready to go and so we want to get those supports into place. 任何诊断的目标都是获得支持，”sandloud说.
专家如何确定ASD诊断
If you and your pediatrician decide your child needs an evaluation by a developmental and 行为al pediatrician or a neuropsychologist, 你的孩子需要见面 诊断标准 被归类为自闭症谱系障碍. 的se criteria include persistent deficits in each of three areas of social communication and interaction, 再加上四种限制中的至少两种, 重复的行为, 根据 需求侧管理.
进行诊断, 医生会评估你孩子的发展历史, 技能, 行为, 还有其他标准. 你的孩子的评估可能包括:
- An assessment of your child’s social interaction, communication 技能, and 行为s
- 听力、言语、语言等技能测试
- 由其他发展专家进行评估, 其中可能包括干预项目
- 考虑家族史和基因检测
- 父母的观察
“没有一种方法可以做出诊断. 我们不能做x光检查，也不能验血. 我们会考虑孩子们在家里的表现, 他们在学校表现如何, 他们如何沟通, 他们是如何参与的, 还有他们是怎么玩的. We put all the pieces together to make the diagnosis based on all of those factors,大声沙说.
Sand-Loud also says no age is too young to bring up your concerns with your child’s pediatrician and that early intervention can make a difference.
的 American Academy of Pediatrics (AAP) recommends that regular developmental and 行为al 筛选 begin during regular well-child visits at nine months. 的 平均诊断年龄 is close to 5 years old but parents report putting together a plan for early intervention or special education at 4.3岁.
如果你的孩子被诊断为ASD
因为自闭症谱系障碍的范围很广, the range of home-based and school-based treatments and interventions varies and can change over time.
ASD治疗和干预策略可能包括:
- 行为和沟通疗法. 这些可能包括ABA.
- 教育疗法. 这些可以在家里、学校或其他地方进行.
- 家庭治疗. Parents and other family members can learn to help promote social interaction 技能, 管理问题行为, 教授日常生活技能和沟通.
- 额外的治疗. 其中可能包括提高沟通技巧的语言治疗, 教导日常生活活动的职业疗法, 改善运动和平衡的物理治疗可能是有益的. 心理学家也可以推荐解决问题行为的方法.
但是再一次, Sand-Loud stresses that your child doesn’t need to have an ASD diagnosis for intervention and she remains concerned about the implications of the rising numbers.
“的re is a researcher in Montreal at Universite De Montreal who says that if diagnoses get much higher, 我们只能说自闭症谱系障碍是一种普遍的诊断,她说。.
“多样性，你知道，是对人性范围的描述,” she points out. “Having the specific label of ASD will not necessarily guide us in terms of treatment. 的 more important thing is to look at what specifically is hard and how to address that.”