孤独症筛查量表在早期识别孤独症谱系障碍中的临床价值

目的 探讨孤独症筛查量表早期识别孤独症谱系障碍(ASD)的临床价值.方法 以于重庆医科大学附属儿童医院就诊,并完成ASD筛查及诊断性测试的2571名儿童为研究对象,最后确诊ASD 2074例,全面发育迟缓(GDD)261例,发育性语言障碍(DLD)206例,正常发育儿童30例.运用受试者工作特征(ROC)曲线评价改良婴...     

利培酮在治疗孤独症儿童行为问题中的作用

目的：研究利培酮在治疗孤独症儿童行为问题中的作用。方法：选取40例5～12岁具有行为问题的孤独症儿童,给予8周的利培酮治疗,在治疗前后进行临床疗效总评量表（CGI）和孤独症治疗评估量表(ATEC)评分,并观察利培酮治疗的不良反应。结果：利培酮治疗后第8周末的病情严重程度、ATEC总分均低于治疗前,且耐受性好;其中在ATEC评分中,除了社交评分在治疗前后无明显改变之外,言语、感知和行为评分均得到明显的改善。结论：利培酮可以显著地改善孤独症儿童的行为问题且具有良好的耐受性。     

三种学龄前儿童孤独症早期筛查工具比较

目的 比较早期孤独症筛查量表(EASI)、孤独症婴幼儿图片筛查量表(PASS-IT)及孤独症婴幼儿筛查量表修订版(M-CHAT)对学龄前儿童孤独症的筛查效果.方法 采用多阶段分层随机抽样方法,选取400例正常儿童和25例孤独症儿童为研究对象,通过比较EASI、PASS-IT和M-CHAT对425例研究对象进行单独筛查和联合筛查所得的评价指标,来衡量新引进的两种筛查量表的筛查效果.结果 EASI和PASS-IT两种量表的灵敏度均比M-CHAT量表高,分别为80.00%、88.00%和72.00%,但其差异均无统计学意义(P均＞ 0.05);特异度则较M-CHAT量表低,分别为75.00%、64.25%和94.50%,其差异均有统计学意义(P均＜ 0.05).三种筛查量表进行联合筛检效果优于单独筛检,平行试验所得灵敏度最高,为92.00%,系列试验所得特异度最高,为98.25%,系列试验所得其他各项评价指标,如阳性似然比、诊断指数、Youden指数、粗符合率、阳性预测值和阴性预测值均优于其他筛检结果.结论 将三种量表联合使用,可提高孤独症的筛查效果.     

孪生兄弟同患儿童孤独症

例 1　兄 ,男 ,3岁 5个月。因不会说话就诊。平时偶尔会说“爸爸、妈妈、爷爷、不、走” ,经常自言自语 ,有时会用手势表示需要 ,不会用“你、我、他”等代词 ,不会玩玩具 ,不与其弟弟做游戏 ,对父母的要求不理睬 ,犹如听不见。平日活动较多 ,常在家中无目的跑来跑去 ,喜欢反复端详手掌 ,会自己吃饭 ,能到指定的地点大小便。和父母容易分开 ,对家人没有亲昵的表示。单卵双胎之长子 ,孕 3 5周早产 ,出生体重2 3 5 0ｇ,混合喂养 ,3～ 4个月会逗笑 ,1岁时曾会和家人玩滚球 ,13个月独走 ,2岁会叫“爸爸、妈妈” ,但极少叫。父母健康 ,母亲性格内…     

儿童孤独症神经病理学研究进展

儿童孤独症是广泛性发育障碍中的代表性疾病.该文综述近年来孤独症患儿神经影像学及神经病理学方面的异常.脑结构的研究显示孤独症患儿的脑体积的增大,额叶、颞叶等处发育异常;脑功能的研究显示孤独症患儿在颞上回、额下回、梭状回等处存在异常活动;脑代谢物的研究显示孤独症患儿存在谷氨酸及γ-氨基丁酸以及5-羟色胺代谢异常;免疫学研究发现孤独症患儿促炎症因子及脑蛋白抗体的出现等.     

儿童孤独症危险因素的研究进展

该文综述了儿童孤独症的危险因素,从遗传生化因素、大脑结构的改变、电生理因素、孕产期因素等多方面进行探讨,这些因素在儿童孤独症的发病中起了一定的作用,还有一些不确切的因素有待研究.     

感觉统合训练治疗儿童孤独症疗效影响因素分析

儿童孤独症是一种严重的广泛性精神发育障碍,发病率较高,预后极差。国外对孤独症儿童开展了多种治疗研究,其中感觉统合训练(sensory integration training,SIT)的疗效尚存有争议,而国内未有报道。我院儿童发育行为中心对1999年12月～2001年10月在本院接受诊治的孤独症患儿进行感觉统合训练治疗,拟探讨该项训练治疗儿童孤独症的疗效及可能影响因素,现将结果报告如下。     

儿童孤独症的遗传学研究进展

儿童孤独症是一种起病于婴幼儿时期的严重发育障碍性疾病,临床主要表现为社会交往障碍、语言交流障碍和兴趣范围狭窄、重复或刻板运动的综合征,目前被认为是多因素、多基因遗传性疾病,但与其相关的基因尚未明确.文章从遗传学的几个方面进行论述,着重介绍与孤独症显著相关的候选基因.     

影响儿童孤独症感觉统合训练疗效的因素分析

目的：在实践中发现,影响儿童孤独症感觉统合训练疗效的因素很多。该文从信息的感觉处理模式方面来探讨影响儿童孤独症感觉统合训练效果的因素,从而为孤独症儿童的康复训练提供新的方法。方法：对93例1.8～8.3岁孤独症患儿分别进行孤独症行为评定量表（ABC）的评估、Dunn模式的感觉处理分型,以感觉统合评定量表进行感觉统合训练前后的评定来评估疗效,分析性别、年龄、ABC评分以及感觉处理模式对疗效的影响。结果：ABC评分（Wald=6.768,P<0.01）和感觉处理模式（Wald=13.549,P<0.01）对疗效有显著影响,尤以感觉处理模式影响最大,而性别（Wald=1.549,P>0.05）和年龄（Wald=0.010,P>0.05）则无影响。结论：孤独症儿童的感觉处理模式是影响感觉统合训练效果的主要因素。［中国当代儿科杂志,2009,11（2）：124-127］     

儿童孤独症听觉反应异常的研究进展

孤独症儿童常伴有一定程度的听觉反应异常,该异常的临床表现多样化,目前其发生机制尚不明确.脑干听觉诱发电位、耳声发射等相关辅助检查的结果也不尽一致,听觉反应异常可能影响孤独症儿童的社交及语言交流等整体发育.     

Cognitive behavioral therapy for children with autism spectrum disorder: A prospective observational study

Objective

To evaluate prospectively the effectiveness of cognitive behavioral therapy (CBT) in children with autism spectrum disorder (ASD).

Joint attention training for children with autism using behavior modification procedures

BACKGROUND: Deficits in joint attention are considered by many researchers to be an early predictor of childhood autism (e.g., Osterling & Dawson, 1994) and are considered to be pivotal to deficits in language, play, and social development in this population (Mundy, 1995). Although many researchers have noted the importance of joint attention deficits in the development of children with autism (e.g., Mundy, Sigman, & Kasari, 1994) and have called for intervention strategies (e.g., Mundy & Crowson, 1997), few studies have attempted to target joint attention. In this study, joint attention behaviors were taught to children with autism using a behavior modification procedure. METHODS: A multiple-baseline design was implemented to evaluate intervention effects. The following target behaviors were included in the intervention: 1) Responding to showing, pointing, and gaze shifting of adult; 2) Coordinated gaze shifting (i.e., coordinated joint attention); and 3) Pointing (with the purpose of sharing, not requesting). Generalization to setting and parent, follow-up sessions, and social validation measures were also analyzed. RESULTS: Joint attention behaviors were effectively trained and targeted behaviors generalized to other settings. In addition, positive changes were noted by naive observers using social validation measures. CONCLUSIONS: Integrating joint attention training into existing interventions may be important for children with autism. In addition, training parents in these techniques may help to maintain joint attention skills outside of the treatment setting.     

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??The comorbidity of epilepsy and autism is a common clinical phenomenon. About 5%??37% of children with epilepsy have autism or have positive screening for autism. About 2%??46% of individuals with autism have epilepsy. The family history of mental disorders??adverse perinatal factors??female??autistic features??intelligence disability??genetic or neurological syndromes and genetic factors increase the risk of comorbidity of the two diseases. In children with the two diseases??epilepsy onsets earlier with two onset peaks before 5 years and during puberty??partial seizure and intractable epilepsy is more common??the symptom of autism is more severe??with more intelligence disability??more motor development and behavior problems and worse adaption behaviors. It is important to recognize?? diagnose and treat the two diseases.     

Resting cortical brain activity and social behavior in higher functioning children with autism

BACKGROUND: Psychophysiological measurement of processes related to social behavior may be valuable for research on individual differences and subgroups among children with autism spectrum disorders (Coleman, 1987; Dawson, Klinger, Panagiotides, Lewy, & Castelloe, 1995; Modahl et al., 1998). In particular, recent research and theory suggests that measures of resting anterior EEG asymmetry reflect complex brain processes associated with individual differences in approach or avoidance motivation that may be associated with social and emotional interaction tendencies among children with autism. METHOD: This hypothesis was examined in a study of the relations among resting anterior asymmetry, social impairment, and social anxiety in 23 high functioning children with autism (HFA) and 20 controls (age range 9-14 years). RESULTS: These groups were significantly different on the measures of anterior asymmetry, social symptoms and anxiety-related measures. Moreover, HFA children who displayed right frontal asymmetry (RFA group) displayed more symptoms of social impairments and better visual analytic skills than did children who displayed left frontal asymmetry (LFA group). Alternatively, while the LFA group displayed fewer symptoms of social impairment they also reported greater levels of social anxiety, social stress, and lower satisfaction with interpersonal relations than did the RFA group. CONCLUSIONS: These observations indicate that anterior EEG asymmetry may be a marker of motivation and emotion processes that refract the autism taxon into important individual differences in social presentation among higher functioning children.     

孤独症谱系障碍儿童的行为管理

孤独症谱系障碍（ASD）是一类发生于儿童期的神经发育障碍性疾病,以社会交往和社会交流缺陷以及限制性重复性行为、兴趣和活动两大核心表现为特征。因此,ASD干预的一个重点即是通过进行有效的行为管理来改善行为紊乱问题。应用行为分析是一门科学,其在ASD儿童康复教育中的运用效果具有循证依据,在ASD儿童行为管理中,康复医师应牢牢掌握行为的基本原理理论,在理论指导下运用具有循证实践基础的策略和方法科学地开展工作。