封闭世界中的孩子——儿童自闭症的分析与治疗

Kanner教授于1943年最先报道了关于儿童自闭症的详细研究,自闭症作为一种症侯群,其具体症状因人而异。社会交往障碍、语言发育障碍、刻板的行为方式是自闭症的三个主要障碍。本文从儿童自闭症的表现特征、原因、治疗等方面入手,详细阐述了这一发生在婴幼儿时期的发展障碍及其治疗方法,为自闭症儿童的早期发现、训练和矫治提供参考。     

自闭症儿童行为评定与社会认知发展的研究

本研究用自闭症儿童发展评定量表,自闭症儿童基本社会认知问卷以及“ＴｏＭ”实验,对４９名自闭症儿童及３０名弱智儿童进行了行为评定与社会认知的研究。研究结果为目前国内自闭症的诊断和治疗提供了新的有效工具及进一步明确化的理论依据,并为其教育训练提供了标准的新的启示。     

自闭症和智力障碍儿童行为问题与父母焦虑的关系:育儿压力的中介作用与领悟社会支持的调节作用

为探讨自闭症和智力障碍儿童行为问题与其父母焦虑的关系及其内在作用机制,研究采用问卷法对1023名自闭症和智力障碍儿童父母进行调查。结果表明：(1)自闭症和智力障碍儿童行为问题对父母焦虑具有正向预测作用;(2)育儿压力在儿童行为问题和父母焦虑间起中介作用;(3)儿童行为问题与育儿压力的关系受到领悟社会支持水平的调节,调节作用只在智力障碍儿童父母群体中显著。研究结果有助于揭示自闭症和智力障碍儿童行为问题对父母焦虑的影响及作用机制,对改善自闭症和智力障碍儿童父母育儿压力与焦虑具有一定指导意义。     

自闭症儿童利用社会性注意线索习得词语的眼动研究

本研究采用眼动技术考察18名自闭症儿童利用社会性注意线索习得词语的能力。结果表明：1）自闭症儿童具有利用他人视线习得词语的能力;2）不同视线对自闭症儿童的词语习得产生不同的影响;3）自闭症儿童视线追随行为的潜在机制与普通儿童存在差异,自闭症儿童的视线追随行为可能是意识性的诱发行为而普通儿童则是反射性的自发行为。     

自闭症儿童疗育事工经验交流会在杭州召开

中国基督教两会社会服务部于2007年7月3日-6日,在杭州基督教青年会隆重召开自闭症儿童疗育事工经验交流会。自闭症又被称为儿童孤独症,是一种以严重孤独、缺乏情感反应、语言发育障碍、刻板重复动作和对环境奇特的反应为特征的疾病。自闭症儿童的不幸,不仅影响自己的一生,还会给家人亲友等带来极大的痛苦。在社会服务部的推动下,浙江省两会、青岛市两会、大连市两会先后开办了自闭症儿童疗育中心,使许多自闭症儿童得到了及时矫治,为患儿家庭排忧解难,获得社会好评。     

自闭症儿童依恋研究述评

摘要　　研究者曾一度认为自闭症儿童无法建立起依恋关系。本文系统回顾了自闭症儿童依恋研究的最新进展,将自闭症儿童是否存在依恋行为（尤其是安全型依恋行为）、依恋发展解释理论、研究方法、类型分布以及影响因素等问题进行了详细梳理,并结合研究分析,提出有关自闭症儿童依恋研究的几点启示,以供参考。     

父母心理弹性与自闭症谱系障碍儿童情绪行为问题的关系：一个有调节的中介模型

本研究采用问卷法对306名自闭症谱系障碍(autism spectrum disorder, ASD)儿童的父母进行调查,考察了教养能力感在父母心理弹性和儿童情绪行为问题间的中介作用,同时检验了父母自尊对该路径的调节作用。结果表明：(1)父母心理弹性可直接预测ASD儿童情绪行为问题;(2)教养能力感在父母心理弹性和ASD儿童情绪行为问题之间起部分中介作用;(3)心理弹性与教养能力感的关系受自尊的调节,即心理弹性对教养能力感的预测作用在自尊水平较高的父母中更大。     

儿童自闭症及其综合干预

儿童自闭症的患病率已经逐年上升至我国精神类疾病的首位.研究人员在描述时使用了不同的标签如堪纳综合征、婴幼儿自闭症、儿童精神分裂症、儿童精神病等.儿童自闭症临床表现为生理、行为、认知、情绪等诸多方面;随着医学的发展和研究手段的改进,人们则多从生理因素方面来解释自闭症儿童的成因应该与儿童的中枢神经、神经传导、遗传基因、病毒感染、代谢异常等生理因素有着密切的关系,此外还和环境、养育方式等因素有很大关系.因而,治疗和干预应该采用综合模式.     

戏剧治疗在自闭症谱系障碍儿童社交能力提升中的应用

社会交往能力的缺乏被认为是自闭症谱系障碍儿童最核心的症状,戏剧治疗被认为能有效提高自闭症谱系障碍儿童的社会交往能力。文章梳理了运用戏剧治疗提升自闭症谱系障碍儿童社会交往能力的理论基础、技术和步骤、实践与疗效,并对该方法的应用进行了简单的总结和展望。技术包括布景、符号表征、视觉形象化和角色法;步骤包括相遇、谐和、习得三个阶段;现有实证研究表明该方法对自闭症谱系障碍儿童的社交能力提升有一定的作用;该方法与其他方法的结合是未来需重视的实践与研究方向。     

辅读学校背景下自闭症儿童的综合干预

<正>近年来,我国被诊断为自闭症的儿童人数日益增长。教育部虽从1994年起已经开始逐步关注自闭症儿童的教育需要,然而,国内为自闭症儿童进入普通学校学习的准备还不充分。目前自闭症儿童就学的主要方式以进入辅读学校学习为主。基于辅读学校师资匮乏以及专业技术薄弱的现状,学校通常的做法是将自闭症儿童与有其他特殊需要的儿童(如智力落后、唐氏综合症等)编入一个班级,接受形式雷同的教育;加之自闭症的症状表现和问题行为,不     

自闭症谱系障碍个体的焦虑：发生机制、评估与治疗

自闭症谱系障碍是一种神经发育性障碍, 主要表现为社会交往互动障碍和重复刻板性行为。焦虑或焦虑障碍常被认为是自闭症个体最普遍的共病之一。焦虑与自闭症之间的关系尚不明确, 自闭症个体的焦虑与无法忍受不确定性、杏仁核功能和体积、情绪调节策略、消极思维存在一定关联; 目前已经开发出专门用于自闭症个体焦虑的评估工具; 修订版认知行为疗法对自闭症个体焦虑的治疗取得了良好效果。未来的研究应着重探索自闭症个体焦虑的认知与神经机制, 检验专用评估工具的有效性, 继续关注现代技术(如虚拟现实技术)对自闭症个体焦虑的治疗效果。     

Novel treatments for autistic spectrum disorders

In no area of developmental pediatric practice is there more controversy regarding the choice of treatment than related to children with autistic spectrum disorders (ASD). Complementary and alternative medical therapies (CAM) are often elected because they are perceived as treating the cause of symptoms rather than the symptoms themselves. CAM used for autism can be divided by proposed mechanism: immune modulation, gastrointestinal, supplements that affect neurotransmitter function, and nonbiologic intervention. Secretin as a therapy for autism is discussed as an example of how a clinical observation rapidly grew to a widespread treatment before well-designed studies demonstrated absence of effect. The plausibility for behavioral effect was not substantiated by clinical studies. CAM used for treatment of autism is examined in terms of rationale, evidence of efficacy, side effects, and additional commentary. Families and clinicians need access to well-designed clinical evidence to assist them in choice of therapies.     

A METHOD FOR INTEGRATING AN AUTISTIC CHILD INTO A NORMAL PUBLIC-SCHOOL CLASSROOM1

This study investigated the feasibility of using behavioral techniques to integrate an autistic child into a normal public-school class with one teacher and 20 to 30 normal children. The results showed: (1) that during treatment by a therapist in the classroom, the child's appropriate verbal and social behaviors increased, and autistic mannerisms decreased; and (2) training teachers in behavioral techniques was apparently sufficient to maintain the child's appropriate school behaviors throughout kindergarten and the first grade.     

CHRM3基因与孤独症谱系障碍

孤独症谱系障碍是一类具有遗传基础的儿童发展障碍疾病。近些年, 研究者们从分子病理学层面发现中枢胆碱能神经系统异常与孤独症患者认知和行为异常存在相关性。尸检研究、临床案例、动物模型研究均发现毒蕈碱型(M型)乙酰胆碱受体异常和孤独症的发生有着密切的关系。在以小鼠为模型的行为学研究中, 编码毒蕈碱型乙酰胆碱受体Ⅲ亚型的CHRM3基因突变会导致小鼠出现认知障碍、刻板行为等孤独症样表现。深入了解CHRM3基因的功能将能够帮助研究者进一步解释孤独症的相关行为特征, 为孤独症儿童教育方案的制定提供新的思路和方法。     

人工智能辅助的自闭症早期患者的筛查与诊断

自闭症谱系障碍(Autistic Spectrum Disorders, ASD)的症状早在婴幼儿期就会显现, 越早发现, 越早干预, 治疗效果越好。传统自闭症早期筛查与诊断在评估方法、流程上存在局限, 无法满足大规模筛查和诊断需求。随着人工智能技术的快速发展, 使用智能化方法进行自闭症早期大规模无感筛查与诊断逐渐成为可能。近10年间, 国内外对自闭症智能化识别方法的探索在经典任务行为、面部表情和情绪、眼动、脑影像、运动控制和运动模式、多模态6个领域积累了丰富的研究成果。未来研究应围绕构建国内自闭症早期智能医学筛查与诊断体系, 开发针对婴幼儿患者的筛查工具, 构建融合多模态数据的自闭症婴幼儿智能化识别模型, 建立结合脑影像技术的自闭症精细化诊断方法等方面来开展。     

Epileptic encephalopathies and their relationship to developmental disorders: do spikes cause autism?

Epileptic encephalopathies are progressive clinical and electroencephalographic syndromes where deterioration is thought to be caused by frequent seizures and abundant EEG epileptiform activity. Seizures occur in approximately 10-15% of children with pervasive developmental disorders (PDD) and 8-10% have epileptiform EEG abnormalities without seizures. Thirty percent of children with PDD have regression of social behavior and language at 2-3 years of age. Some authors speculate that the regression is caused by epileptiform activity even in the absence of overt clinical seizures ("autism with epileptic regression") and suggest that elimination of the epileptiform activity, either medically or surgically, should lead to improvement in behavior. This review examines the data showing that interictal epileptiform discharges are associated with transient clinical dysfunction and discusses the implications of these observations for autistic behavioral abnormalities. The results of resective surgery, vagal nerve stimulation, and multiple subpial transaction on children with autism and epileptiform EEG abnormalities are also discussed. I conclude that there is no evidence that interictal discharges per se cause (or contribute to) the complex behavioral phenotype of autism. There is no justification to support the use of anticonvulsant medication or surgery in children with PDD without seizures; that is, there is no evidence that treatment to eliminate EEG spikes will have a therapeutic effect on the behavioral abnormalities of PDD and autism.     

EXTENDED REDUCTIONS IN STEREOTYPIC BEHAVIOR OF STUDENTS WITH AUTISM THROUGH A SELF-MANAGEMENT TREATMENT PACKAGE

The literature suggests that self-management treatment packages have two potential strengths for the reduction or elimination of stereotypic behavior: (a) Self-management may be used for extended periods of time in the absence of a treatment provider, and (b) self-management techniques are easily adapated and used in a wide variety of natural settings. We assessed whether students with severe autistic disabilities could learn to use a self-management treatment package to reduce their stereotypic behavior within a multiple baseline across subjects design with withdrawals. The results showed that all of the students learned to use self-management procedures to reduce greatly levels of stereotypic behavior (typically to zero), and improvement occurred for extended periods of time in new settings without the presence of a treatment provider. The results are discussed in terms of the practical value of the treatment package and in terms of the implications for understanding autism.     

Behaviors of children with high‐functioning autism when paired with typically developing versus delayed peers: a preliminary study

Children with high‐functioning autistic disorder (HAD) in a comprehensive behavioral treatment program (n = 9, age = 5–7 years) alternated between pairings with a typically developing peer and pairings with a peer who had both autism and developmental delay. All pairings took place in a free play setting. The children with HAD displayed much more interactive play and speech (as well as much less self‐stimulation) with typically developing peers than with delayed peers. They received frequent cues and consequences for interaction from typically developing peers, but not in sessions with delayed peers. These results suggest that placement with typically developing peers is critical for children with HAD in behavioral treatment. Copyright © 2002 John Wiley & Sons, Ltd.     

A Case of Partial Biotinidase Deficiency Associated With Autism

We report the case of a child with partial biotinidase deficiency and autistic developmental disorder. We arrived at the diagnosis of biotinidase deficiency when the child was almost 4 years of age. Consequently, he began cofactor biotin treatment (10 mg daily) which did not resolve his autistic behavior. His younger brother was affected by partial biotinidase deficiency diagnosed at birth through our neonatal screening program. He was precociously treated with cofactor biotin therapy (10 mg daily) and did not show any behavioral abnormality or developmental delay. Since the brain is quite vulnerable to biotin deficiency, delayed biotin therapy could result in neurological damage. Our patient is the first case of partial biotinidase deficiency associated with autism. We hypothesize that the low biotinidase activity could have caused biotin deficiency in his brain and cerebrospinal fluids and consequently serious neurological problems, such as stereotyped and autistic behaviors, which were irreversible in spite of biotin supplementation.