淺談自閉症類群障礙

An Overview of Autism Spectrum Disorder

王南凱(Nan-Kai Wang) ； 吳岱穎(Tai-Yin Wu) ； 鄒國蘇(Kuo-Su Tsou) ； 黃宜靜(Yi-Jing Huang) ； 郭冠良(Kuan-Liang Kuo) ； 吳逸帆(Yi-Fan Wu) ； 陳建志(Chien-Chih Chen)

《北市醫學雜誌》 10卷3期 (2013/09) Pp. 173-181

https://doi.org/10.6200/TCMJ.2013.10.3.01

摘要

自閉症類群障礙是兒童常見的發展障礙。其最早被發現，也最具特異性的核心症狀是社交互動障礙，如共同注意力、社會定向、模仿性的遊戲困難。溝通障礙也很常見，且具特異性。重複而侷限的行為或興趣也是重要的核心症狀。其致病機轉是複合式的且尚未完全被明瞭。目前已知的證據顯示是由於包括基因在內的多重因素，共同造成神經發展過程中非典型的表現，導致臨床上的症狀。其治療需要各領域的團隊合作，行為治療目前是最有實證證明能改善其核心症狀與功能發展的治療方式。醫師在幼兒生長發展評估時，宜運用相關篩檢工具，評估幼兒是否有自閉症類群障礙或其他發展疾患，並轉介兒童精神科與早期療育中心進行進一步的評估與治療。

關鍵字

自閉症 ； 自閉症類群障礙 ； 廣泛性發展障礙 ； 亞斯伯格症

並列摘要

Autism spectrum disorder (ASD) is a common childhood pervasive developmental disorder and its prevalence is rising in across countries. Impairment in social interaction, such as lack of joint attention, social orienting and pretend play, is the first sign and the most specific core symptom of autism. Impairment in communication is also a prevalent and specific sign. Repetitive behaviors and restricted interests are important core symptoms of autism, too. The etiology and mechanism of ASD are multifactorial and not yet fully understood. Current evidence shows that multiple factors, including genetic factors, contribute to atypical presentations in the process of neural development and thus leading to the clinical symptoms. Behavior therapy is a treatment strategy most strongly supported by evidences for improving the core symptoms and functional development of ASD. Treatment of ASD requires collaboration from multidisciplinary professionals. Primary care physicians can play their part during child development assessment and evaluate the children if they show autistic features or other developmental disorders, and refer the sick children to child psychiatry department and early treatment center for further assessment and treatment.

並列關鍵字

autism ； autism spectrum disorder ； pervasive developmental disorders ； Asperger syndrome

參考文獻

丘彥南、賴孟泉、徐如維、劉弘仁。兒童 青少年精神疾病工作小組報告之一：自閉 症類群障礙、溝通障礙症、智能發展障礙 症、學習障礙症、注意力不足過動症之 DSM-5 草案內容相較於DSM-4 之變革。 DSM-5 通訊 2011; 4:17-21[ 檢索日期2013 年4 月9 日]； 檢索自：Available from: http://www.sop.org.tw/Dsm5/journal_info04. asp。

姜忠信、吳進欽、劉俊宏、侯育銘。2~3歲自閉症幼兒篩檢量表的發展：T-STAT 的 初究。中華心理衛生學刊 2012; 25(1):135- 54

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Revision. Washington, DC, American Psychiatric Publishing, 2000:75.

Weaving L, Ellaway C, Gecz J, Christodoulou J. Rett syndrome: clinical review and genetic update. J Med Genet 2005; 42:1-7.

Kurita H. Childhood Disintegrative Disorder. In: Hollander E, Kolevzon A, Coyle JT, editors. Textbook of Autism Spectrum Disorders, 1st edition. Arlington, VA, American Psychiatric Publishing 2010; 99-105.