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自閉症譜系障礙 Autism Spectrum Disorder

簡介 Introduction

自閉症譜系障礙 (ASD) 是一系列發展障礙,可使患者行為和溝通方面受到嚴重影響。ASD之特徵是社交互動和溝通上之困難。據估計,ASD在兒童及青少年之盛行率約為0.6%至1% (Simonoff et al., 2008)。儘管ASD的症狀通常在出生後2至3年便識別出來,但ASD可以在任何年齡診斷出來。一些患有ASD的兒童及青少年或許會同時出現其他心理或認知問題,譬如智能障礙、抑鬱和恐懼症。ASD的確切成因至今仍不得而知,但一些生理因素(e.g., 基因缺陷、染色體異常)和環境因素(e.g., 產前暴露於致畸物)可能會增加患有ASD之風險。教育訢!與行為介入及藥物治療,都可能對ASD患者有幫助。一些介入方法,譬如認知行為法、備忘稿 (scripting)和結構性遊戲小組,被視為有實證研究支援的方法(Wong et al., 2015)。

在2013年,美國精神醫學學會 (American Psychiatric Association) 出版了《精神疾病診斷與統計手冊(第五版)》(Diagnostic and Statistical Manual of Mental Disorders, 5th Edition),將自閉症、亞氏保加症、兒童時期崩解症及未分類的廣泛性發展障礙歸納為自閉症譜系障礙 (American Psychiatric Association, 2000, 2013)。

Autism spectrum disorder (ASD) is a set of developmental disorders which could profoundly affect behaviors and communication. ASD is characterized by difficulties in social interaction and communication. The prevalence of ASD is estimated to be about 0.6% to 1% in children and adolescents (Simonoff et al., 2008). While the symptoms of ASD are usually recognized in the first two to three years of life, ASD can be diagnosed at any age. Some children and adolescents with ASD might also suffer from other psychological or cognitive problems, such as intellectual disability, depression and phobias. The exact cause of ASD remains to be unknown, but some biological factors (e.g., gene defects, chromosomal anomalies) and environmental factors (e.g., prenatal exposure to teratogens) may increase the risk for ASD. Both educational and behavioral interventions and medications may be helpful in the management of ASD. Some interventions, such as cognitive behavioral intervention, scripting and structured play groups, were identified as evidence-based approaches (Wong et al., 2015).

In 2013, the American Psychiatric Association released the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), which puts several disorders under the umbrella of Autism Spectrum Disorder. Those disorders include Autism, Asperger's Disorder, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (American Psychiatric Association, 2000, 2013).


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