What is Autism Spectrum Disorder (ASD)? 什么是泛自闭症障碍 (ASD)? (English and Mandarin)

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What is Autism Spectrum Disorder (ASD)?

Autism Spectrum Disorder is a term that current medical/allied health professionals use to encompass the diagnoses of Autism, Atypical Autism and Asperger’s Syndrome.

 

In general, individuals with Autism Spectrum Disorder presents with:

  • Social skills deficits
  • Social communication impairments, and
  • Restrictive and or repetitive patterns of behaviours

 

什么是泛自闭症障碍 (ASD)?

泛自闭症障碍（Autism spectrum disorders，ASD ）是一组类似症状的合称，其中包括自闭症（Autism）、非典型自闭症（Atypical Autism）以及阿斯伯格综合症（Asperger’s Syndrome）。我会使用“泛自闭症障碍”这个词囊括上述各种障碍。

 

患有泛自闭症障碍的青少年通常会在以下三方面有发育障碍，即：

  • 社交障碍；
  • 语言和交流障碍；以及
  • 行为和想象力障碍。

 

How do parents determine if their child could be on the Autism Spectrum?

As parents or caregivers, you may have concerns about your child’s physical, cognitive, language, and social development. Sometimes, children do not present with any difficulties/symptoms until they attend kindergarten or primary school. For others, it is also not uncommon for the kindergarten or primary school teachers to raise their concerns with parents/caregivers. It is important that you seek professional opinion should you have concerns about your child.

 

For children in childcare and/or kindergarten, the following presentations are indicative of ASD:

  • Speech delay
  • Lack of awareness of people around them
  • Does not respond to other’s facial expressions or feelings
  • Lack creativity, imagination, and/or does not engage in pretend play
  • No interest in playing with peers
  • Awkward turn-taking during play
  • Does not share his/her interests
  • Delays in non-verbal communication skills such as gestures
  • Does not point
  • Does not initiate play with others and/or know how to play with toys
  • Is hyper- or hypo- sensitive to certain sensory input (Touch, Taste, Visual, Sound, Smell)

  

家长该怎样判断自己的孩子是否患有泛自闭症障碍？

作为家长或者看护人，您可能会看到您的孩子的发育障碍。 有时孩子的交流障碍只有在他们开始上幼儿园或者上学时才开始显露。其他人，比如幼儿园员工或者老师提出的担忧也很重要。在你有疑虑时，医疗人员的回应至关重要。您应该与他们讨论这些疑虑。泛自闭症障碍的症状在儿童的各个年龄段有不同的表现。

 

可能患有泛自闭症障碍的学前儿童的症状

您的孩子可能：

  • 说话能力达不到对他们这个年龄段的预期水平，或者根本不会说话；
  • 似乎注意不到他们身边的人；
  • 对其它人的面部表情或感觉没有反应；
  • 很少有或完全没有想像力，或者不会玩扮演游戏
  • 对其他儿童不感兴趣或不愿和他们一起玩耍
  • 玩耍时不会轮流交替
  • 不会分享乐趣或快乐；
  • 在非语言交流（比如目光接触和面部表情等）方面有障碍；
  • 不会通过手指物体来引起别人注意；
  • 不会向别人注视的方向看去（又称 “盯视监控”）；
  • 不会开始活动或玩耍；
  • 使用异常的重复性手臂和手指动作，或
  • 对特定声音或视像有反应或者对特定声音和视像完全没有反应。

 

For school aged children, professionals often look for the following:

Delay in communication skills

  • Odd/inappropriate speech intonation
  • Speech is monotone and/or is very formal
  • Repeats phrases/sentences they have heard
  • Inappropriate use of pronounce (I, he, she, they, etc.)
  • Use language not typically heard among children of a similar age
  • Is only able or willing to communicate when the topic of conversation is related to their interest.

 

Social Skills Delay

  • Does not like playing with others
  • Uses inappropriate means to join others in play (e.g. aggression)
  • Behaves in a way that is hard to understand (e.g. criticizes teachers or does not follow simple and direct instructions)
  • Relates either really well with adults or struggles to relate to adults
  • Does not like others entering their personal space

 

Restrictive and Repetitive Behaviours

  • Struggles with pretend play with others
  • Has difficulty with group activities and or turn taking activities
  • Struggles in open spaces (e.g. would stand of the edges of the oval/basketball court)
  • Struggles with transition
  • Has interest in certain things that seem abnormal in intensity and focus
  • Has a strong preference for routine and becomes distressed if routines must be changed

 

Others

  • Is especially talented in certain things (e.g. has very good memory and is a prodigy)
  • Seeks or avoids certain sensory input

 

可能患有泛自闭症障碍的学龄儿童的症状

交流障碍

您的孩子可能：

  • 在年幼时有异常的语言发展障碍（使用与其他同龄儿童不同的语言）；
  • 讲话方式异常；
  • 重复他们听到的词语或短语，但是对这些词语或短语没有回应；
  • 在3岁以后仍然用“你”、“她”或“他”指代自己；
  • 使用与年龄不符的词语；或
  • 只会使用有限的词语或只能对自己感兴趣的事情自如交谈

 

社交障碍

您的孩子可能：

  • 不喜欢与其他儿童一起玩耍；
  • 试图以不恰当的方式加入其他儿童的游戏中（比如您的孩子可能看起来有攻击性）；
  • 举止行为让别人很难理解（比如，他们可能批评老师或者不按指令做事）；
  • 身边有人时很容易不知所措；
  • 与成年人关系反常（比如可能会过份强烈或者完全不建立关系）；或
  • 不喜欢别人进入他们的私人空间或被人催促。

 

兴趣、活动和行为障碍

您的孩子可能：

  • 很难参与到其他儿童的假想游戏中或很难参加需要分工合作和轮流参加的游戏；
  • 不适应大型开放空间，比如，他们可能只待在游乐场的边缘）；或
  • 很难处理变化或非惯常情况，即使是那些其他儿童很喜欢的变化（比如学校集体出游或老师不在的情况）

 

其它因素

您的孩子可能会：

  • 拥有不同寻常的技能（比如，有很好的记忆力或者在数学或音乐方面很有天赋）；或
  • 不喜欢某些特定事物的声音、味道、气味或者触感。

 

Youth/Adolescents with ASD may present with the following symptoms:

Overall

  • Present with delays in adaptive skills and social skills
  • Seems to be less independent that individuals their age

 

Language and communication skills

  • Presents with a lack in socials skills. This is despite them having very fluent speech and a wide vocabulary of words
  • Appear to be more reserved
  • Struggle to carry a conversation with others
  • Is only interested in expressing their thoughts/sharing their interests and struggle to consider the thoughts/interests of others.
  • Do not understand sarcasm or jokes/humour
  • Presents with unusual eye contact
  • Acts silly or laughs inappropriately

 

Social Skills

  • Relates better to adults or children younger than them
  • Does not have similar interests to individuals of similar ages
  • May intrude other’s personal space

Cognition and Behaviour

  • Has very restricted and narrow interests
  • Has a strong preference for routine
  • Presents with repetitive behaviours
  • Struggles with imagination and abstract thinking

 

 

可能患有泛自闭症障碍的青少年的症状

总体而言

您的孩子可能：

  • 显示出学校生活能力与社交能力的差距（比如，他们可以应对学业或工作但是不知道如何应对学校假期或工作假期）；
  • 缺乏“生存能力”（换言之，不具备现代生活的能力和知识）；或
  • 不像同龄人那样独立

 

语言、社交技能和交流

您的孩子可能：

  • 有交流障碍，即使他们可能知道很多词汇并能正常使用语法 – 比如，他们可能会很沉默，只对他人讲话而没有双向对话，或提供过多他们感兴趣的事情的信息；
  • 不能根据不同的社交场景而变换交流方式（比如，他们听起来可能比同龄人更成人化，或者与成年人过份亲近）；
  • 不明白有讽刺意味的语言（即当别人嘲笑他们的时候）；或
  • 在不当场合与人发生目光接触、做出不当手势或面部表情。

 

社交障碍

您的孩子可能：

  • 更容易与成年人或比自己年幼的儿童交朋友，而很难与同龄人交友；
  • 不能与同龄人分享同样的观点或兴趣；或
  • 很难接受与别人有身体接触或他们或者不知道如何把握自己和他人的距离

 

思考与行为

您的孩子可能：

  • 拥有非常特别的兴趣或爱好，或可能喜欢收集、编号或列举事物；
  • 对熟悉的惯常生活有强烈的喜好，或者可能有重复性的行为；或
  • 在运用想像力方面有困难（比如在写作或做计划时）。

 

Diagnostic assessment

Should you have concerns that your child may be presenting with the aforementioned symptoms, discuss your concerns with a general practitioner (GP). Your GP may then refer you to a Peadiatrician.

The Peadiatrician may request that your child is assessed by a speech pathologist, psychologist and or occupational therapist.

Some of the more common assessment tools used by psychologist include the ADI-R, ADOS-2 and CARS-2. In addition to these, the clinician will also interview the parents to gain a better understanding the child’s development since birth.

 

评估与诊断

如果医护专业人员怀疑您的孩子可能患有泛自闭症障碍，那么他们应该将您的孩子转介给专家组（儿科，心理学家 以及 语言专家）做评估。 如果医护人员考虑转介您的孩子接受评估，那么他们应该与您讨论，并在您等待接受评估期间向您和您的孩子提供帮助。

 

当询问您的孩子的病史时，专家有时可能会使用特别方法（比如自闭症诊断访谈量表修订版（ADIR））。这能帮助专家在询问与泛自闭症障碍相关的问题时保持连贯性。参与评估您的孩子的专家们能够告诉您有关此类家长和看护人访谈的信息。

 

专家对您的孩子的观察也很重要。他们可能会在您的孩子玩耍或完成任务过程中进行观察，也可能在诊所对他们进行访谈。专家组有时还使用一种特殊工具 – 比如，

自闭症诊断观察量表（ADOS－2）或儿童自闭症评定量表（CARS-2）。这些工具同样可以帮助专家们对儿童进行一致性观察。专家组可能还需要了解您的孩子在日常生活中的表现。他们会联系能够提供相关信息的人（比如您的孩子的老师或者社工）。

 

 

Comorbidities

A proportion of children with Autism Spectrum Disorder may also struggle with the following conditions:

  • Depression and anxiety
  • Attention Deficit/Hyperactivity Disorder (AD/HD)
  • Sleeping difficulties
  • Delays in gross and fine motor skills

 

泛自闭症障碍会使孩子更容易患其它病吗？

还有一些其它问题常见于患泛自闭症障碍的儿童中，包括：

  • 精神健康问题（特别是焦虑症和抑郁症）；
  • 注意缺陷多动障碍（ADHD），俗称多动症；
  • 在与看护人分离或重逢时有异常行为（又称“不安全型依恋”）；
  • 睡眠问题；及
  • 活动困难 （比如，笨拙和抽动）；

 

The information provided in this blog post was obtained from the “Autism Spectrum Disorder Booklet for parents and carers” published by The Scottish Intercollegiate Guidelines Network，SIGN in 2011.

 

以上的讯息是来自于苏格兰院际指南网（The Scottish Intercollegiate Guidelines Network，SIGN）编写指南在2011年所出版的 “家长与儿童看护人： 知识手册。

 

For more information about Autism Spectrum Disorder please visit AMAZE at http://www.amaze.org.au

您可以联络下列机构瞭解更多詳情：

AMAZE          http://www.amaze.org.au

 

For further enquires, you may also contact Your Mind Matters’ psychologists on (03)98095947.

如果有需要， 您也可以拨打电话（0398095947 与我们诊所的心理学家 Dr . Shannon Choong 联系获取更多相关信息。

 

Resource /有用的出版物

1） Autism Spectrum Disorder Info Pack (中文版)

http://www.amaze.org.au/uploads/2012/11/Info-Pack-for-translation-Mandarin.pdf

 

2) A mind apart: understanding children with autism and Asperger’s syndrome

《一念之隔：理解自闭症和阿斯伯格综合症患儿》

Author/作者：P Szatmari, Publisher/出版社：Guilford Press (2004)

Shannon

This blog was written by Dr Aiyuen (Shannon) Choong, Psychologist at Your Mind Matters. Aiyuen is fluent in English and Mandarin, and is passionate about working with children from preschool years through to adolescence. 

To learn more about Aiyuen, click here.