上海交通大学学报（医学版）

上海交通大学学报（医学版） >

2025 , Vol. 45 >Issue 2: 222 - 227

DOI: https://doi.org/10.3969/j.issn.1674-8115.2025.02.011

综述

孤独症谱系障碍婴儿期超早筛查和干预的研究进展

  • 曹思瑶 ,
  • 刘洁琼 ,
  • 王广帅 ,
  • 王广海
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  • 1.上海交通大学医学院附属上海儿童医学中心儿科转化医学研究所，上海 201200
    2.华中师范大学人工智能教育学部，教育大数据应用技术国家工程研究中心，武汉 430079
    3.上海脑科学与类脑研究中心，上海 201602
    4.上海交通大学医学院附属新华医院教育部和上海市环境与儿童健康重点实验室，上海 200092
曹思瑶（1995—），女，硕士生；电子信箱：caosiy0@163.com。
王广海，研究员，博士；电子信箱：wang-guanghai@163.com。

收稿日期: 2024-05-20

  录用日期: 2024-10-08

  网络出版日期: 2025-02-28

基金资助

国家科技创新2030—“脑科学与类脑研究”重大项目(2021ZD0204205);国家自然科学基金(8207053221);上海市浦江人才计划(22PJC074)

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Research progress in preemptive screening and intervention for autism spectrum disorder in infancy

  • CAO Siyao ,
  • LIU Jieqiong ,
  • WANG Guangshuai ,
  • WANG Guanghai
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  • 1.Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 201200, China
    2.Faculty Artificial Intelligence in Education, National Engineering Research Center of Educational Big Data, Central China Normal University, Wuhan 430079, China
    3.Shanghai Center for Brain Science and Brain-Inspired Intelligence Technology, Shanghai 201602, China
    4.Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
WANG Guanghai, E-mail: wang-guanghai@163.com.

Received date: 2024-05-20

  Accepted date: 2024-10-08

  Online published: 2025-02-28

Supported by

National Science and Technology Innovation 2030 Major Project of China(2021ZD0204205);National Natural Science Foundation of China(8207053221);Shanghai Pujiang Program(22PJC074)

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摘要

孤独症谱系障碍（autism spectrum disorder，ASD）是一种起病于儿童早期的神经发育障碍。当前儿童ASD的确诊年龄通常在2岁之后，但其行为迹象或前驱症状在12月龄前即可出现，并随着年龄增长逐渐发展为明显的核心症状。因此，ASD的早期筛查与干预尤为关键，其有助于最大程度改善患儿预后，促进患儿最佳发展结局。近年来，临床和研究领域愈加强调针对12月龄前儿童的ASD前驱症状开展“先发制人”的超早筛查和超早干预，旨在一定程度上减少儿童前驱症状或使其趋于正常。然而，在前驱症状期，特别是1岁以内进行ASD超早筛查和超早干预面临诸多挑战，导致相关研究非常有限。如ASD超早筛查存在婴幼儿个体生长发育差异性大、症状未巩固、评估方法不统一等问题，超早干预需克服筛查工具和家长可控性的差异等。该文重点介绍适用于1岁以内的ASD超早筛查工具，和英国孤独症儿童年幼同胞研究中的干预方案视频互动促进积极养育法，以及改善婴儿环境与接纳承诺疗法、改编的回应式教学法等超早干预方法，并阐释神经影像技术和人工智能技术的应用进展，以期为相关研究和临床实践提供参考。

关键词： 孤独症谱系障碍; 超早筛查; 超早干预; 婴儿

本文引用格式

曹思瑶 , 刘洁琼 , 王广帅 , 王广海 . 孤独症谱系障碍婴儿期超早筛查和干预的研究进展[J]. 上海交通大学学报（医学版）, 2025 , 45(2) : 222 -227 . DOI: 10.3969/j.issn.1674-8115.2025.02.011

Abstract

Autism spectrum disorder (ASD) is a neurodevelopmental disorder starting from early childhood. At present, the age of diagnosis for ASD in children is significantly delayed, typically occurring after two years of age, although behavioral signs or prodromal symptoms can emerge before the age of 12 months. These early indicators gradually evolve into the core symptoms of ASD. It has been well recognized that early screening and intervention can maximally improve its prognosis and promote optimal development of the affected children. Therefore, there has been increasing emphasis on preemptive screening and intervention for prodromal symptoms of ASD before the age of 12 months in clinical practice and research, so as to reduce the symptoms to a normal state to some extent. However, during the prodromal period of ASD, especially before the age of one, preemptive screening and intervention present many challenges. Preemptive screening faces obstacles such as significant individual differences in infant growth and development, incomplete presentation of ASD symptoms, and differing assessment content and criteria; preemptive intervention must overcome challenges like the diversity of screening tools and varying factors of parents. As a result, few research has been conducted in this field. This review mainly introduces preemptive screening tools and intervention techniques for children with ASD in the first year of life, including the intervention used in the British Autism Study of Infant Siblings-video interaction for promoting positive parenting (iBASIS-VIPP), the promoting first relationships, the environmental enrichment for infants, parenting with acceptance and commitment therapy (ENACT), and the adapted response teaching. The application of neuroimaging technology and artificial intelligence technology is also explained to provide reference for relevant research and clinical practice.

Key words： autism spectrum disorder (ASD); preemptive screening; preemptive intervention; infant

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