Emuva kuma-1990, abaphandi baqala ukuqaphela ukuba abantwana abane-autism babenobumba obukhulu kunabo abangenalo mqathango. Ngokukodwa, izifundo ezilandelelanayo ezilandela abantwana abaneminyaka emi-2 ubudala abaneminyaka engama-4 baye babonisa ukwanda kwentloko kunye nenkozo yengqondo.
Ngokusekelwe kwezi ngqalelo, kwakucetyiswa ukuba ukukhula kobuchopho kungasetyenziswa njenge-biomarker ukufundwa kwangaphambili kwe-autism kwiintsana.
(I-biomarker idibanisa amagama athi "biological" kunye ne "marker" kwaye ibhekisela kwizibonakaliso zengqondo okanye iimpawu ezinokulinganiswa kwiindlela ezichanekileyo nezizalisekayo.) Noko ke, ixesha lokukhulisa ubuchopho kunye nolwalamano phakathi kwale ngxaki kunye nokuziphatha efana ne- autism disorder disorder (ASD) yahlala ingaziwa.
Uphando olutsha olushicilelwe kwiphephancwadi leNdalo lubonisa ukuba inguqu yenguqu ekhokelela ekugqibeleni kwengqondo iqala ngoxa iinyanga ezineminyaka engama-6 kubantwana abavavanyelwa nge-autism. Olu phando lubonisa ukuba ukucinga ngethuba lokuxilonga (oko kukuthi, ukucinga ngomfanekiso wamaginethi okanye iMRI ) kubantwana abasengozini enkulu yokuphuhlisa i-autism kunokunceda ukuqikelela ukuxilongwa kwexesha elizayo.
I-Autism Spectrum Disorder ihlolwe
I-Autism disorder disorder ibhekisele kwiinkalo ezininzi zeempawu zekliniki, izakhono kunye namanqanaba okukhubazeka. Nazi ezinye iimpawu eziqhelekileyo ezibonakalisa i-autism :
- Unzima ukuthetha nabanye
- Unzima ukusebenzisana nabanye
- Iminqweno okanye imisebenzi
- Ukuziphatha okuphindaphindiweyo
- Umdla
- Ukukhathalela ngezinto okanye iindawo zezinto
- Ukungabikho kokuzimela
- Ukuphazamiseka kwamehlo okujonga amehlo, ukubonakalisa ubuso, kunye nesimo somzimba
- Ubuzwe obungavamile kwiimeko ezingapheliyo
- Ubunzima ngokusebenza kwentlalo, umsebenzi kunye nobomi bomntu
Ezi zibonakaliso ziqala ukubonakalisa malunga no-2 ubudala ubudala-ngaphambi kolu xesha, i-autism ayifumananga ngokuqinisekileyo. Ngamanye amazwi, abantwana abaphethwe ukuba bafumane i-ASD phakathi kweminyaka emi-2 ne-3 abaqhelekanga kubonakala bengenayo i-ASD ngaphambi konyaka wokuqala wobomi.
Abanye abantu abane-autism bafumana ukukhubazeka okukodwa, njengaleyo kunye ne-Asperger syndrome edlalwa ngokuthi "ukusebenza okuphezulu." Abanye abantu abane-autism bafumana ukukhubazeka okukhulu. Ipesenti ezingamashumi amabini okanye ngaphezulu kwabantwana abane-autism baqhubeka bephila ngokuzimeleyo nokuzimela. Izibonakaliso ezifanelekileyo zokubandakanya ziquka ukukwazi ukuthetha ngokusebenzisa intetho ngeminyaka emihlanu okanye ezintandathu kunye nezakhono eziqhelekileyo ezingenanto.
Nangona kungekho nonyango okanye iyeza ngokuthe ngqo kwi-autism, unyango oluthile lunokukunceda ukuphucula ukusebenza kunye nokunciphisa impawu. Unyango lufuna igalelo kwiintlobo ezininzi zeengcali zezempilo kwaye zigxininise kwizakhono zoluntu, zolwimi kunye nezilungelelaniso (ukuzinceda).
Amaziko ase-United States yokuLawula nokuVikela (i-CDC) aqikelele ukuba enye yabantwana abangama-68 ichongiwe nge-ASD, kwaye le miqathango ithintela abantu abavela kuzo zonke iintlanga, ubuhlanga kunye neemeko zentlalo. I-ASD i malunga nama-4.5 amaxesha amaninzi kumakhwenkwe kunokuba amantombazana.
Kuloo ntsana ezisengozini enkulu okanye abo abanomntwana omdala ose-ASD, amathuba okuphuhlisa imeko iya kwiqela elihlanu.
Nangona utshintsho oluthile olunqabileyo ludibaniswe nokuphuhliswa kwe-autism, ezininzi iziganeko azikwazi ukulandelwa emva kokufumanisa iziganeko zobungozi okanye iinguqu ezithile. Ngenxa yoko, kuye kwaba nomdla omkhulu wakutshanje ekuphuhlisweni kwezixhobo zokuxilonga ezingezizo ukuvelisa i-ASD.
Umsebenzi onokubaluleka kobunzima bokuqala kwi-ASD
Kwisifundo seNdalo esichazwe ngentla apha, abaphandi basebenzisa i-MRI ukutshekisha ubuchopho be-106 abantwana abasengozini yokuguquka kwengqondo. Ezi ntsana ezinobungozi obuphezulu zinabantwana abakhulileyo abane-ASD.
Iintsana zacatshulwa kwiinyanga ezintandathu, ezili-12 neye-24. Ukongezelela, abaphandi bahlalutya ubuncinci beentsana ezingama-42 engozini ephantsi ye-ASD.
Ezilishumi elinesihlanu zeentsana ezisemngciphekweni zafumanisa ukuba zine-ASD kwiminyaka emi-2 ubudala. Kule ntsana, inguqu yengqondo yaqala ukubonisa phakathi kweenyanga ezili-6 ukuya kwe-12 ubudala. Ukongezelela, ezi zinguqu zalandelwa ngongqoqo lweengqondo phakathi kweenyanga ezili-12 neye-24. Ngokukodwa, abaphandi babonisa ukuba phakathi kweenyanga ezili-6 ukuya kwe-12 ubudala, kwakukho ukwanda kwamanzi kwimihlaba ye-coripital kwaye, kwinqanaba elingaphantsi, lobes temporal and frontal lobes yengqondo. Ukukhula kwendawo yendawo ye-cortical umyinge wobukhulu beengxowa ngaphandle kwengqondo. Kwaye i-lobe ye-occipital ibandakanyeka ekusebenziseni ulwazi lwengqondo.
Olu tshintsho kwindawo yommandla we-cortex zadibaniswa nokugqithisa kwengqondo kamva kwaye ekugqibeleni ukulahleka kwezentlalo kubantwana abaxilongwa nge-ASD kwiminyaka emibini ubudala. Ukongezelela, le patheni yokwanda kwenkunkuma ifana nesimo esivamile, nangona isithintelo esiphezulu, ukwanda kwendawo yomhlaba ebonakalayo kubantwana abangenayo i-autism.
Ngokutsho kwabaphandi:
"Iimodeli zokuqulunqa ezivela kwiimpawu zokuziphatha ezisekelwe kwisisu zisenakubonelela ngokwaneleyo amandla okuqikelela ukuba abe luncedo eklinikhi. Sifumene ukuba i-algorithm enzulu yokufunda ngokubanzi isebenzisa ulwazi lwendawo yommandla kwi-MRI yengqondo kwiminyaka eyi-6 kunye ne-12 yobudala iqikelele ukuxilongwa kweenyanga ezingama-24 kwi-autism kubantwana abasemngciphekweni we-autism.
Ukusebenzisa i-algorithm enzulu-kufunda, abaphandi bacetyisa ukuba banokuqikelela ukuba i-autism inabantwana abalishumi elinesibhozo abasengozini enkulu kule meko.
Impembelelo
Ngaphandle kokungathandabuzeki, iziphumo zale ngcamango-yokukhangela isisombululo kunye nokutshintsha kwimidlalo. Kwakhona, ngokutsho kwabaphandi:
"Oku kufumaniswe kunokuba nefuthe lokufumanisa kwangaphambili kunye nokungenelela, kuba kunikwe ithuba lokuba kuhlanganiswe iinkcukacha ze-ASD kunye nexesha eliqhelekileyo lokuxilongwa. Inxalenye yokugqibela yesibini yokuqala kunye neyokuqala kwiminyaka yobomi ibonakaliswe ngeplastiki yobukhulu becala kunye nexesha elizayo kunye nexesha apho iintlupheko zentlalo ezinxulumene ne-autism azikabi kakuhle. Ukungenelela kweli nqanaba kunokubonisa ukuba luncedo ngakumbi kunokuba emva koko kuphuhliso. "
Ngamanye amazwi, abaphandi bacetyisa ukuba i-algorithm yabo inokuvula indlela yokufumana kwangaphambili kunye nokungenelela kwangaphambili kwiintsana ezisemngciphekweni-ezinokungenelela ezingabonakalisa ukusebenza ngakumbi kuba ingqondo yintsana inokutshintsha kwaye iguquke. Ukungenelela kwangaphambili kunokunceda uncedo lwezenzululwazi olungenelelo olungakumbi kwaye lubone ukuba unyango lusebenza kangangoko kunokuba lunokwenzeka ngaphambili.
Okwangoku, awaziwa ukuba ukungenelela kwangaphambili kunokuphucula iziphumo zeklinikhi ezide kwiigulane ezine-autism. Nangona kunjalo, iingcali ezininzi zixhasa ingcamango yokuba ukungenelela kwangaphambili kunika unyango nangona kungabikho uphando kwintsimi.
Ngokubalulekayo, iziphumo ezivela kwi-Trial Autism Communication Trial (PACT) -iyona nkqubela enkulu kunazo zonke nangaphezulu kunazo zonke zokungenelela kwe-autism ukuxhaswa ngokukhawuleza okufundisa abazali abantwana abane-autism indlela yokusebenzisana kangcono nabantwana babo inikeza uncedo olunokudlula iminyaka.
Nangona kunjalo, oku kungenelela koqeqesho bekugxilwe kubazali babantwana abane-autism engundoqo abaneminyaka engama-2 ukuya kwe-4 kwaye kungekhona abantwana ngokwabo . Ukongezelela, iziphumo zongenelelo zancipha ngokuhamba kwexesha kwaye zazingabaza kakhulu. Esikhundleni sokunciphisa uxhalaba, ukungenelela kwe-PACT kunciphise ukuziphatha okuphindaphindiweyo nokuphucula izakhono zokunxibelelana.
Kufuneka kuqatshelwe ukuba uphando lwe-brain-scan luhlola abantwana abasengozini enkulu yokuphuhlisa i-ASD kwaye kungekhona abantu abaninzi abane-ASD abangenabo abakhulileyo kunye neemeko. Nangona kunjalo, lo msebenzi unikezela ubungqina benkcazo engasetyenziselwa kamva kwabanye abasengozini ye-ASD. Kodwa ukuze kusetshenziswe kubemi jikelele, kunjalo, ukuphuhliswa "kwitshati yokukhula kwengqondo" efanelekileyo yokusebenza kufuneka kufezeke-into ebonakalayo kude.
Ngaphezu koko, ngaphambi kokuba ezi ziphumo zibe nokusebenza kliniki, kufuneka kwenziwe izifundo ezinkulu zokulandelelanisa ukuxhasa ezi ziphumo zophando. Uphando lwexesha elizayo kufuneka lihlolisise nokuba i-algorithm yokufunda isingenakunokudibaniswa nezinye iindidi zokuziqhelanisa, kuquka ukuziphatha, i-electrophysiology, i-genetic yamathambo, kunye nezinye iindlela zokucinga, njenge-MRI yobuchopho. Inqaku, njengoko kushiwo ngaphambili, asikacaci ukuguquka kwemfuyo enoxanduva lobuninzi beemeko ze-autism. Nangona kunjalo, uhlalutyo lwezinto ezinjalo zofuzo luhlala kwindawo echaphazelekayo yophando kunye nomdla kubaninzi.
Ekugqibeleni, ukungafani kwezibalo ze-MRI kunye neendlela zokukhupha idatha kungenza ukuphindaphinda kwezi ziphumo zilukhuni. Ngamanye amazwi, i-MRI scanners ihluke kwaye le nto yohlukwano ingenza kube nzima ukuphindaphinda ukuguqulwa, kodwa okuphawulekayo, utshintsho oluphawuliweyo kwisifundo esilandelayo.
> Imithombo
> Callaway, E. Brain uhlola indawo yeempawu zokuqala ze-autism kwiintsana ezisemngciphekweni. Ubume: Iindaba kunye neNgxelo. 2/15/2017.
> Hazlett, HC et al. Uphuhliso lobuchopho bokuqala kwiintsana ezisengozini enkulu ye-autism disorder disorder. Uhlobo. 2017; 542: 348-351.
> Leidford, H. Ukufundwa kwe-Autism kufumana ukungenelela kwangethuba kunemiphumo engapheliyo. Ubume: Iindaba kunye neNgxelo. 10/25/2016.
> Pickles, A et al. Ulwaphulo-nxu lumano lwezentlalo kubantwana abancinci nge-autism (i-PACT): ukulandelelwa kwexesha elide lovavanyo olulawulwa ngononophelo. 2016; 388 (10059): 2501-2509.
> Volkmar FR. Isahluko 34. I-Autism kunye neengxaki eziPhuculo zoPhuhliso. Ku: Ebert MH, Loosen PT, Nurcombe B, uLeckman JF. eds. UKUPHATHWA KWEZINDAWO ZONYAKA Nonyango: I-Psychiatry, 2e eNew York, NY: McGraw-Hill; 2008.