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Child Developmental Evaluation Center
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Shalu Branch 04-26625111
No.117, Shatian Road Shalu District, Taichung City 433, Taiwan (R.O.C.)

Dajia Branch 04-26885599
No.321, Jingguo Road Dajia District, Taichung City 437, Taiwan (R.O.C.)


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Autism Spectrum Disorder

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Autism Spectrum Disorder: The prevalence rate has shown an increasing trend year by year. According to the latest 2023 report by the Autism and Developmental Disabilities Monitoring Network (ADDM), which included surveys of 8-year-old children in 11 U.S. communities in 2020, the prevalence rate of Autism Spectrum Disorder (ASD) was as high as 2.76% (1 in every 36 children). Boys are 3.8 times more likely to be diagnosed than girls, and approximately one-third (37.9%) of those diagnosed also have intellectual disabilities. In 2013, the American Psychiatric Association (APA) published the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which classified Autism Spectrum Disorder (ASD) under "Neurodevelopmental Disorders." It merged DSM-IV’s "Autistic Disorder," "Asperger’s Disorder," and "Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS)" into ASD. The three core symptoms in DSM-IV’s "Autistic Disorder" (qualitative impairments in social interaction, qualitative impairments in communication, and restricted, repetitive behaviors, interests, and activities) were reorganized into two core symptoms: deficits in social interaction and communication, and restricted, repetitive behaviors, interests, and activities. Additionally, DSM-5 categorizes ASD into three levels based on the severity of the two core symptoms and the level of support needed. The World Health Organization (WHO) reflected DSM-5 standards in the 2018 edition of the International Classification of Diseases (ICD-11), incorporating Autism, Asperger's Syndrome, and PDD-NOS under the diagnosis of Autism Spectrum Disorder (ASD), further subdividing it into six subtypes based on the individual’s intellectual development and language impairments. Social interaction and communication development typically begin before language emerges. Infants at around 2 to 4 months old will turn toward sounds, make eye contact, and smile at people. By 6 to 8 months, they can recognize primary caregivers versus strangers and may show signs of separation anxiety or stranger anxiety (e.g., crying when their mother leaves or when held by a stranger). Studies have shown that joint attention is foundational for early communication development in infants and is closely related to subsequent learning, socialization, and language development. By 6 to 9 months, infants engage in non-verbal communication, such as looking at adults, vocalizing, or reaching for objects. Between 9 to 12 months, they develop the ability to share objects, point, and shift their gaze between people and objects, a skill known as joint attention. Most children develop the ability to initiate joint attention (IJA) by 12 to 14 months, where they intentionally use eye contact, facial expressions, gestures, and postures to attract attention, request objects, or share emotions and interests. Research indicates that a lack of joint attention between 14 and 18 months is a significant predictor of Autism Spectrum Disorder (ASD). Early signs of ASD in infants aged 6 to 12 months include lack of eye contact with caregivers, no response to their name, minimal sharing of smiles, no vocalization attempts, and a lack of ability to express intentions through gestures. Children with ASD often exhibit delayed language development (e.g., inability to say meaningful words by 12 to 18 months, inability to speak simple sentences or follow basic instructions by ages 2 to 3), pronoun reversals (confusion between pronouns like 'you,' 'I,' and 'he'), and echolalia (e.g., immediate echolalia, where they repeat others' questions, or delayed echolalia, where they inappropriately repeat phrases heard earlier). These children may struggle with understanding sentence meanings and give irrelevant answers, relying on rote memorization to respond. They also lack generalization skills and fail to adjust their tone, volume, or gestures according to different situations. Their play may be repetitive or rigid (e.g., lining up toys, stacking them, or repeatedly tapping them), and they may lack symbolic play (e.g., feeding a doll or pretending to make a phone call). Some children may exhibit stereotyped behaviors, such as body rocking, hand flapping, running back and forth, spinning in circles, fixating on spinning objects, or repeatedly opening and closing doors or lights. Others may engage in ritualistic behaviors, insisting on fixed routines, and struggle with changes in schedules. Some children may be overly sensitive to certain sounds or tactile sensations or may show unusual preferences for specific sensory stimuli. Early diagnosis and intervention are especially important for children with Autism Spectrum Disorder (ASD). Research shows that early intervention can improve outcomes and enhance the ability to live independently in the future. The younger the child, the greater the brain's plasticity. It is particularly important to take advantage of the golden period of early intervention before the age of 3 to promote potential development. Our hospital's Child Development and Early Intervention Center (Children's Day Care Ward) is located in the Community Rehabilitation Center building near the roundabout in Caotun Township. It is equipped with facilities for children with special needs and a complete professional medical team, including pediatric psychiatrists, nurses, psychologists, occupational therapists, and social workers. The center serves children aged 0-6 who are suspected of having developmental delays or ASD, and who have been assessed by a physician as needing early intervention. Families are encouraged to accompany their child throughout the intervention sessions. The medical team provides integrated intervention programs based on individual clinical needs, including social interaction training, communication skills training, cognitive development courses, sensory integration training, and life education. These programs are offered in both group and individual therapy formats to enhance basic cognitive abilities and life skills. Through group activities, children learn self-control, emotional regulation, and adaptability, reducing problem behaviors. Additionally, the center offers parents relevant knowledge and skills regarding child development and intervention.1. Mundy, P. and W. Jarrold, Infant joint attention, neural networks and social cognition. Neural Netw, 2010. 23(8-9): p. 985-97.2. Rogers, S.J., Dawson, G,丹佛早療模式:促進自閉症幼兒的語言、學習及參與能力(姜忠信、劉瓊瑛、朱思穎譯)。台北:洪葉文化。(原著出版年:2010). 2014.3.Yoo, H., Early Detection and Intervention of Autism Spectrum Disorder. hmr, 2016. 36(1): p. 4-10.4.Zwaigenbaum, L., J.A. Brian, and A. Ip, Early detection for autism spectrum disorder in young children. Paediatrics & Child Health, 2019. 24(7): p. 424-432.

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