孤独症社会交流功能分级系统的临床应用

Clinical application of the Autism Classification System of Functioning: Social Communication

摘要

社会交流障碍是孤独症谱系障碍(ASD)的核心症状之一,其能力水平从轻度功能缺陷到完全无语言交流不等,症状表现异质性高。基于ICF理论框架,孤独症社会交流功能分级系统(ACSF:SC)为ASD儿童的社会交流功能提供了系统的分级标准,将社会沟通功能分类量化为5个等级,替代模糊的“轻/中/重度”标签。ACSF:SC在国外的临床实践中展现出良好的信效度,为制定个性化干预方案和教育策略提供了重要依据。本文对ACSF:SC的理论基础、核心维度、优势、应用现状和局限性进行论述,为推动ACSF:SC在我国的本土化研究和实践提供参考与意见。

Abstract

Social communication disorder is one of the core symptoms of autism spectrum disorder (ASD), with ability levels ranging from mild functional deficits to complete absence of verbal communication, and showing high heterogeneity in symptom manifestations. Based on the International Classification of Functioning, Disability and Health (ICF) theoretical framework, the Autism Classification System of Functioning: Social Communication (ACSF: SC) provides a systematic grading standard for the social communication function of children with ASD. It quantitatively classifies social communication functions into five levels, replacing the vague labels of mild, moderate, and severe. In international clinical practice, the ACSF: SC has demonstrated robust reliability and validity, providing an essential basis for the development of individualized intervention programs and educational strategies. This article discusses the theoretical foundation, core dimensions, advantages, current application status, and limitations of the ACSF: SC, aiming to provide references and recommendations for the localization and practical implementation of the ACSF: SC in China.

关键词

孤独症谱系障碍 / 社会交流功能 / 分级系统

Key words

autism spectrum disorder / social communication function / classification system

[1] Hirota T, King BH. Autism spectrum disorder: A review[J]. JAMA, 2023,329(2):157-168.
[2] Gander F, Proyer RT, Ruch W, et al. The good character at work: An initial study on the contribution of character strengths in identifying healthy and unhealthy work-related behavior and experience patterns[J]. Int Arch Occup Environ Health, 2012,85(8):895-904.
[3] Kuo DZ, Houtrow AJ, Arango P, et al. Family-centered care: Current applications and future directions in pediatric health care[J]. Matern Child Health J, 2012,16(2):297-305.
[4] Steiner AM. A strength-based approach to parent education for children with autism[J]. J Posit Behav Interv, 2011, 13(3): 178-190.
[5] Frigaux A, Evrard R, Lighezzolo-Alnot J. ADI-R and ADOS and the differential diagnosis of autism spectrum disorders: Interests, limits and openings[J]. L'encephale, 2019, 45(5): 441-448.
[6] Di Rezze B, Rosenbaum P, Zwaigenbaum L, et al. Developing a classification system of social communication functioning of preschool children with autism spectrum disorder[J]. Dev Med Child Neurol,2016,58(9):942-948.
[7] Di Rezze B, Gentles SJ, Hidecker MJC, et al. Adaptation, content validity and reliability of the autism classification system of functioning for social communication: From toddlerhood to adolescent-aged children with autism[J].J Autism Dev Disord,2022,52(12):5150-5161.
[8] Tajik-Parvinchi D, Rosenbaum P, Hidecker MJC, et al. Construct validity of the Autism Classification System of Functioning: Social Communication (ACSF:SC) across childhood and adolescence[J]. J Autism Dev Disord,2023,53(8):3246-3256.
[9] Leonardi M, Lee H, Kostanjsek N, et al. 20 years of ICF-International Classification of Functioning, Disability and Health: Uses and applications around the world[J]. Int J Environ Res Public Health, 2022,19(18):11321.
[10] 杨晴, 王秋, 李娜, 等. 手功能分级系统在脑性瘫痪中的应用研究[J]. 中国儿童保健杂志, 2020, 28(4):419-422.
Yang Q,Wang Q,Li N, et al. Research on the manual atility classification system in cerebral palsy assessment[J]. Chin J Child Health Care,2020, 28(4):419-422.(in Chinese)
[11] Liu J, Zhang R, Xie E, et al. Shared intentionality modulates interpersonal neural synchronization at the establishment of communication system[J]. Commun Biol, 2023,6(1):832.
[12] Eloi DS, Mareco KKG, Queiroz AG, et al. Cross-cultural adaptation of Autism Classification System of Functioning: Social Communication (ACSF: SC) for use in Brazil[J]. Cadernos Brasileiros de Terapia Ocupacional, 2019, 27: 293-301.
[13] Mazahery S, Soleymani Z, Jalaie S. Preliminary psychometric properties of the Autism Classification System of Functioning: Social Communication (ACSF: SC) in Farsi speaking children[J]. Appl Neuropsychol Child, 2022,11(4):652-657.
[14] Shanmugarajah K, Rosenbaum P, Zubairi M, et al. A narrative review of function-focused measures for children with neurodevelopmental disorders[J]. Front Rehabil Sci, 2021,2:709978.
[15] Craig F, Fanizza I, Russo L, et al. Social communication in children with autism spectrum disorder (ASD): Correlation between DSM-5 and autism classification system of functioning-social communication (ACSF:SC)[J]. Autism Res, 2017,10(7):1249-1258.
[16] Craig F, Crippa A, Ruggiero M, et al. Characterization of autism spectrum disorder (ASD) subtypes based on the relationship between motor skills and social communication abilities[J]. Hum Mov Sci, 2021,77:102802.
[17] Craig F, Lorenzo A, Lucarelli E, et al. Motor competency and social communication skills in preschool children with autism spectrum disorder[J]. Autism Res, 2018,11(6):893-902.
[18] Khalifa G, Rosenbaum P, Georgiades K, et al. Exploring the participation patterns and impact of environment in preschool children with ASD[J]. Int J Environ Res Public Health, 2020,17(16):5677.
[19] Wright FV, Wright A, Bauve C, et al. Getting into the game: Evaluation of the reliability, validity and utility of the Ignite Challenge Scale for school-aged children with autism spectrum disorder[J]. Disabil Rehabil, 2024,46(7):1374-1390.
[20] Loffi RG, Cruz TKF, Paiva GM, et al. Theoretical-Methodological Foundations for the Global Integration Method (Método de Integraçäo Global-MIG) in the treatment of autism spectrum disorder[J]. Children (Basel), 2024,11(2):191.
[21] Yazdanian H, Rekhne ZB, Soltani A, et al. Efficacy of virtual reality-based joint attention interventions in enhancing social-communication skills of school-aged children with autism:A randomized controlled trial protocol[J].JMIR Research Protocols,2023.DOI:10.2196/55803
[22] Fernandes AC, Souto DO, de Sousa Junior RR, et al. Sports Stars Brazil in children with autism spectrum disorder:A feasibility randomized controlled trial protocol[J].PLoS One, 2023,18(11):e0291488.
[23] Ricart Jiménez A. Propuesta de investigación: La comunicación social en alumnos con trastorno del espectro autista[D].San GabrielArcángel:Universidad Católica de Valencia,2022.
[24] Prenenski JJ. Enhancing generalization of social skills with students with significant disabilities[D].Glassboro:Rowan University, 2019.

基金资助

深圳市福田区卫生健康系统科研项日(FTWS080)