E wehewehe paha nā hoʻololi o ke kaiapuni i ka piʻi ʻana o nā Autism Diagnoses?

ʻO ka piʻi ʻana i nā diagnostics autism ua kū mau a hahau. I nā makahiki 1960, ma kahi o 1 i ka 10,000 mau kānaka i ʻike ʻia me ka autism. I kēia lā, aia he 1 i nā keiki he 54 i ke ʻano, e like me nā Centers for Disease Control and Prevent. A ke aniani nei ka US i nā ʻāina a puni ka honua.

He aha ke kuleana no kēia piʻi ʻana? Ua hoʻopaʻapaʻa ikaika nā kānaka ʻepekema i ke ʻano o nā genetics, ke kaiapuni, a me nā hoʻololi i ka ʻike ʻia ʻana o ke ʻano. I kahi hana hou e hoʻokaʻawale i kēia mau pae, ua hoʻoholo nā kānaka noiʻi i ke kūpaʻa o nā hopena a me nā hopena o ke kaiapuni e hoʻopili i nā loli i nā hana diagnostics a hoʻonui i ka ʻike e like me nā ikaika o ka loli.

"ʻO ka mahele o ka autism e pili ana i ka moʻomeheu a me ke kaiapuni e kū mau ana i ka manawa," wahi a Mark Taylor, kahi luna noiʻi kiʻekiʻe ma ka Karolinska Institutet ma Suetena a me ke alakaʻi o ka noi. "ʻOiai ua hoʻonui nui ka preismence o ka autism, ʻaʻole hōʻike kēia aʻo ʻana no ka mea aia kekahi hoʻololi i ke kaiapuni."

Ua kālailai ʻo Taylor a me kona mau hoapili i ʻelua mau ʻikepili mai nā māhoe: ʻo ka Sweden Twin Registry, ka mea i nānā i nā diagnose o ka maʻi autism spectrum mai ka 1982 a hiki i ka 2008, a me ke aʻo ʻana a ke keiki a me ke keiki ʻ Twinpio ma Suedena, kahi i ana i nā helu makua ma nā ʻano autistic mai 1992 a 2008. . Hoʻopuni ka ʻikepili ma kahi o 38,000 pālua māhoe.

Ua loiloi ka poʻe noiʻi i ka ʻokoʻa ma waena o nā māhoe like (kaʻana like i ka 100 pākēneka o kā lākou DNA) a me nā māhoe fraternal (e kaʻana like i ka 50 pākēneka o kā lākou DNA) e hoʻomaopopo inā a pehea ka nui o nā aʻa a me nā aʻa a me nā aʻa o ka autism i loli i ka hala ʻana o ka manawa. A he kuleana koʻikoʻi nā genetics i ka autism - pili kekahi mau koho i ka heritability ma 80 pakeneka.

E like me ka mea i hōʻike ʻia e ka ʻepekema i ka puke pai ʻO JAMA Psychiatry, ʻaʻole i hoʻololi iki nā hanauna a me nā nohona i ka manawa. Ke hoʻomau nei nā noiʻi i ka noiʻi ʻana i nā kumu o ke kaiapuni e hoʻopili ʻia i loko o ka autism, e like me ka maʻi makuahine i ka wā hāpai, diabetes, a me ke koko kiʻekiʻe. ʻAʻole hāʻawi ka noiʻi o kēia manawa i nā mea kikoʻī i pololei ʻole akā hōʻike ʻia ʻaʻole kuleana o lākou no ka ʻākoakoa o nā diagnoses.

Hōʻike nā mea i loaʻa i nā noiʻi ma mua i hōʻea i kahi hopena like ma o nā ʻano like ʻole. ʻO kahi noi 2011, no ka laʻana, loiloi i nā mākua me nā ana maʻamau a hoʻoholo ʻia ʻaʻohe ʻokoʻa nui ma ka autism prevalence ma waena o nā keiki a me nā mākua.

Kūkākūkā pinepine ʻia ka makahiki makua ma ke ʻano he pilikia no ka autism. Hoʻonui ka makahiki o kahi makuakāne i ka likelihood o nā mutation genetic spontaneous, i kapa ʻia ʻo de novo a i ʻole germline mutations, i hiki ke kōkua i ka autism. A ʻo ka makahiki i lilo ai nā kāne i mau mākua i māhuahua ma mua o ka manawa: i ka US, no ka laʻana, piʻi ka makahiki maʻamau o ka makua kāne mai 27.4 a 30.9 ma waena o 1972 a me 2015. Akā ʻo ka hoʻololi wale nō ka helu o kahi piʻi liʻiliʻi o ka helu autism diagnosis, e wehewehe. ʻO John Constantino, he polofesa psychiatry a me pediatrics a me ka luna hui o ka Intellectual and Developmental Disability Research Center ma ke Kulanui o Medicine ma Wakinekona Wakinekona ma Saint Louis.

"Ke kuhikuhi nei mākou i ka autism 10 a 50 mau manawa i kēia manawa ma mua o 25 mau makahiki i hala. ʻO ka mua i ke au o ka makua ke kuleana no ka 1 pakeneka o kēlā hopena holoʻokoʻa, "i ʻōlelo ʻo Constantino. ʻO ke ʻano o ka makahiki mākua i ke kino kīnā e ulu pono ai, no ka mea, he mea nui ka hoʻololi iki i ka pōʻaiapili o ka lehulehu o ka honua. ʻAʻole helu wale ia no ke ʻano holoʻokoʻa.

Inā paʻa paʻa nā genetic a me nā mea pili i ke kaiapuni i ka manawa, pono ke hoʻololi i ka moʻomeheu a me nā diagnostics no ka piko o ka prevalence, i ʻōlelo ʻo Taylor. ʻOi aku ka ʻike o nā ʻohana a me nā kauka i kēia lā i ka autism a me kāna mau hōʻailona ma mua o nā makahiki he hala i hala aku nei, e like me ka ʻike ʻana i ka hōʻoia.

ʻO nā loli i nā pae hoʻohālikelike kahi hana. Hoʻomaopopo nā kauka lapaʻau i nā kūlana olakino noʻonoʻo e pili ana i nā pae hoʻohālikelike i hōʻike ʻia i loko o ka Diagnostic and Statistical Manual of Mental Disorder (DSM). ʻO ka mana ma mua o 2013, ʻo ka DSM-IV, i loaʻa ʻekolu mau mahele: autistic maʻi, Asperger's maʻi, a me ka maʻi ulu ulu ākea ʻole i kuhikuhi ʻia. ʻO ka iteration o kēia manawa, ʻo ka DSM-5, pani i kēlā mau ʻāpana me hoʻokahi diagnose overarching: autism spectrum maʻi.

Ke hana nei i kahi lepili e hoʻopuni i nā kūlana hoʻokaʻawale mua e pono ai ka ʻōlelo ākea, wehewehe ʻo Laurent Mottron, he polofesa psychiatry ma ke Kulanui o Montreal. ʻO kēia mau hoʻololi i nā pae hoʻohālikelike i hopena i ka poʻe hou aʻe e loaʻa ana i kahi hōʻoia autism.

Kūpono kēia hoʻololi i ka autism kokoke i ke ala a ka ʻepekema a me ka lāʻau e ʻike ai i nā kūlana ʻē aʻe, i ʻōlelo ʻo Constantino. "Inā ʻoe e anamanaʻo i ka heluna lehulehu āpau no nā ʻano o ka autism, hāʻule lākou i ka piʻo bele, e like me ke kiʻekiʻe a me ke kaumaha a i ʻole ke kaomi koko," wahi a Constantino. ʻAʻole mālama ʻia ka wehewehe o ka autism i kēia manawa no nā hihia ʻoi loa; apo pū ia i nā mea subtler kekahi.