autismo_deteccion temprana _academia americana de pediatría

8/2/2019 AUTISMO_Deteccion Temprana _Academia Americana de Pediatra

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992? IAJXDGIE IGIMJAT LO ^JMDI]XDGWht le Elvjahjx 94# 8>>6%~jmdi}xdgw%lxfMleclimjm oxla
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iem wjglem }xdajw}jxw lo ~xjfeiegt#9=9#9=8 jevdxleaje}ic

oig}lxw "jf# }jxi}lfjew# wzgb iw }bicdmladmj iem vic~xldg

igdm$67 ixj alxj cd`jct }l ~cit i xlcj de }bj oj}zw vdi

ai}jxeic oig}lxw% D} dw ~lwwdhcj }bi} ai}jxeic dccejww "jf#

xzhjcci$ mzxdef ~xjfeiegt ~citw i xlcj%9=7#9== Xjgje}ct#

}bj ~lwwdhcj iwwlgdi}dle hj}jje oj}ic }jw}lw}jxlej gle!

gje}xi}dle iem gjx}ide iz}dw}dg hjbivdlxw wzgb iw ihelx!

aic wlgdic xjci}dlewbd~w iem xjw}xdg}jm de}jxjw}w i} = tjixw

lo ifj iw devjw}dfi}jm%9=:

9922 IAJXDGIE IGIMJAT LO ^JMDI]XDGWht le Elvjahjx 94# 8>>6%~jmdi}xdgw%lxfMleclimjm oxla
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ublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/


10/37

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icwl# hz} emdefw bivj el} hjje glewdw}je}%68#9=?9:8 I

wdfedgie} iwwlgdi}dle hj}jje }jxa ejhlxe jegj~bi!

cl~i}bt iem gbdcmxje ci}jx mdifelwjm d}b IWM iw xj!

~lx}jm xjgje}ct%68#9:> Himid j} ic9:> xj~lx}jm }bi} :* lo

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gxjiwj gla~ixjm d}b ai}gbjm gle}xlcw% ]bdw degxjiwj

ait xj~xjwje} i fjej}dgicct mjxdvjm ~xjmdw~lwd}dle

"bdgb ai`jw }bj deoie}w vzcejxihcj }l hl}b jegj~bi!

cl~i}bt iem IWM$ lx ie demj~jemje} ajgbiedwa%

^lw}ei}ic ^jxdlm

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viggdej9:7 iem ajxgzxt!gle}idedef viggdejw%9:=9:?

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}bj AAX viggdej iem iz}dwa% W}zmdjw }bi} jriadejm }bj

iwwlgdi}dle hj}jje AAX viggdej iem iz}dwa wdegj }bj

~zhcdgi}dle lo }bi} xjvdj bivj wz~~lx}jm }bdw glegcz!

wdle%86#4:#9>7#9:29?9 Yzjw}dlew icwl bivj hjje xidwjm ihlz}

}bj joojg}w lo jevdxleaje}ic ajxgzxt jr~lwzxj "degczm!

def ajxgzxt!gle}idedef viggdejw$ le hxide mjvjcl~aje}

de IWMw iem l}bjx mjvjcl~aje}ic mdwihdcd}djw%9:=9:? Ajx!

gzxt# de d}w lxfiedg olxa# dw i èle ejzxl}lrde d}b

ejzxlclfdg wjyzjcij# degczmdef al}lx da~idxaje} iem

vdwzic iem de}jccjg}zic mjgd}w# mj~jemdef le }bj ifj i}

jr~lwzxj iem }bj }t~j lo ajxgzxt% ]bjxj dw el jvdmjegj

}l mi}j }bi} gbdcmxje d}b ejzxlmjvjcl~aje}ic mdwihdcd!

}djw# degczmdef iz}dwa# de }bj Zed}jm W}i}jw bivj de!

gxjiwjm ajxgzxt glegje}xi}dlew lx jevdxleaje}ic jr~l!

wzxjw%9?8 Zwdef cixfj mi}i wj}w oxla }bj Zed}jm W}i}jw#

Wjmje# iem Mjeaix`# }l mi}j# el glewdw}je} iwwlgdi!

}dle biw hjje olzem hj}jje }bdajxlwic!gle}idedef vig!

gdejw iem ejzxlmjvjcl~aje}ic lz}glajw lx ~xjvicjegj

lo IWMw%86#4:#9?89?= Mjw~d}j jvdmjegj }l }bj gle}xixt# i

xjgje} wzxvjt lo ~ixje}w lo gbdcmxje d}b IWMw xjvjicjm

}bi} :=* hjcdjvjm }bi} }bjdx gbdcmw IWM iw gizwjm ht

daazed{i}dlew0 :7* }blzfb} d} iw gizwjm ht fjej}!

dgw%9?:

Ic}blzfb }bj ~xjvdlzw mdwgzwwdle xjvjicw }bj dmj

vixdj}t lo glemd}dlew èle }l hj iwwlgdi}jm d}b IWMw#

gzxxje}ct# ie j}dlclfdg devjw}dfi}dle lo }bj demdvdmzic

gbdcm d}b ie IWM deoxjyzje}ct dmje}djw i èle gizwj

de }bj ihwjegj lo FMM,AX# mtwalx~bdg oji}zxjw# i ~lw!

d}dvj oiadct bdw}lxt# iem,lx i olgic ejzxlclfdg jriadei!

}dle%8#8>#89#24#9>9#9>?9>2

EJZXLÎ]BLCLFTIEMEJZXLDAIFDEF

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hlmt lo jvdmjegj oxla ejzxl~i}blclft iem ejzxldaif!

def w}zmdjw demdgi}jw }bi} }bjxj ixj ozemiaje}ic mdoojx!

jegjw de hxide fxl}b iem lxfied{i}dle de ~jl~cj d}b

IWMw }bi} bivj }bjdx lxdfde de }bj ~xjei}ic ~jxdlm hz}

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d}b iz}dwa bivj xjvjicjm wjvjxic ihelxaicd}djw9??969

degczmdef;

xjmzgjm ezahjxw lo ^zx`dekj gjccw de }bj gjxjhjccza0

ihelxaic ai}zxi}dle lo }bj olxjhxide cdahdg wtw}ja#

degczmdef xjmzgjm ejzxleic wd{j# degxjiwjm gjcc!~ig`!

def mjewd}t# iem mjgxjiwjm gla~cjrd}t lo }bj ejzxl~dc

"dj# }bj gla~cjr ej} lo irleic# mjemxd}dg# iem fcdic

hxiegbdef de bdgb }bj ejxvj gjcc dw jahjmmjm$0

ihelxaicd}djw de oxle}ic iem }ja~lxic clhj glx}dgic

adedglczaew# bdgb ixj alxj ezajxlzw# waiccjx# iem

cjww gla~ig} de }bjdx gjcczcix glefzxi}dle iem mja!

lew}xi}j xjmzgjm ejzxl~dc w~igj de }bj ~jxd~bjxt9?60

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ezgcjd# iem deojxdlx lcdvj0 iem

hxidew}ja ihelxaicd}djw iem ejlglx}dgic aicolxai!

}dlew "jf# bj}jxl}l~diw$%969

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lo hxidew# iem ozx}bjx devjw}dfi}dle dw xjyzdxjm% Cdad}jm

ividcihdcd}t lo hxide }dwwzj oxla ~jl~cj d}b jcc!gbix!

ig}jxd{jm IWMw iem ifj!ai}gbjm gle}xlcw biw da~jmjm

ejzxl~i}blclfdg devjw}dfi}dlew% Joolx}w }l xjajmt }bdw

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d}b ie IWM bivj hjje wble# iw i fxlz~# }l bivj

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d}b iggjcjxi}dle de hxide fxl}b mzxdef }bj xw} tjix lo

^JMDI]XDGW _lczaj 98># Ezahjx :# Elvjahjx 8>>6 9924ht le Elvjahjx 94# 8>>6%~jmdi}xdgw%lxfMleclimjm oxla
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11/37

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d}b gle}xlcw# demdgi}def }bi} }bjxj ait hj mjgjcjxi}dle

lo hxide fxl}b i} wlaj ~lde} hjtlem jixct gbdcm!

bllm%96?#962#964 D} dw de}jxjw}def }l el}j }bi} degxjiwjm hcllm

glegje}xi}dlew lo hxide!mjxdvjm ejzxl}xl~bdg oig}lx iem

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emdef# do xj~cdgi}jm# ait bivj da~cdgi}dlew xjfixmdef

}bj ajgbiedwa lo jixct hxide lvjxfxl}b% Ifj!xjci}jm

mdoojxjegjw de wjxl}lede wte}bjwdw gi~igd}t icwl bivj

hjje mjalew}xi}jm hj}jje gbdcmxje d}b IWMw iem

gbdcmxje de gle}xlc fxlz~w#929 bdgb cjimw }l w~jgzci}dle

xjfixmdef }bj ejzxl}xl~bdg xlcj lo wjxl}lede de ihelx!

aic hxide fxl}b iem lxfied{i}dle de gbdcmxje d}b

IWMw%

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jegjw bivj hjje mjwgxdhjm% ]bj oxle}ic# cdahdg# hiwicfiefcdi# iem gjxjhjccix xjfdlew bivj hjje da~cdgi}jm

alw} glewdw}je}ct%968#92892= Ihelxaicd}djw de wzcgic iem

ftxic iei}lat bivj hjje olzem ht zwdef wzxoigj!ai~!

~def }jgbedyzjw%92:#92? ]bj xjfdleic fxit! iem bd}j!ai}!

}jx vlczaj mdoojxjegjw icwl wjja }l hj ifj xjci}jm# ic!

}blzfb cixfjx gxlww!wjg}dleic w}zmdjw iem clefd}zmdeic

w}zmdjw ixj ejjmjm }l gcixdot }bj ajiedef lo }bjwj em!

defw%

I vixdj}t lo ozeg}dleic AXD w}zmdjw mzxdef glfed}dvj

}iw`w lx de xjw~lewj }l vdwzic lx izmd}lxt w}dazcd wzffjw}

}bi} demdvdmzicw d}b IWMw zwj mdoojxje} glfed}dvj w}xi}!

jfdjw iem# de wlaj giwjw# mdoojxje} hxide ixjiw }l ~xlgjww

gjx}ide }t~jw lo deolxai}dle%928#926 Olx jria~cj# ozeg!

}dleic ejzxldaifdef }jgbedyzjw bivj demdgi}jm }bj ~xjw!

jegj lo ihelxaicd}djw de oigj xjglfed}dle iem jrjgz}dvj

ozeg}dledef de imzc}w d}b bdfb!ozeg}dledef IWMw%922 Bt!

~lig}dvi}dle lo }bj ozwdolxa ftxzw de oigj!xjglfed}dle

}iw`w biw hjje lej lo }bj alw} glewdw}je} emdefw926 iem#

de glegjx} d}b ihelxaicd}djw de iatfmici ig}dvi}dle#

ait xjci}j }l }bj ihelxaicd}djw de fi{j ri}dle }bi} ixj

wjje de ~jl~cj d}b IWMw%924 Ozeg}dleic AXD jvdmjegj

biw icwl hjje zwjm }l ~lw}zci}j da~idxjm gleejg}dvd}t

hj}jje vixdlzw glx}dgic xjfdlew de }bj hxidew lo ~jl~cj

d}b IWMw%94>948 Alw} xjgje}ct# wlaj devjw}dfi}lxw bivj

i}}ja~}jm }l jr~cide mjgd}w de ja~i}bt# dad}i}dle# iem

ciefzifj iw ihelxaicd}djw de }bj ozeg}dledef lo adxxlx

ejzxle wtw}jaw%947 ]bjwj wtw}jaw ixj i ejct mdwglvjxjm

wzhwj} lo gjccw olzem de wjvjxic ixjiw lo }bj hxide }bi}

wjja }l xj bje ie demdvdmzic wda~ct lhwjxvjw iel}b!

jxw ig}dlew}bi} dw# d} wjjaw }bjt mdxjg}ct xjjg} ig}dlew

~jxolxajm ht iel}bjx de }bj lhwjxvjxw hxide% ]bjt icwl

ait ~cit i xlcj de }bj ihdcd}t }l xjglfed{j iem ja~i}bd{j

d}b lx adxxlx }bj ojjcdefw lo l}bjxw% ]bjwj ozeg}dleic

hxide mdoojxjegjw ~xlvdmj de}xdfzdef cde`w hj}jje }bj

ejzxliei}ladgic wzhw}xi}j iem }bj gbixig}jxdw}dg gcdedgic

oji}zxjw lo ~jl~cj d}b IWMw%

Ic}blzfb ejzxldaifdef xjwjixgb biw dmje}djm vlcz!

aj}xdg iem l}bjx ihelxaicd}djw de fxlz~w lo ~i}dje}w d}b

IWMw gla~ixjm d}b gle}xlcw# i xjcdihcj aix`jx biw el}

hjje dmje}djm# iem xlz}dej gcdedgic ejzxldaifdef olx

demdvdmzicw d}b IWMw dw el} xjglaajemjm%9>?#9>6#927#94=

GCDEDGICWDFEW

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ig}dvd}djw ixj glxj oji}zxjw lo icc IWMw# wdfedgie} cie!

fzifj mjcitw ixj gbixig}jxdw}dg lo lect IM iem ^MM!

ELW%7#= Lej lo }bj alw} gbiccjefdef iw~jg}w de xjglfed{!

def IWMw dw }bj dmj bj}jxlfjejd}t lo oji}zxjw de

demdvdmzic gbdcmxje% ]bjxj dw el ~i}blfelaledg oji}zxj0

bljvjx# i oj lo }bj jixct wlgdic mjgd}w "jf# mjcitjm lx

ihwje} klde} i}}je}dle PKIQ$ wjja }l hj oidxct xjcdihcj xjm

ifw olx IWMw% ]bj iz}dwa w~jg}xza jegla~iwwjw ie

jr}xjajct bj}jxlfjejlzw ~bjel}t~j d}b demdw}deg} jem

~lde}w# jw~jgdicct i} }bj adcm jem lo }bj w~jg}xza% ]bj

wjvjxd}t lo jigb lo }bj glxj mjgd}w vixdjw wdfedgie}ctialef gbdcmxje d}b IWMw%

Ic}blzfb }bj wlgdic mjgd}w lggzx jixcdjx iem ait hj

alxj w~jgdg# }bjt gie hj wzh}cj iem cjww lo}je xjglf!

ed{jm lx ix}dgzci}jm ht ~ixje}w% W~jjgb mjcitw zwzicct

~xla~} ~ixje}w }l xidwj glegjxew }l }bjdx gbdcmw ^G^%

Alw} ~ixje}w hjglaj glegjxejm hj}jje 9: iem 92

ale}bw lo ifj hz} ait mjcit mdwgzwwdef }bjdx glegjxew

d}b }bjdx gbdcmw ~btwdgdie olx wjvjxic ale}bw%7:#94:942

Xjgje}ct# }bj ajmdi iem ~zhcdg ifjegdjw bivj xidwjm

~zhcdg iixjejww ihlz} }bj da~lx}iegj lo xjglfed{def

}bj jixct wdfew# degczmdef }blwj ~xjwje} mzxdef }bj xw}

tjixw lo cdoj% ]bdw hjdef }bj giwj# d} dw ie}dgd~i}jm }bi}

~ixje}w ait hjfde }l vldgj glegjxew }l }bjdx deoie}w

~jmdi}xdgdie jixcdjx iem }bi} }bjwj glegjxew ait el

}ixfj} }bj lo}je jixcdjx!i~~jixdef wlgdic mjgd}w% ^xjwje!

}i}dlew gie mdoojx dmjct oxla lej gbdcm }l }bj ejr}0

wlaj ixj ~jxgjdvjm ht ~ixje}w iw mdoojxje} mzxdef }bj

xw} oj ale}bw lo cdoj# l}bjxw ~xjwje} d}b mjcitjm

w~jjgb mjvjcl~aje} mzxdef }bj wjglem tjix lo cdoj# iem

w}dcc l}bjxw ait i~~jix }l hj elxaic lect }l xjfxjww iem

clwj w`dccw io}jx }bj xw} tjix lo cdoj%944#8>> IW de gbdcmxje

ait fl zeel}dgjm ze}dc }bjt ixj lo wgbllc ifj# bje

}jigbjxw el}dgj mdogzc}djw d}b ~jjx de}jxig}dlew% Jr!

~iemjm xjvdjw xjfixmdef jixct wdfew ixj ividcihcj%8>98>7

Wlgdic W`dccw Mjgd}w

Ic}blzfb alxj w~jgdg }bie ciefzifj mjgd}w# wlgdic

mjgd}w i~~jixdef de }bj xw} 8 tjixw lo cdoj lo}je bivj

jwgi~jm ~ixje} xjglfed}dle%8>=8>? Gbdcmxje d}b IWMw

zedvjxwicct mjalew}xi}j mjgd}w de wlgdic xjci}jmejww mj!

ejm iw }bj debjxje} mxdvj }l gleejg} d}b l}bjxw iem

wbixj gla~cjaje}ixt ojjcdef w}i}jw%8>6 Gbdcmxje d}b

IWMw lo}je ml el} i~~jix }l wjj` gleejg}jmejww0 }bjt

ixj gle}je} hjdef iclej# dfelxj }bjdx ~ixje}w hdmw olx

i}}je}dle# iem wjcmla ai`j jtj gle}ig} lx hdm olx l}b!

jxw i}}je}dle d}b fjw}zxjw lx vlgicd{i}dlew% De ci}jx

994> IAJXDGIE IGIMJAT LO ^JMDI]XDGWht le Elvjahjx 94# 8>>6%~jmdi}xdgw%lxfMleclimjm oxla
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ublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/


12/37

tjixw# }bjt bivj mdogzc}t wbixdef }bj jal}dleic w}i}j lo

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bivj oj# do iet# oxdjemw%

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