时间：2026-09-30     【转载】

他们被温柔地叫作“星星的孩子”，活在自己的小世界里，对呼唤少回应、对人群有距离，却同样有血有肉、渴望被懂。在我们身边，这样的孩子越来越多地被看见。“孤独症早已不是罕见病，而是需要家庭、专业机构与社会共同面对的公共议题。”近日，北京大学第六医院儿童精神科主任医师贾美香结合一线接诊与干预经验，直面家长最焦虑、网络最热议的话题，清晰解读孤独症的识别、干预与照护。

视频制作：李源

别把异常当 “内向”，两大核心症状早看清

“很多家长常常把已经出现的症状判断为性格内向。”贾美香指出，孤独症有两大核心症状，是区别于普通孩子的重要标志。

第一，社交交流与互动缺陷。患儿从小不合群，喜欢独自玩耍，对集体活动没有兴趣；叫名字常常不应，或者只应声不看人，缺乏眼神交流；有需求时只会拉大人的手，不会用手指指向想要的东西。不少孩子还伴随语言发育落后，甚至出现语言倒退 —— 原本会说的词句，两岁后反而越来越少。

第二，兴趣狭窄与刻板行为。孩子玩玩具方式机械重复，搭积木只摆一条线或一味摞高；饮食极度挑食，只接受固定几样食物；物品摆放必须一成不变，环境稍有改变就哭闹抗拒。这种刻板不是普通的 “固执”，而是疾病带来的刻板行为模式，年龄越大越难改变，严重时会引发自伤、攻击等情绪问题。

贾美香提醒，正常孩子的刻板行为单一、可引导，而孤独症孩子随着年龄增长，刻板多且顽固，一旦形成习惯，再想纠正就要付出数倍努力。

耐心观察早识别 抓住干预黄金期

孩子的成长千姿百态，没有统一标准。如何区分孩子是性格内向、脾气固执，还是已经有了“孤独症”的信号？贾美香指出，早期识别并不难，家长只要留心观察：正常宝宝 3 个月会追听妈妈声音、认亲人，而孤独症孩子常出现追物不追人；有些孩子虽然早早会认字、背诗，却只是机械记忆，不理解、不会运用到生活中，这也是危险信号。

贾美香建议，家长多带孩子到户外、游乐场，仔细观察是否愿意凑近同伴、对新鲜事物是否好奇。若总是独处、不理人、不互动，一定要尽快就医评估。临床上有完整的筛查、诊断与评估体系，能尽早给出专业判断。

她强调，孤独症干预越早越好，公认黄金期在 6 岁前，而4 岁前更是语言发育的关键窗口期。如果 4 岁前孩子仍无有效语言，后续训练难度会急剧上升，即便学会说话，也多是鹦鹉学舌式的模仿语言，不理解意思、不会交流。真正实现自然沟通，往往需要漫长时间。

无特效药，很多成功案例，是家长在努力

“能不能吃药治好？” 是家长问得最多的问题。贾美香回应：目前没有有效的药物能根治孤独症，康复训练是目前公认的最有效的干预方式。“目前，已有二三十种循证方法，如应用行为分析、自然情景教学、地板时光、感知觉运动训练等，专业人员会根据每个孩子的情况定制个性化方案。”贾美香介绍，药物常常用于辅助控制严重自伤、睡眠颠倒、青春期剧烈情绪问题等，让孩子能稳定参与训练、保障安全。“当然，随着科技进步，新的治疗技术不断涌现，也给了我们治疗甚至治愈孤独症的新期待。”

“在整个干预过程中，家庭远比机构更重要。”贾美香总结，能够给予孩子充足支持的家庭，要满足三个关键因素：第一，敢于面对，不逃避，及时就医并坚持家校同步；第二，保持身心健康，长期照护需要体力与心力，家长要首先照顾好自己，才能更长久、更有效地陪伴孩子；第三，稳固的婚姻关系，家庭同心，不推诿、不放弃，分工配合，才能让治疗更持久，更有效。

“我们已经看到了很多成功的案例，往往都是家长在努力。”贾美香强调，无数案例证明，只要早发现、家长全力配合，轻度患儿经过干预训练，症状会得到很大改善，有些孩子完全可以融入幼儿园、小学，实现生活自理、正常学习。

“对孤独症的支持，应覆盖全生命周期。”贾美香呼吁，低龄抓干预、成年有托养、社会多包容，才能真正解决家庭后顾之忧。从“星星的孩子”刷屏，到社会对孤独症群体的关注度持续走高，大众的认知正在改变。贾美香希望，社会能够再多一份理解、多一点包容，尊重每一个独特的个体，接纳每一种不同，这才是对生命最温柔的善待。

They are tenderly called "children of the stars." They live in their own small worlds, rarely answering when called, keeping their distance from crowds — yet they are just as flesh and blood as anyone else, and just as eager to be understood. Around us, more and more of these children are being seen.

"Autism is no longer a rare disease; it is a public issue that families, professional institutions, and society as a whole must face together." Recently, Jia Meixiang, chief physician of the Department of Child Psychiatry at Peking University Sixth Hospital, drew on her frontline experience in diagnosis and intervention to confront the topics parents worry about most and the internet discusses most heatedly, offering a clear explanation of how autism is identified, treated, and cared for.

**Don't Mistake Difference for "Shyness": Two Core Symptoms to Recognize Early**

"Many parents often mistake symptoms that have already appeared for an introverted personality." Jia Meixiang points out that autism has two core symptoms that set it apart from ordinary children.

First, deficits in social communication and interaction. Affected children fail to fit in from an early age and prefer playing alone, showing no interest in group activities; they often don't respond when their name is called, or answer only with their voice without looking at the person, lacking eye contact; when they need something, they only pull an adult's hand rather than pointing at what they want. Many also lag behind in language development, and some even regress — words and sentences they once spoke become fewer and fewer after the age of two.

Second, narrow interests and stereotyped behaviors. Children play with toys in mechanical, repetitive ways, lining up blocks in a single row or simply stacking them higher and higher; they are extremely picky eaters, accepting only a fixed few foods; objects must be arranged in exactly the same way, and the slightest change in their environment triggers crying and resistance. This rigidity is not ordinary "stubbornness" but a pattern of stereotyped behavior caused by the disorder; the older the child, the harder it is to change, and in severe cases it can give rise to emotional problems such as self-injury and aggression.

Jia Meixiang reminds parents that a typically developing child's rigidity is simple and can be guided, whereas for children with autism, stereotyped behaviors multiply and harden with age — once a habit takes hold, correcting it costs several times the effort.

**Observe Patiently, Identify Early, and Seize the Golden Window for Intervention**

Children grow in a thousand different ways; there is no single standard. How can you tell whether a child is simply introverted and stubborn, or is already showing signs of autism? Jia Meixiang notes that early identification is not difficult — parents need only watch closely: a typically developing baby will turn toward the mother's voice by three months and recognize familiar people, whereas children with autism often follow objects but not people; some children may learn to read characters and recite poems early, but only through rote memory, without understanding or applying them in daily life — another warning sign.

Jia Meixiang advises parents to take their children outdoors and to playgrounds more often, and to observe carefully whether they are willing to approach other children and whether they are curious about new things. If a child always stays alone, ignores people, and does not interact, medical evaluation should be sought as soon as possible. Clinically, there is a complete system for screening, diagnosis, and assessment that can provide a professional judgment early on.

She stresses that the earlier intervention begins, the better. The widely recognized golden period is before age six, and before age four is an even more critical window for language development. If a child still has no functional language before age four, subsequent training becomes dramatically harder; even if the child learns to speak, it is often parrot-like imitation — no understanding of meaning, no real communication. Achieving genuine, natural communication often takes a very long time.

**No Miracle Drug; Many Success Stories Come from Parents' Efforts**

"Can it be cured with medication?" is the question parents ask most. Jia Meixiang responds: there is currently no effective drug that can cure autism, and rehabilitation training is recognized as the most effective intervention. "Today there are more than twenty or thirty evidence-based methods — applied behavior analysis, naturalistic teaching, Floor Time, sensory-motor training, and others — and professionals tailor an individualized plan for each child," Jia Meixiang explains. Medication is often used to help control severe self-injury, reversed sleep patterns, and intense emotional problems during adolescence, so that the child can participate steadily in training and stay safe. "Of course, as technology advances, new treatment techniques keep emerging, giving us fresh hope of treating, and even curing, autism."

"Throughout the intervention process, the family matters far more than any institution," Jia Meixiang concludes. A family able to give a child ample support must meet three key conditions: first, the courage to face the situation without avoidance, seeking medical help promptly and keeping home and school in step; second, maintaining physical and mental health — long-term care demands both strength and emotional energy, so parents must take care of themselves first in order to accompany their child longer and more effectively; third, a stable marriage — the family united, no shifting of blame, no giving up, with division of labor and cooperation, so that treatment can be more enduring and more effective.

"We have already seen many success stories, and they almost always involve parents making the effort," Jia Meixiang emphasizes. Countless cases prove that as long as autism is detected early and parents cooperate fully, mild cases can improve greatly through intervention training — some children are able to integrate into kindergarten and primary school, take care of themselves, and study normally.

"Support for autism should cover the entire life cycle," Jia Meixiang urges. Intervention in early childhood, residential care in adulthood, and greater tolerance in society — only then can families truly be relieved of their worries. From "children of the stars" going viral to society's steadily rising attention to the autistic community, public understanding is changing. Jia Meixiang hopes society will offer one more measure of understanding and a little more tolerance, respecting every unique individual and accepting every difference — for that is the gentlest way to treat life.