Chẩn đoán phân biệt và tình trạng đồng diễn ở trẻ có rối loạn phổ tự kỉ: Tổng quan tích hợp và minh họa trường hợp

Tóm tắt

Autism spectrum disorder is clinically heterogeneous, while many observable features overlap with other neurodevelopmental, psychiatric and medical conditions. This overlap can delay accurate diagnosis and fragment educational and clinical support. This article synthesises evidence on differential diagnosis, on the identification of co-occurring conditions, and on coordinated assessment and intervention for children with autism. An integrative review was conducted on PubMed/Medline and Google Scholar up to July 2026, combined with DSM-5-TR, ICD-11 and the Vietnamese national guideline (Ministry of Health, 2022). Three findings stand out. First, core autistic features must be distinguished from ADHD, anxiety, language disorder and physical health problems, since pooled prevalence reaches 28% for ADHD, 20% for anxiety disorders and 11% for depressive disorders. Second, no single instrument establishes a diagnosis; information from the family, the school and health professionals must be combined. Third, newly emerging or rapidly escalating behaviour requires a review of communication and health before behavioural control is intensified. Educational decisions should be based on the child’s functional profile, participation, strengths, health needs and environmental barriers. One clinical case is used to illustrate interdisciplinary decision-making; it does not evaluate intervention effectiveness and no result is generalised from it.