Otizm İlişkili Belirtiler için Tanı Olarak Kullanılabilen “Uyaran Eksikliği” Kavramının İncelenmesi: Eleştirel Derleme

Although "stimulus deficiency" is not a defined diagnosis in diagnostic classification systems, children with autism-related symptoms (e.g. delayed language development, difficulties in social interaction) may be diagnosed with "stimulus deficiency" in Türkiye. In the international literature, the term "stimulus deficiency" is not mentioned as a developmental diagnosis/phenomenon. Instead, it is used as a developmental risk factor, mostly in earlier publications. On the contrary, a national literature review shows that "stimulus deficiency" is used as a diagnosis in different contexts. In these publications, the condition of "stimulus deficiency" is not described in detail, the descriptions vary considerably, and the distinction from autism and language development difficulties is not adequately made. These publications mention the possible etiology of this clinical condition as inadequate social interaction with the child and intensive screen viewing. However, there are no studies in the literature to clarify the etiology of this condition. Thus, the etiology mentioned is an expert opinion rather than evidence-based data. It was noted in national literature that children on the autistic spectrum may be diagnosed with "stimulus deficiency" instead of autism, to give parents a "milder" explanation. This situation, which may violate the physician's ethical obligation to tell the truth, may result in delay or failure to provide early intervention, which is the most effective treatment for autism, failure to provide social and financial entitlements, disruption of follow-up, and failure to manage co-morbidities that may manifest with increasing age.