Персонализированная реабилитация при расстройстве аутистического спектра: технологии искусственного интеллекта для диагностики, прогнозирования и адаптивных вмешательств

Расстройства аутистического спектра (РАС) представляют собой гетерогенную группу нарушений нейроразвития. Проблема диагностики и терапии аутизма характеризуется высокой социальной значимостью и необходимостью разработки эффективных реабилитационных стратегий. Технологии искусственного интеллекта (ИИ) открывают принципиально новые возможности для персонализации реабилитационных вмешательств при РАС. В настоящем обзоре рассматриваются ключевые направления интеграции ИИ в клиническую практику: объективизация диагностики чрез анализ цифровых фенотипов, прогнозирование индивидуальных траекторий развития и ответа на терапию, а также создание адаптивных терапевтических систем. Отдельное внимание уделено ИИ-ассистированным технологиям развития социально-коммуникативных навыков, включая виртуальную реальность и социальную робототехнику. Метааналитические данные подтверждают клиническую пользу ИИ-технологий с умеренно высокими эффектами для социальной коммуникации, распознавания эмоций и адаптивных навыков. Показано, что естественные развивающие поведенческие вмешательства в сочетании с технологиями альтернативной коммуникации демонстрируют устойчивые улучшения спонтанной коммуникации у минимально вербальных пациентов. Обсуждаются перспективы персонализации терапии на основе данных физиологического мониторинга и прогностического моделирования, а также роль телемедицинских технологий и интеллектуальных систем поддержки семей. Анализируются критические вызовы внедрения ИИ-систем: от рисков конфиденциальности до трансляционного разрыва между исследованиями и клинической практикой. В целом максимальная реализация потенциала ИИ в реабилитации пациентов с РАС требует сбалансированного подхода, объединяющего точные и объяснимые алгоритмы, инклюзивный пользовательский дизайн и междисциплинарное сотрудничество с активным вовлечением аутичных лиц и их семей на всех этапах разработки и внедрения передовых технологий.

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