标签： 南京夜生活交流

　　Cctv newsNational Health Commission website reported on September 21st that autism, also known as autism, is a kind of neurodevelopmental disorder that occurs in early childhood. The cause is unclear, and it usually starts before the age of 3, mainly manifested as social communication disorder, communication disorder and limitation, rigidity, repetitive behavior and other psychological developmental disorders, which seriously affects children’s social function and quality of life. The survey shows that the prevalence rate of autism in children in China is 7‰ . Children’s autism lacks effective drug treatment. At present, the main treatment is rehabilitation training, and the best treatment period is before the age of 6. If scientific intervention can be received before the age of 3, the symptoms and prognosis of children can be improved to varying degrees. Therefore, early screening and early intervention are particularly important for children with autism. In order to further improve the service chain of children’s autism, promote the construction of children’s mental health care service network, and promote the early detection, diagnosis and intervention of children’s autism, National Health Commission has formulated the Service Specification for Autism Screening Intervention for Children Aged 0-6 (Trial) (hereinafter referred to as the Service Specification) on the basis of in-depth investigation and systematic summary.

　　The Service Specification consists of 7 parts and 8 annexes. First, the clients are children aged 0-6 who live in the jurisdiction; Second, the purpose of the service is to improve the awareness rate of children’s parents’ autism scientific knowledge, standardize children’s autism screening, diagnosis, intervention and rehabilitation services, improve the intervention effect, reduce the occurrence of mental disabilities and promote children’s health; The third is the service content, including health education, screening (primary screening and re-screening), diagnosis and intervention rehabilitation. The fourth is the technical requirements of service institutions and personnel, which require the housing, equipment and personnel of township hospitals and community health service centers, county-level maternal and child health care institutions, children’s autism diagnosis institutions and intervention and rehabilitation institutions; Fifth, the division of tasks, to further clarify the division of labor and responsibilities of township hospitals and community health service centers, county-level maternal and child health care institutions, children’s autism diagnosis institutions and intervention and rehabilitation institutions, and provincial and prefecture-level maternal and child health care institutions; Sixth, job requirements, which mainly put forward clear requirements for health administrative departments at all levels to promote and guarantee autism screening, diagnosis and intervention rehabilitation services for children aged 0-6; The seventh is the evaluation index, which puts forward three indicators: the initial screening rate, the re-screening rate and the diagnostic rate, so as to promote the work evaluation in various places. The eight accessories are,Screening form for early warning signs of children’s psychological and behavioral development problems, psychological and behavioral development files of children aged 0-6, referral form for initial screening of children’s psychological and behavioral development of children aged 0-6, referral form for re-screening of children’s psychological and behavioral development of children aged 0-6, registration form for re-screening of children’s psychological and behavioral development of children aged 0-6, registration form for diagnosis results of children’s psychological and behavioral development of children aged 0-6, and schematic diagram of contents of rehabilitation services for autism screening, diagnosis and intervention of children aged 0-6.

　　The main features of the Service Specification are as follows:

　　(1) Focus on the key stage of 0-6 years old. According to the characteristics that autism usually starts in infancy, and there is no effective treatment drug at present, the main treatment way is rehabilitation training, and the best treatment period is before the age of 6, and the earlier the intervention effect is, the better the prevention and control work will be. We will focus on the key stage of 0-6 years old, provide autism screening intervention services for children, implement the disease prevention and control strategy of early screening, early diagnosis and early intervention, and strive to improve children by grasping early and grasping small, and implementing early intervention on the basis of early detection.

　　(2) Emphasize the development of group prevention and control. It is clearly required to provide autism screening service for children aged 0-6 years in the permanent population in combination with the national basic public health service project, and to find individuals with abnormal development from the group as soon as possible. Emphasis is placed on establishing and improving the service model of primary screening of children’s autism at the township level, re-screening at the county level and diagnosis and rehabilitation in professional medical institutions, clarifying the responsibilities and tasks of institutions at all levels, gradually forming a service network with division of labor and linkage from top to bottom, and promoting the implementation of group prevention and control.

　　(3) Pay attention to the convenience and accessibility of services. It is clearly required that primary medical and health institutions such as township hospitals and community health service centers undertake primary screening services, and county-level maternal and child health care institutions undertake re-screening services. Special emphasis is placed on the principle of intervention and rehabilitation based on grass-roots units to help autistic children to intervene nearby. By narrowing the service radius, we strive to improve the accessibility of screening intervention services, and at the same time require grassroots units to continuously improve their service capabilities and provide scientific and standardized related services.

　　(4) Guide families to actively participate. Family is a warm harbor for children’s healthy growth. The "Service Standard" clearly requires parents to carry out health education, guide parents to establish the consciousness of being the first responsible person for children’s health, and actively accept autism screening, diagnosis and intervention services. Emphasis is placed on the families of children, parents are encouraged to actively participate in intervention and rehabilitation, and family intervention is carried out through companion interaction, life care and game play in the process of parenting to promote the improvement and rehabilitation of children’s symptoms.

Specification for intervention service of autism screening for children aged 0-6 years (for Trial Implementation)

　　Autism spectrum disorder’s disease (also called autism, hereinafter referred to as autism) is a kind of neurodevelopmental disorder that occurs in early childhood. It is characterized by social communication disorder, narrow interest and repetitive behavior, which seriously affects children’s social function and quality of life. The prevalence of autism in children in China is about 7‰ , seriously endangering children’s health and family happiness. Autism usually begins in infancy, and there is no effective treatment drug at present. The main treatment way is rehabilitation training. The best treatment period is before the age of 6, and the earlier the intervention, the better the effect. Early detection, early diagnosis and early intervention can improve the symptoms and prognosis of children to varying degrees. In order to standardize the screening, diagnosis and intervention services for children with autism and promote children’s health, this specification is formulated.

　　First, the service object

　　Children aged 0-6 who are resident in the jurisdiction.

　　Second, the purpose of service

　　(a) to carry out popular science propaganda for the public, and form a good social atmosphere for the whole society to care for autistic children and their families.

　　(two) strengthen health education for the target population, improve the awareness rate of children’s parents’ autism science knowledge, and enhance the initiative and enthusiasm of parents to receive screening, diagnosis and intervention services.

　　(3) Standardize the screening, diagnosis and intervention rehabilitation services for children with autism, improve the intervention effect, reduce the occurrence of mental disabilities and promote children’s health.

　　Third, the service content

　　Including health education, screening, diagnosis, intervention and rehabilitation.

　　(1) Health education.

　　Through various ways, popularize the basic knowledge of autism to the public and parents of children, publicize screening, diagnosis and intervention measures, and improve the awareness rate of scientific knowledge. Guide parents to establish the consciousness of being the first responsible person for children’s health and actively accept autism screening, diagnosis and intervention services.

　　(2) screening.

　　1. Preliminary screening. Grassroots medical and health institutions such as township hospitals and community health service centers undertake primary screening services. Combined with the service time and frequency of the national basic public health service health management project for children aged 0-6 years, 11 times of psychological and behavioral development screening services were provided for children aged 0-6 years by applying the methods such as "Screening Form for Early Warning Signs of Children’s Psychological and Behavioral Development Problems" (that is, the contents related to the development assessment in the National Basic Public Health Service Standard for Children’s Health Management Services).

　　(1) Initial screening time. Four times in infancy within one year old, at the age of 3, 6, 8 and 12 months respectively; Four times in the early childhood from 1 to 3 years old, at the age of 18, 24, 30 and 36 months respectively; Three times in preschool, at the age of 4, 5 and 6 respectively.

　　(2) Primary screening tools. "Screening Form for Early Warning Signs of Children’s Psychological and Behavioral Development Problems" (Annex 1).

　　(3) Primary screening method and content.

　　Use the "Screening Form for Early Warning Signs of Children’s Psychological and Behavioral Development Problems" to screen the development status of children aged 0-6 and check whether there are early warning symptoms of corresponding months. Any early warning sign in the corresponding screening age group is positive, suggesting the possibility of developmental deviation.

　　Ask parents to find out whether children have language function and social communication ability obstacles or retrogression. For example, you can’t express it in words, don’t look at each other, repeat rigid behavior, or you can express it in words before, look at each other before, but now you can’t express it in words, and now you don’t look at each other.

　　In any of the following circumstances, it is abnormal in the initial screening.

　　First, there are one or more positive early warning signs of children’s psychological and behavioral development problems.

　　Second, children of any age have obstacles or retrogression in language function and social communication ability.

　　According to the examination results, fill in the psychological and behavioral development file of children aged 0-6 (Annex 2, Table 2— Table 4). If no abnormality is found, parents should be informed to take their children for psychological and behavioral development assessment regularly. If any abnormality is found, timely health education and intervention guidance shall be provided, and parents shall be informed to refer them in time.

　　(4) Referral service. For children with abnormal initial screening, fill in the Referral Form for Psychological and Behavioral Development of Children Aged 0 ~ 6 (Annex 3) to guide parents to refer them to county-level maternal and child health care institutions for re-screening as soon as possible. The primary screening referral is made in duplicate. The first copy is kept by the institution that provides primary screening service, and the second copy is taken by the parents to the institution that provides secondary screening service.

　　Grass-roots medical and health institutions shall fill in the Registration Form for the Initial Screening of Abnormal Psychological and Behavioral Development of Children Aged 0 ~ 6 (Annex 4), regularly count the number of children with abnormal psychological and behavioral development within their respective jurisdictions and relevant information, and report them to county-level maternal and child health care institutions.

　　2. Re-screening. County maternal and child health care institutions undertake re-screening services. Re-screening was carried out through medical history inquiry and autism screening scale.

　　(1) Re-screening tool.

　　Autism screening scale, including "Revised Autism Screening Scale (M-CHAT)" and "Autism Behavior Rating Scale (ABC)"; Development scales such as "developmental behavior assessment scale for children aged 0 ~ 6" (referred to as "child heart scale -II").

　　(2) Re-screening method and content.

　　Medical history inquiry. Understand the current medical history of children, ask and observe whether children have language barriers, communication barriers, rigid behavior, narrow interests and other symptoms, and understand the results of initial screening.

　　The autism screening scale and the "fetal heart scale -II" and other developmental scales were used to carry out re-screening.

　　Children under the age of 18 months should be re-screened with developmental scales such as "Child Heart Scale -II". "Child Heart Scale -II" measures children’s development level from five energy areas: big movement, fine movement, adaptability, language and social behavior. The total evaluation score is less than 70 points, suggesting that there is developmental disorder; A total score of more than 80 points but a single score of less than 70 points in any energy area of language, adaptability or social behavior suggests developmental deviation. If the total score of evaluation is 70 ~ 79, the same method should be used for re-examination within 3 months.

　　Children aged 18 ~ 24 months were re-screened with the Revised Autism Screening Scale (M-CHAT). There are 23 items in the scale, and each item has a grade of 2. Answering "Yes" to items 11, 18, 20 and 22 in the scale, and answering "No" to other items is deemed as failing. If two or more of the core items 2, 7, 9, 13, 14 and 15 fail, or three or more of all the items fail, it is considered as a screening failure, suggesting that there is a risk of autism.

　　Children aged 24 months and above were re-screened with "Autism Behavior Rating Scale (ABC)". There are 57 items in 5 energy zones in the scale. The total score of assessment is greater than or equal to 53, indicating that there are suspicious autism symptoms.

　　All children aged 18 months and above were re-screened with developmental scales such as "Fetal Heart Scale -II". "Child Heart Scale -II" measures children’s development level from five energy areas: big movement, fine movement, adaptability, language and social behavior. The total evaluation score is less than 70 points, suggesting that there is developmental disorder; A total score of more than 80 points but a single score of less than 70 points in any energy area of language, adaptability or social behavior suggests developmental deviation. If the total score of evaluation is 70 ~ 79, the same method should be used for re-examination within 3 months.

　　One of the following circumstances is abnormal re-screening.

　　First, one or more abnormalities such as language barrier, communication barrier, rigid behavior and narrow interest are found by medical history inquiry or observation.

　　Second, the autism screening scale suggests that there are autism risks and suspected autism symptoms.

　　Third, developmental scales such as "Child Heart Scale -II" suggest that there are developmental disorders or developmental deviations.

　　According to the examination results, fill in the Re-screening Record Form of Psychological and Behavioral Development of Children Aged 0 ~ 6 (Annex 2, Table 5). This form is made in duplicate, one for the re-screening institution and one for the parents.

　　(3) Re-screening result processing and referral service.

　　Screening personnel reasonably explain the re-screening evaluation results to parents and decide to review or refer them according to the results.

　　First, there is no abnormality in re-screening. Inform parents to return to primary health care institutions and continue to receive health management services for children aged 0-6; Re-check with the original re-screening institution within 3 months. Those who are still not abnormal will continue to receive health management services for children aged 0-6 years in primary medical and health institutions, and those who are abnormal will be treated as abnormal after re-screening.

　　For children who have been evaluated by the development scale such as "Heart of the Child Scale -II" and the total score is 70 ~ 79, they will be given intervention guidance and re-examined in the original re-screening institution within 3 months. If there is no abnormality in the review, inform parents to return to primary medical and health institutions to continue to receive health management services for children aged 0-6; If it is found that there is developmental disorder or developmental deviation, it shall be treated as abnormal after re-screening.

　　Second, the re-screening is abnormal. Fill in the Refreshing Referral Form for Psychological and Behavioral Development of Children Aged 0 ~ 6 (Annex 5) to guide parents to refer their children to professional medical institutions with the ability to diagnose children’s autism as soon as possible for further diagnosis. The referral is made in duplicate, the first copy is kept by the re-screening institution, and the second copy is taken to the diagnosis institution by the parents. Inform parents to bring the Referral Form for the Re-screening of Psychological and Behavioral Development of Children Aged 0-6 (Annex 5) and the Record Form for the Re-screening of Psychological and Behavioral Development of Children Aged 0-6 (Annex 2, Table 5) when visiting the diagnosis institution.

　　For children with abnormal re-screening, the re-screening institution should actively contact the referral, and at the same time, carry out health education in time, carry out personalized guidance and intervention to alleviate or correct the developmental deviation of children.

　　Maternal and child health care institutions at the county level shall fill in the Registration Form for Abnormal Re-screening of Psychological and Behavioral Development of Children Aged 0 ~ 6 (Annex 6), regularly count the number of children with abnormal re-screening within their respective jurisdictions and relevant information, and report them to the municipal maternal and child health care institutions. Regularly feed back the Registration Form of Re-screening Abnormal Psychological and Behavioral Development of Children Aged 0 ~ 6 (Annex 6) to township hospitals and community health service centers.

　　(3) diagnosis.

　　Medical institutions with autism diagnosis ability undertake autism diagnosis services for children, mainly including pediatrics and child health care departments of general hospitals, pediatrics of psychiatric hospitals, children’s hospitals and maternal and child health care institutions.

　　1. Auxiliary diagnostic tools. Children Autism Rating Scale (CARS), etc.

　　2. Diagnostic methods. According to the International Statistical Classification of Diseases and Related Health Problems (ICD-10), the diagnosis of autism was made after comprehensive evaluation through medical history inquiry, behavior observation, physical examination and nervous system examination, autism scale evaluation and necessary auxiliary examination.

　　(1) medical history inquiry. Learn about children’s growth and development history in detail, focusing on social communication, speech, cognitive ability, sports and other aspects of development, and learn about children’s present and past history, as well as parents’ gestation history and family history.

　　(2) Behavior observation. Focus on children’s behavior observation, focusing on children’s social interaction, verbal and nonverbal communication. Some specific environments and activities can be set up to observe children’s social communication, reaction to people, reaction to environment and toys, eye contact, attention state, spontaneous speech expression and special speech expression, emotional adjustment, special behavior and interest, physical activity and sports coordination. The behavior of the developmental scale should also be recorded properly.

　　(3) Physical examination and nervous system examination. Understand physical growth, measure head circumference, height and weight, understand development, observe facial features and whole body skin, check whether there are congenital malformations, audio-visual impairment, and check whether there are positive signs in the nervous system.

　　(4) Scale evaluation. Children Autism Rating Scale (CARS) and other scales were used for evaluation. There are 15 items in CARS scale, and each item has 4 grades. A total score of less than 30 is considered as non-autism, and more than 30 is considered as autism.

　　(5) Auxiliary inspection.

　　To identify mental disorders caused by nervous system diseases and metabolic diseases, or to find possible related pathogenic factors for children who meet the diagnostic criteria of autism. Necessary auxiliary examinations, such as electrophysiological examination (EEG, evoked potential), imaging examination (head CT or magnetic resonance imaging), chromosome and gene examination, can be selected according to the specific situation of children.

　　The diagnosis of autism needs to be differentiated from speech and language development disorders, intellectual development disorders, reactive attachment disorders, childhood social anxiety disorders, selective mutism, childhood schizophrenia and so on.

　　At the same time, pay attention to the diagnosis of comorbidity, such as attention deficit hyperactivity disorder, TIC disorder, epilepsy, obsessive-compulsive disorder and so on.

　　According to the diagnosis results, fill in the Diagnostic Record of Abnormal Psychological and Behavioral Development of Children Aged 0 ~ 6 (Annex 2, Table 6). This form is made in duplicate, one for the diagnosis institution and one for the parents.

　　3. Diagnosis result notification and referral service.

　　(1) For children diagnosed with autism, explain the diagnosis results and illness to parents, inform them of the intervention and rehabilitation methods that can be adopted, the rehabilitation assistance policies and information of relevant government departments, and choose general hospitals, children’s hospitals, psychiatric hospitals, maternal and child health care institutions and qualified intervention and rehabilitation institutions for intervention and rehabilitation.

　　(2) For children with autism, explain the diagnosis to their parents in combination with clinical symptoms, developmental assessment and related examination results. If you find any health problems other than autism, you should inform the corresponding medical institutions for further diagnosis and treatment.

　　(3) For children who can’t be diagnosed for the time being, inform parents to go to the original diagnosis institution for reexamination two months later, and guide parents to intervene as soon as possible.

　　The diagnosis institution shall fill in the Registration Form for Diagnosis Results of Abnormal Psychological and Behavioral Development of Children aged 0-6 (Annex 7), record the diagnosis results and suggestions for intervention and rehabilitation of children with abnormal re-screening within its jurisdiction, and feed back to the municipal maternal and child health care institutions, which will feed back to the county-level maternal and child health care institutions, and then feed back to township hospitals or community health service centers.

　　(4) Intervention and rehabilitation.

　　Intervention rehabilitation training is undertaken by special education institutions with the ability to intervene and rehabilitate children’s autism, pediatrics and child health care departments of general hospitals, pediatrics of psychiatric hospitals, children’s hospitals, maternal and child health care institutions, qualified primary medical and health institutions and qualified children’s psychological rehabilitation institutions.

　　1. Basic principles.

　　(1) Early intervention. Early intervention can significantly improve the prognosis of autistic children, and the earlier the intervention, the better. The diagnosed children should be intervened immediately, and the children who meet the referral conditions at the initial screening and re-screening stages should be given health education, guidance and intervention in time.

　　(2) Individualized intervention. The development level of autistic children is different, so the development level of children’s social interaction, language, cognition and adaptability should be evaluated, and an individualized education intervention plan should be made according to the evaluation results.

　　(3) scientific evidence. At present, there are many intervention methods for autism, and scientific and effective methods with clear evidence-based medical evidence should be chosen.

　　(4) Long-range high strength. Autism, as a neurodevelopmental disorder, needs long-term intervention, which usually lasts for several years or even longer. At the same time, we must ensure that there is enough effective intervention time every day, and the weekly intervention time should be more than 20 hours.

　　(5) Grass-roots units are the mainstay. Actively promote the intervention and rehabilitation model based on county-level maternal and child health care institutions and grassroots medical and health institutions, and help autistic children to intervene nearby. At the same time, give play to the backbone role of medical and health institutions at the prefecture level and above, and strengthen technical guidance to primary medical and health institutions.

　　(6) Family participation. Encourage families and parents to actively participate in the intervention, provide all-round support and education to families and parents, and improve the participation of families in the intervention.

　　2. Intervention methods.

　　(1) Behavior intervention. Choose early intervention methods based on evidence-based medicine according to age and development level, with improving social communication, verbal and nonverbal communication skills as the core content, behavioral therapy as the basic means, structured education and parenting in natural situations as the basic framework of intervention, cultivate self-care and independent living ability, reduce unsuitable behavior, and improve survival skills and communication ability.

　　(2) Family intervention and support. The participation and support of parents and family members is an important strategy and measure for the intervention and rehabilitation of autistic children. Encourage parents and family members to learn autism-related knowledge and family intervention methods through popular science education and demonstration consultation. The main principles include: understanding, acceptance, tolerance, respect and care for autistic children’s behavior; For the emotional and behavioral problems of autistic children, family intervention is carried out in a happy, moderate and ingenious way through companion interaction, life care and play in the process of parenting; Pay attention to children’s growth performance, discover children’s special interests and personal abilities, and cultivate and transform them accordingly. At the same time, care about parents’ psychological state and physical health, and provide corresponding help.

　　(3) medication. At present, there is a lack of drugs for the core symptoms of autism in children. Autistic children with serious emotional and behavioral disorders and comorbid diseases should be referred to relevant medical institutions in time, and drugs should be selected and used strictly under the guidance of specialists.

　　3. Intervention steps.

　　(1) Conduct assessment. Before the intervention, we should use the standardized developmental and behavioral assessment scale to evaluate the core symptoms, the development level of various abilities and the quality of life of children with autism.

　　(2) make a plan. According to the evaluation results, the intervention objectives, intervention plans, intervention methods and intervention places are determined to promote the emergence and development of autistic children’s social communication behavior, improve autistic children’s serious emotional disorder, correct autistic children’s abnormal behavior, cultivate good adaptive behavior, and promote the all-round development of language, communication and cognition.

　　(3) implement intervention. Make long-term, medium-term, short-term and daily training plans; Intervention training should focus on children’s social communication and communication obstacles and pay attention to all-round development; Emphasize the application of behavior analysis technology and natural development behavior intervention.

　　(4) Effect evaluation. Intervention rehabilitation institutions should cooperate closely with diagnostic institutions. For autistic children who receive intervention rehabilitation, the intervention effects such as improvement of core symptoms, ability development and improvement of quality of life are evaluated every 3 to 6 months, so as to understand the improvement situation and evaluate the intervention effect, and the intervention rehabilitation institutions adjust the objectives, programs and methods in time according to the evaluation results.

　　4. Intervention in rehabilitation places.

　　In the process of intervention and rehabilitation, appropriate intervention and rehabilitation places and methods can be selected according to the age, severity of illness, ability level and family status of autistic children.

　　Children under the age of one and a half can be guided by professional medical institutions to give priority to family intervention, helping parents to take the initiative to use various resources and constantly learn and improve rehabilitation training techniques.

　　Children aged one and a half to three can choose professional medical institutions for rehabilitation training and family intervention at the same time.

　　After the age of 3, children with relatively mild illness and certain social communication and communication skills can receive integrated education in ordinary kindergartens and be trained in professional institutions; Those who are seriously ill and have weak social communication and communication skills can receive rehabilitation in professional medical institutions, special education institutions or qualified rehabilitation institutions, and continue to encourage family participation.

　　Intervention and rehabilitation institutions should evaluate the rehabilitation of children in time and make records of intervention and rehabilitation.

　　See Annex 8 for a schematic diagram of autism screening, diagnosis, intervention and rehabilitation services for children aged 0-6.

　　IV. Technical Requirements of Service Organizations and Personnel

　　(1) Township hospitals and community health service centers that undertake primary screening services. A relatively independent space should be set up, equipped with necessary measuring tables and chairs, measuring beds and other equipment, and the environment is relatively quiet and safe. Identify at least one medical staff who has been trained in screening techniques for children’s psychological and behavioral development and is qualified to engage in children’s health care services.

　　(2) County-level maternal and child health care institutions that undertake re-screening services. A consulting room and an independent psychological and behavioral testing room should be set up, equipped with necessary testing facilities and equipment, and the environment is quiet and safe. Identify at least 2 medical personnel who have received training in screening and developmental assessment techniques for children’s autism and are qualified to engage in child health care services.

　　(3) institutions for diagnosing children’s autism. It is a medical institution with the ability to diagnose autism. It should be equipped with 1 consulting room and 1 independent psychological and behavioral testing room that meet the requirements of clinical diagnosis and treatment. Diagnostics should be doctors in mental health department, pediatrics department and children’s health department with diagnostic qualifications.

　　(4) Intervention in rehabilitation institutions. With corresponding qualifications, facilities, equipment and personnel can meet the needs of intervention services for autistic children.

　　V. Division of tasks

　　(1) Township hospitals and community health service centers.

　　1 to carry out social publicity and health education on children’s psychological and behavioral development-related scientific knowledge, and to promote autism by early screening, early diagnosis and early intervention. Mobilize parents to take their children to receive autism screening services regularly.

　　2. To undertake the initial screening of children’s psychological and behavioral development from 0 to 6 years old, provide referral service for positive children, provide intervention guidance at the same time, and establish and improve children’s psychological and behavioral development files.

　　3. Follow-up the children with abnormal initial screening who did not receive re-screening in time, and cooperate with county-level maternal and child health care institutions to follow-up the children who did not review in time after re-screening.

　　4. Regularly summarize the basic information and data of children with abnormal screening within the jurisdiction, and report to the county-level maternal and child health care institutions in time.

　　(2) County-level maternal and child health care institutions.

　　1 to carry out social publicity and health education on children’s psychological and behavioral development-related scientific knowledge, and to promote autism by early screening, early diagnosis and early intervention.

　　2. Re-screen children with abnormal initial screening results, refer children with abnormal re-screening and re-examination results, provide intervention guidance, follow-up services and parents’ psychological support, and manage and improve children’s psychological and behavioral development files.

　　3. Follow-up children who failed to re-examine in time after re-screening, and children who failed to visit the diagnosis institution in time after re-screening or re-examination results were abnormal.

　　4. Conduct personnel training, technical guidance and quality assessment for institutions providing primary screening services within their jurisdiction.

　　5 responsible for the project management of autistic children within the jurisdiction. Regularly summarize the basic information and data of re-screened abnormal children within the jurisdiction, report them to the maternal and child health care institutions at the prefecture level in time, and feed back the information of re-screened abnormal children and the information of diagnosed children fed back at the prefecture level to township hospitals and community health service centers.

　　(3) institutions for diagnosing children’s autism.

　　1 to carry out social publicity and health education on children’s psychological and behavioral development-related scientific knowledge, and to promote autism by early screening, early diagnosis and early intervention.

　　2. To provide diagnosis for children with abnormal re-screening results, put forward suggestions for intervention and rehabilitation, assist children in need to be referred, and inform parents of relevant medical security and social assistance policy information.

　　3. Follow-up services should be provided to children with autism diagnosed, in principle, once every 3 months for children under 3 years old and once every 6 months for children over 3 years old. By evaluating the intervention effect of children with autism diagnosed, suggestions for intervention and rehabilitation in the next stage are given.

　　4. Assist health departments to carry out autism screening, diagnosis and intervention rehabilitation technology promotion, business guidance, personnel training and quality control.

　　5. Statistically summarize the information related to the diagnosis and intervention suggestions of children’s autism in this institution, and feed it back to the corresponding municipal maternal and child health care institutions in time.

　　(4) Intervention in rehabilitation institutions.

　　1 to carry out social publicity and health education on children’s psychological and behavioral development-related scientific knowledge, and to promote autism by early screening, early diagnosis and early intervention.

　　2. Provide intervention and rehabilitation services for autistic children according to the assessment results and training plan, and record the intervention and rehabilitation situation in time.

　　3 to publicize the knowledge and methods of intervention and rehabilitation, as well as relevant medical security and social assistance policies to parents of autistic children.

　　4 to provide counseling and guidance services for parents of autistic children, carry out family intervention rehabilitation technical skills training, and provide psychological counseling and support to parents.

　　5 do a good job in the management and referral of autistic children, and cooperate with diagnostic institutions to organize regular follow-up services to evaluate the rehabilitation effect.

　　(five) provincial and municipal maternal and child health care institutions.

　　Combined with the functional orientation of maternal and child health care institutions, strengthen the capacity building of their own children’s mental health care departments and rehabilitation departments, and assist health administrative departments to focus on the construction of service networks and information systems, personnel training, business guidance, technology promotion, quality control, health education and data management.

　　VI. Job Requirements

　　Health administrative departments at all levels should attach great importance to the screening, diagnosis, intervention and rehabilitation of children with autism, strengthen organizational leadership, strengthen arrangements and work guidance, and continuously improve the screening rate, diagnosis rate and intervention rate. Continue to improve the capacity of primary health care institutions, strengthen the capacity building of county-level maternal and child health care institutions, rationally arrange diagnosis institutions and intervention and rehabilitation institutions in combination with medical and health resources in the jurisdiction, and build an integrated service chain for screening, diagnosis, intervention and rehabilitation of children’s autism. Strengthen personnel training, strengthen quality control and ensure service quality. It is necessary to strengthen information security and privacy protection, strengthen the construction of regional information platforms, promote the interconnection and sharing of information on children’s autism screening intervention, improve service quality, reduce the burden on the grassroots, and facilitate the masses to do things.

　　VII. Evaluation indicators

　　(1) Primary screening rate. The number of children aged 0-6 years in the jurisdiction receiving the initial screening of psychological and behavioral development within the statistical period/the number of children aged 0-6 years in the jurisdiction within the statistical period ×100%.

　　(2) Re-screening rate. The number of children aged 0-6 years who have been screened for abnormal psychological and behavioral development in the jurisdiction for re-screening institutions within the statistical period/the number of children aged 0-6 years who have been screened for abnormal psychological and behavioral development within the statistical period ×100%.

　　(3) Diagnostic rate. The number of children with abnormal psychological and behavioral development who have been referred to the diagnosis institution for diagnosis within the statistical period/the number of children with abnormal psychological and behavioral development who have been re-screened within the statistical period ×100%.

The launch of "double 11" is just around the corner, and the gameplay and rules of major e-commerce platforms are also announced one after another. Judging from the activity cycle, intensity and richness, this year may be "the highest in history". This year, various platforms have "rushed to run" and greatly advanced the "double 11" promotion time. Among them, Tmall, JD.COM and Pinduoduo all chose to start their activities today (14th).

What is the investment of each platform this year? What are the new changes and new ways of playing?

▲ Photo by Xin Jingwei Chang Tao in the data map

How strong is the platform investment?

Double 11 has been in operation for 15 years since it was opened in 2009. In recent years, various "calculation problems" such as "double 11" collecting orders, reducing large sums, earning points, and endless brain-burning games have made consumers feel headache.

As an old player of double 11, Tmall said at the double 11 conference on the 12th that there are only two prices on the product interface this year: the price before discount and the price after various discounts are superimposed. Consumers only need to look at one price, so it will be easier to place an order.

Specifically, this year, Tmall still divided the activities into two waves. The first wave was from October 14 to 31, and the deposit was paid at 8: 00 on the evening of the 14 th; The second wave is from 8: 00 pm on October 31 to November 11.

Tmall said that this year’s "double 11" was the largest investment in recent years, and an additional 30 billion coupons and red envelopes will be invested on the basis of full reduction and reduction activities, and 88VIP coupons will be issued in advance at 2 pm on October 14th. It is reported that on October 14th, Tmall had 100 live broadcast rooms opened at the same time, and a total of 1 billion red envelopes were distributed.

According to the news of anchor Li Jiaqi Weibo on 12th, on 14th-15th, 500 million red envelopes will be distributed in the live broadcast room of Li Jiaqi, which can be used to pay the final payment of pre-sale and purchase spot goods.

This year’s "double 11" in JD.COM lasted from 8 pm on October 14th to November 11th. Specifically, JD.COM said that during the "double 11" period, preferential measures will be introduced, such as receiving extra subsidies from 60 yuan every day, and reducing 50 yuan for each full 300 yuan across stores. Since then, special stage, climax stage and return stage have been launched, including different nodes such as "Ten Billion Subsidy Day", "9.9 Postage Day" and "PLUS Member Day" to meet consumers’ shopping needs. In addition, we will, as always, continue to make efforts in trade-in of home appliances and subsidies for digital products.

Pinduoduo, another home appliance platform, recently released the "double 11" subsidy game. Zhongxin Jingwei learned that this year’s "double 11", Pinduoduo announced the first launch of the "Billion Coupon" campaign, and upgraded the "Billion Double Supplement" to "Super Double Supplement". In addition, Pinduoduo recently issued a new regulation in official website, which will upgrade the previous "if you buy expensive, you will lose" service to "if you buy expensive, you will lose twice" service, which will take effect on October 16th.

For consumers, there is another difference between this year’s "double 11" and the past, that is, the interconnection of payments.

On September 12th, Taobao officially announced its support for WeChat payment function, and gradually opened it to all sellers. By the end of September, WeChat Pay had been fully connected to Taobao.

According to the news of CCTV news client on September 26th, JD.COM will also access rookie express and rookie post station, which are rookie’s self-operated express brand and parcel collection site respectively. In addition, JD.COM will officially access Alipay payment, which is expected to be launched on the eve of "double 11".

Wu Jia, vice president of Alibaba Group and president of Taotian User Platform Division, said in an interview earlier that Taobao Tmall is expected to purchase the largest number of users in the history of Tmall’s "double 11" after realizing interconnection and cooperation with multiple Internet platforms. He also said that the opening of payment is the first step of cooperation between the two sides, and cooperation in traffic and other aspects will continue to deepen in the future.

In addition, Wu Jia also revealed that Jingdong Logistics is expected to access Taobao before "double 11" to provide services for users.

For a long time in the past, it was impossible to use WeChat to pay for shopping in Taobao. Now, will this huge change break the current competitive pattern of e-commerce platforms and have a greater impact on the transaction volume of double 11?

Jiang Han, a senior researcher at Pangu think tank, told Zhongxin Jingwei that from the perspective of competition, Taobao’s support for WeChat payment will break the barriers of payment methods of e-commerce platforms in the past, making consumers have more convenient and flexible choices. Secondly, it will enhance consumers’ shopping experience and convenience, which will help Taobao achieve higher sales and transaction growth during the "double 11" period.

However, Ma Jihua, an Internet analyst, believes that Taobao’s support for WeChat payment will not have a great impact on Taobao’s overall sales volume, because on Taobao platform, more users have become accustomed to Alipay, and relatively few people use WeChat to pay. However, for WeChat users, they can now directly open Taobao to go shopping, which may have a great impact on the design of Taobao’s entire promotion activities and enrich users’ purchase channels.

The longest "double 11"

Zhongxin Jingwei combed and found that lengthening shopping time has become the collective action of e-commerce this year. Among them, Taobao Tmall, JD.COM and Pinduoduo all started this year’s "double 11" activity on 14th.

Specifically, compared with last year, the biggest change in the duration of the event was the Taobao Tmall platform: the pre-sale preheating was started on the 14th, 10 days earlier than in 2023 and 2022; JD.COM is 9 days ahead of 2023 and 2022; Pinduoduo is six days ahead of schedule.

▲ Photo by Xin Jingwei Chang Tao in the data map

In terms of new e-commerce platforms, Tik Tok is the first platform to launch the "double 11" this year. Earlier, Tik Tok Platform announced that the "double 11" Good Things Festival would be held on October 8th, one week earlier than 2023.

Aauto Quicker is the first e-commerce platform to announce the "double 11" in advance this year. At the investment promotion meeting on September 19th, Aauto Quicker announced that it would enter the "double 11" warm-up period on October 16th, and it would be officially put on sale on the 18th. Compared with last year, it was two days ahead of schedule.

As a player who entered the market later, Xiaohongshu E-commerce recently announced that the "One-year and One-degree Shopping Carnival" opened on October 12 and lasted until November 11.

In this regard, some netizens said on social platforms that this year’s "double 11" is too long, and it feels almost connected with the National Day holiday. Some netizens said that "every year is ahead of schedule, and every year is the longest in history."

Why did the major platforms decide to lengthen the "double 11" campaign front this year?

Wu Jia explained: "double 11 has its own rhythm every year. It is not in advance, but we have added some content. As you can see, different content is for different consumers."

Jiang Han said that by extending the activity cycle, the platform can provide consumers with more shopping time and choices, thus increasing sales and user stickiness. In addition, it can also provide more time and space for merchants to plan and implement various promotional activities, thus enhancing market competitiveness.

In Ma Jihua’s view, the current "double 11" activity is very different from that of a few years ago. Now e-commerce companies mainly use "double 11" as a gimmick to lengthen the whole marketing cycle as far as possible, with the aim of expanding sales. In addition, in order to better promote users’ desire to buy, they can also compete with friends for traffic.

Quality live broadcast has become a new highlight of this year’s "double 11"

Recently, traffic anchors such as "Xiao Yang Ge" and "Northeast Rain Sister" have caused concern about false propaganda when they bring goods live. In this context, the industry’s call for quality live broadcast has also become a highlight of this year’s "double 11".

Recently, the Report on High-quality Development of Live E-commerce Industry (2023-2024) issued by China Institute of Metrology, China Quality Certification Center, Meiwan and other units (hereinafter referred to as the report) pointed out that live e-commerce is moving towards the development path of "quality live broadcast".

At the release site of the report, Lao Yuling, director of the E-commerce Center of Shanghai University of Finance and Economics, said that in the future, the development of live broadcast e-commerce will pay more attention to the quality itself and help emerging consumption through live broadcast of quality. Among them, the head enterprises need to do a good demonstration role and drive the industry to positive energy.

Jia Luo, vice president of Ali Group and president of Tmall’s business unit, said at the Tmall double 11 conference that boosting consumption should not only expand "quantity" but also attach importance to "quality". It is necessary to promote the order transaction, "expand" the consumer market, but also pay attention to the brand and quality, and "improve" the consumption. The unique role of Tmall Double Eleven is to create more brand increments and quality increments.

At the press conference, Meng Xin, general manager of Taobao Live Shop, also said that the live e-commerce has entered a new stage of "quality live broadcast" from the entertainment red man mode, and the quality live broadcast mode of professional anchor, brand pallet and platform quality service guarantee will become the mainstream of the industry.

According to the Research Report on the Development of Network Audiovisual in China (2024), by December 2023, the total number of short video accounts in the whole network had reached 1.55 billion, and the number of professional anchors had reached 15.08 million.

It is worth mentioning that on July 31 this year, the Ministry of Human Resources and Social Security, together with the State Administration of Market Supervision and the National Bureau of Statistics, officially released 19 new jobs to the society, including network anchors.

Not long ago, the Shanghai Municipal Commission of Commerce and other departments issued the "Three-year Action Plan for Shanghai to Promote the High-quality Development of live stream economy (2024-2026)", in which it is particularly clear that it is necessary to establish and improve high-standard industry norms and supervision mechanisms, and at the same time, it is necessary to cultivate a number of large-scale, driving and influential anchor service organizations in China to play a leading role.

At the release site of the above report, Li Tong, deputy director of the Innovation and Internet Supervision Research Department of the Development Research Center of the State Administration of Markets, said, "It is very important to build a compliance evaluation system in the live broadcast e-commerce industry. Relevant regulatory authorities should pay attention to the improvement of laws and regulations, pay attention to collaborative supervision, and give play to the organizational role of industry associations to guide the standardized operation of enterprises. At the same time, it is necessary to broadcast the self-discipline of practitioners in the e-commerce industry. "

Text: Li xiaoxuan

(Zhongxin Jingwei)

Topic: 2008 US Presidential Election

　　Xinhuanet Washington, November 4 th (Yang Qingchuan, Wang Wei) The preliminary statistics of the presidential election on the 4 th announced by the US media show that it is a foregone conclusion that the Democratic vice presidential candidate and Delaware Senator Joe Biden will be elected as the next vice president of the United States.

　　Biden was born in November 1942 in a middle-class family in Pennsylvania, USA. He graduated from the University of Delaware in 1965 and the Law School of Syracuse University in 1968. Biden worked as a lawyer for a while and then went into politics. In 1972, Biden was elected to the Senate for the first time and became one of the youngest senators in American history.

　　However, just a few weeks after Biden was elected to the Senate, his wife and youngest daughter were killed in a car accident and their two sons were seriously injured. This heavy blow almost crushed Biden. Persuaded by colleagues and friends, he decided to take office in the Senate. Since then, Biden has been re-elected as a senator. He used to be the chairman of the Senate Judiciary Committee and is now the chairman of the Foreign Relations Committee. He has rich political experience, especially in the diplomatic field. He is also a part-time law professor at the university.

　　Despite Biden’s influence in Congress, his two presidential campaigns ended in failure.

　　Public opinion believes that Obama’s choice of Biden as his running mate can make up for his lack of experience in political and foreign affairs.

　　Biden is regarded as a moderate liberal of the Democratic Party. He voted for the Bush administration to launch the Iraq war, but later admitted that it was a mistake and has been calling for an early timetable for withdrawing troops from Iraq.

　　Biden visited China twice in 1979 and 2001.

Editor: Wang Jiaolong

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Summarizing the owner’s evaluation, the Volvo XC90 has not only won the trust of consumers with its excellent brand reputation, but also its excellent quality, reassuring safety performance and eye-catching exterior design are even more impressive. Driving this XC90, whether it is confidence or return rate, has been fully reflected. Therefore, choosing the Volvo XC90 is undoubtedly a persistent pursuit of quality life.

　　CCTV News:Overloaded trucks carrying hundreds of tons of traffic at every turn on the road, illegal taxis grabbing business at stations and scenic spots, all interfere with traffic order and even bring safety hazards, which are deeply abhorrent. However, in some places, overloaded trucks and black taxis are like psoriasis that cannot be cured. They are treated, rebounded, and then treated and rebounded. Why are these cars so difficult to manage? This problem also plagues Harbin, Heilongjiang. After more than a year of rectification storms, Harbin has found the source of the problem.

　　In a video shot by local media in Heilongjiang Province at the end of 2016, it can be seen that long lines of overloaded trucks are whizzing past police cars.

　　The driver revealed that these cars are all sand, 80 or 90 square meters folded into a load of 130 tons. Trucks with a load of 100 tons are not uncommon in Harbin. Local media reports show that overloaded goods have exploded 150 tons of large scales, and accidents caused by overloading are constantly emerging. When these large trucks are mentioned, local residents complain.

　　Freight vehicles are wildly overloaded, and the undercurrent in the passenger transportation field is also turbulent. In the passenger distribution centers such as Harbin West Railway Station and Xiangfang Railway Station, regular taxi drivers complain about black taxis. Some taxi drivers told reporters that in order to grab business, black car drivers will beat regular taxi drivers.

　　However, according to public reports, whether it is overloaded trucks or illegal taxis, the local area has been cracking down. For trucks, the traffic police department averages nearly 50 times a year at peak times. With such a strong crackdown, why is the public response so strong? Drivers say the root of the problem lies behind the scenes.

　　Car protection refers to the people who provide protection behind these overloaded vehicles. These people are mostly gangs, collecting protection fees from the owners of large trucks, and at the same time seeking protection from law enforcement through illegal profit transfer. When these large trucks violate the law, the car protection gang members will contact the police on duty not to intercept the vehicles; or after the vehicles are detained, the internal operation of these large trucks will not be punished or mitigated. If you don’t get rid of the car protection gang and unplug the umbrella company behind it, no amount of rectification can only be a formality.

　　On October 23, 2017, the Harbin Municipal Commission for Discipline Inspection and Supervision Commission started from the umbrella company behind the interest chain and set up a task force to intervene in the investigation.

　　After more than 7 months, 6 gangs involved in evil car protection were destroyed in one fell swoop, 70 suspected criminal social personnel were investigated and 122 crazy big goods umbrella companies were punished.

　　As long as the protection fee is collected, it can provide all-round protection before, during and after the event. In the eyes of these law enforcement officers, law enforcement has become a business, not for the people, but for money; the basis of law enforcement is not the law, but the relationship of money piled up. Objectively speaking, the traffic police umbrella company that Harbin destroyed involves cadres whose positions are not high, but they are government officials who deal with the people all the time and hold power. It is this kind of micro-corruption that the people feel the deepest and has the greatest social impact. Destroy these umbrella companies and dry the soil under the umbrella in the sun, so that all kinds of pests who are afraid of the sun can have no way to escape; the law enforcement department has a clear political ecology and hangs the sword of fairness and justice high, so that the society can see the power of the rule of law.