疑诊孤独症谱系障碍儿童的结局随访及发育特征分析

doi:10.11852/zgetbjzz2024-0808

中国儿童保健杂志 ›› 2025, Vol. 33 ›› Issue (1): 39-42.DOI: 10.11852/zgetbjzz2024-0808

疑诊孤独症谱系障碍儿童的结局随访及发育特征分析

李慧美, 刘晓, 代英, 程茜

国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,认知发育与学习记忆障碍转化医学重庆市重点实验室,重庆医科大学附属儿童医院儿童保健科,重庆 400014

收稿日期:2024-07-11 修回日期:2024-11-04 发布日期:2025-01-16 出版日期:2025-01-10
通讯作者: 刘晓,E-mail:xiaoliucq@hospital.cqmu.edu.cn
作者简介:李慧美(1996—),女,住院医师,硕士学位,主要研究方向为儿童保健学。

Follow-up outcomes and developmental characteristics of children with suspected autism spectrum disorder

LI Huimei, LIU Xiao, DAI Ying, CHENG Qian

Department of Child Health Care,Children's Hospital of Chongqing Medical University; National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders,Chongqing 400014, China

Received:2024-07-11 Revised:2024-11-04 Online:2025-01-10 Published:2025-01-16
Contact: LIU Xiao,E-mail:xiaoliucq@hospital.cqmu.edu.cn

摘要/Abstract

摘要： 目的随访早期疑诊孤独症谱系障碍(ASD)儿童在学龄前期的诊断结局,并分析相关发育特征,为早期确诊提供依据。方法选取2017年6月—2022年8月因语言问题就诊并疑诊ASD(n=95)与发育性语言障碍(DLD)(n=76)的幼儿,随访至4岁,初诊时用 Gesell 婴幼儿发育量表评估适应性、精细运动、大运动、言语和个人社交发育商(DQ),采用SPSS 26.0软件分析早期发育特征及语言、社交能力转归情况。结果 1)95例早期疑诊为ASD的儿童,4岁确诊为ASD 57例(60%),DLD 18例(18.95%),全面发育迟缓4例(4.21%),典型发育12例(12.63%),其他4例(4.21%);2)疑诊ASD组儿童,婴幼儿期言语中度迟缓;非语言发育方面个人社交、适应性轻度迟缓,精细运动、大运动处于边缘状态。3)复诊时确诊为ASD儿童言语DQ的提高值较个人社交明显(t=-2.11,P＜0.05),而复诊DLD儿童言语、个人社交DQ的提高值之间差异无统计学意义(t=-0.862,P＞0.05)。结论幼儿期疑诊ASD儿童,复诊时60%明确诊断为ASD,诊断稳定性较高;疑诊ASD的儿童,婴幼儿期语言能力落后明显,大运动及精细运动无明显落后;学龄前期ASD儿童语言与个人社交能力发展轨迹不同,语言能力提高明显,个人社交能力有持续的落后,而DLD儿童的语言与社交能力平行发展。

关键词: 孤独症谱系障碍, 发育性语言障碍, 发育特征

Abstract: Objective To follow up the diagnostic outcomes of children with early suspected autism spectrum disorder (ASD) during the preschool period, and to analyze their related developmental characteristics, so as to provide a basis for early diagnosis of ASD. Methods Children who visited the hospital due to language problems and were suspected of having ASD (n=95) or developmental language disorder (DLD) (n=76) between June 2017 and August 2022 were followed up until they were 4 years old. At the initial diagnosis, the Gesell Developmental Scales for infants and young children were used to assess developmental quotient of adaptability, fine motor, gross motor, language, and personal-social dimension. SPSS 26.0 software was used to analyze early developmental characteristics and outcomes in language and social skills. Results 1) Among the 95 children initially suspected of having ASD, 57 (60%) were confirmed to have ASD at age 4, 18 (18.95%) had DLD, 4 (4.21%) had global developmental delay, 12 (12.63%) were typically developed, and 4 (4.21%) had other diagnosis. 2) In the suspected ASD group, there was moderate delay in DQ of language during infancy, mild delays in DQ of personal-social and adaptability for non-verbal development, and borderline DQ of fine motor and gross motor skills. 3) At the follow-up visit, children diagnosed with ASD showed significantly greater improvement in DQ of language compared to DQ of personal-social (t=-2.11, P<0.05), while no significant difference was observed between the improvement in DQ of language and DQ of personal-social dimension among children diagnosed with DLD (t=-0.862, P>0.05). Conclusions Among children suspected of having ASD during infancy, 60% are definitively diagnosed with ASD at the follow-up, indicating high diagnostic stability. Children suspected of having ASD exhibit significant delays in language abilities during infancy, with no significant delays in gross motor or fine motor skills. In preschool children with ASD, the trajectories of language and personal-social skill development differ, with notable improvements in language abilities but persistent delays in personal-social skills, whereas children with DLD show parallel development in both language and personal-social skills.

Key words: autism spectrum disorder, developmental language disorder, developmental characteristics

中图分类号:

R749.94

李慧美, 刘晓, 代英, 程茜. 疑诊孤独症谱系障碍儿童的结局随访及发育特征分析[J]. 中国儿童保健杂志, 2025, 33(1): 39-42.

LI Huimei, LIU Xiao, DAI Ying, CHENG Qian. Follow-up outcomes and developmental characteristics of children with suspected autism spectrum disorder[J]. Chinese Journal of Child Health Care, 2025, 33(1): 39-42.

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疑诊孤独症谱系障碍儿童的结局随访及发育特征分析

Follow-up outcomes and developmental characteristics of children with suspected autism spectrum disorder

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