目的 探讨孤独症幼儿早期临床表现和预警信号,为孤独症的早期诊断提供理论依据。方法 采用问卷调查法,对广州中山大学附属第三医院儿童发育行为中心确诊的孤独症儿童102例发放调查问卷,采用χ²检验,Logistic多元回归分析法对所有数据进行分析。结果 孤独症患儿与正常幼儿在缺乏目光注视、唤名不应、缺乏食指指物、缺乏分享、缺乏炫耀、对所指物品没有注意、缺乏参照注视、不听指令、不关注周围小朋友、不能寻求安慰、缺乏动作模仿、使用别人手做工具、缺乏点头表示同意、缺乏摇头表示不同意、不会说话、不能理解大人的话、刻板身体动作、刻板操作物体、踮脚走路、斜眼看物、对声音敏感、玩玩具单一、缺乏假想性游戏、缺乏社交性游戏差异有统计学意义(P<0.05)。其中缺乏目光注视、缺乏炫耀、缺乏点头表示同意、不会说话、刻板操作物体、玩玩具单一是孤独症儿童的显著临床特征(P<0.05)。结论 缺乏目光注视、缺乏炫耀、缺乏点头表示同意、不会说话、刻板操作物体、玩玩具单一可作为孤独症幼儿的早期预警信号,为今后深入研究并制定我国儿童孤独症早期筛查和诊断量表奠定基础。

Objective To analyze the clinical manifestation and early signs of autism. Method The clinical characteristics of 102 children with autism diagnosed by Child Developmental Behavior Center of the Third Affiliated Hospital of Sun Yat-Sen University in Guangzhou were analyzed by using questionnaire. Results Clinical manifestation Results indicated that the following signs differentiated children in the autism group from children in control group.They were lack of appropriate gaze,response to name when called,lack of pointing,sharing enjoyment or interest,lack of showing,referential looking,lack of orienting in the direction in which an adult was looking,listening to command,interesting in children,seeking comfort,lack of imitating behaviors,using person's hand as a tool,lack of nodding,lack of head shaking,failure to talk,failure to understand words,repetitive movements with bodies,repetitive movements with objects,toes walking,abnormal gaze,hyper-responsiveness to auditory,lack of playing with a variety of toys,lack of social play,lack of pretending play.Logistic regression analysis showed that there were six significant factors for clinical manifestations which are lack of appropriate gaze,lack of showing,lack of nodding,failure to talk,repetitive movements with objects,lack of playing with a variety of toys. Conclusions Lack of appropriate gaze,lack of showing,lack of nodding,failure to talk,repetitive movements with objects,lack of playing with a variety of toys which are early autistic signs.The final aim is to establish the Chinese early screening checklist and early diagnosis questionnaires in near future.