目的 分析孤独症谱系障碍(ASD)儿童中喂养问题的现状及ASD儿童喂养问题的相关因素,为临床指导ASD儿童喂养问题的行为矫正提供理论依据。方法 于2015年8月—2016年1月通过收集119例ASD儿童和185名正常儿童的进食行为量表(BAMBI)得分来比较两组在喂养问题上的差异,采用Spearman秩相关分析喂养问题的相关因素。结果 ASD男童的拒绝进食行为、食物谱狭窄和BAMBI总分均高于正常男童(9.64±3.18 vs. 8.15±2.85,P=0.003;21.21±5.53 vs. 18.76±4.93,P=0.004;41.44±9.41 vs. 37.05±7.41,P=0.001),ASD女童的孤独症特征相关的喂养问题得分明显高于ASD男童(12.17±2.25 vs. 10.58±2.60,P=0.029)。低功能ASD男童拒绝进食行为得分、孤独症特征相关的喂养问题得分和BAMBI总分均高于正常男童(9.83±3.21 vs. 7.61±2.56,P=0.004;11.72±3.03 vs. 10.07±2.31,P=0.029;42.62±10.54 vs. 36.89±7.41,P=0.028)。ASD儿童中,拒绝进食行为得分与刻板行为、自伤行为、强迫行为、仪式单调行为、受限行为得分呈正相关(P＜0.05);孤独症特征相关的喂养问题得分与年龄、刻板行为、仪式单调行为、受限行为得分呈正相关(P＜0.05);食物谱狭窄得分与刻板行为、强迫行为、仪式单调行为、受限行为得分呈正相关(P＜0.05)。结论 ASD男童较正常男童存在更多的喂养问题,低功能ASD男童的喂养问题可能受重复刻板行为影响,临床工作者需给予更多的关注,并进行个体化的行为矫正。
Abstract
Objective To investigate current status and related factors of feeding problems in children with autism spectrum disorder (ASD),in order to provide reference for behavior modification of feeding problems in ASD children. Methods Totally 119 ASD children and 185 normal children were enrolled in this study from August 2015 to January 2016. Brief Autism Mealtime Behaviors Inventory (BAMBI) was used to assess feeding problems. The correlation between related factors and feeding problems was analyzed by spearman correlation analysis. Results The scores of food refusal,limited variety of food and BAMBI total scores in ASD boys were significantly higher than those in normal boys (9.64±3.18 vs. 8.15±2.85,P=0.003; 21.21±5.53 vs. 18.76±4.93,P=0.004; 41.44±9.41 vs. 37.05±7.41,P=0.001). ASD girls had more feeding flexibility-hurtful behaviors when eating scores than boys with ASD (12.17±2.25 vs. 10.58±2.60,P=0.029). Compared with normal boys,boys with low-functioning autism had higher scores on the scores of food refusal,feeding flexibility-hurtful behavior when eating and BAMBI total scores (9.83±3.21 vs. 7.61±2.56,P=0.004; 11.72±3.03 vs. 10.07±2.31,P=0.029; 42.62±10.54 vs. 36.89±7.41,P=0.028). In ASD children,food refusal was positively related with stereotypic behavior,self-injurious behavior,compulsive behavior,ritualistic/sameness behavior and restricted interests(P＜0.05). Moreover,feeding flexibility-hurtful behavior was positively related to age,stereotypic behavior,compulsive behavior and restricted interests(P＜0.05). Limited variety of food had positive correlation with stereotypic behavior,compulsive behavior,ritualistic/sameness behavior and restricted interests(P＜0.05). Conclusions ASD boys have more feeding problems than normal boys,and repetitive and stereotypic behavior probably affect feeding problems in children with low-functioning ASD. Clinical medical staff should pay more attention to such problems and individual behavior modification in ASD children.
关键词
孤独症谱系障碍 /
喂养问题 /
相关因素
Key words
autism spectrum disorder /
feeding problems /
related factors
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参考文献
[1] Lai MC,Lombardo MV,Baron-Cohen S. Autism[J]. Lancet,2014,383(9920):896-910.
[2] Sharp WG,Berry RC,Mccracken C,et al. Feeding problems and nutrient intake in children with autism spectrum disorders:a meta-analysis and comprehensive review of the literature[J]. J Autism Dev Disord,2013,43(9):2159-2173.
[3] Ledford JRGD. Feeding problems in children with autism spectrum disorders:a review[J]. Focus on Autism and Other Developmental Disabilities,2006,21:153-166.
[4] Bandini LG,Anderson SE,Curtin C,et al. Food selectivity in children with autism spectrum disorders and typically developing children[J]. J Pediatr,2010,157(2):259-264.
[5] Meral BF. A study on turkish adaptation,validity and reliability of the brief autism mealtime behavior inventory(BAMBI)[J]. Procedia Soc Behav Sci,2014,116(2014):403-408.
[6] Demand A,Johnson C,Foldes E. Psychometric properties of the brief autism mealtime behaviors inventory[J]. J Autism Dev Disord,2015,45(9):2667-2673.
[7] 中国肥胖问题工作组. 中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准[J]. 中华流行病学杂志,2004,25(2):97-102.
[8] 龚耀先,蔡太生. 中国修定韦氏儿童智力量表(C-WISC)手册[M]. 1993:11-50.
[9] Lam KS,Aman MG. The Repetitive Behavior Scale-Revised:independent validation in individuals with autism spectrum disorders[J]. J Autism Dev Disord,2007,37(5):855-866.
[10] Schreck KA,Williams K,Smith AF. A comparison of eating behaviors between children with and without autism[J]. J Autism Dev Disord,2004,34(4):433-438.
[11] Herndon AC,Diguiseppi C,Johnson SL,et al. Does nutritional intake differ between children with autism spectrum disorders and children with typical development?[J]. J Autism Dev Disord,2009,39(2):212-222.
[12] Martins YYRA. Feeding and eating behaviours in children with autism and typically developing children[J]. J Autism Dev Disord,2008,38:1878-1887.
[13] Gray HL,Chiang HM. Brief report:mealtime behaviors of Chinese american children with autism spectrum disorder[J]. J Autism Dev Disord,2017,47(3):892-897.
[14] 寿小婧,邢燕,韩济生,等. 孤独症儿童饮食谱及食物偏好研究[J]. 中华行为医学与脑科学杂志,2014,23(5):413-415.
[15] 周自云,陶玺宬,朱静,等. 孤独症谱系障碍儿童饮食行为问题的研究[J]. 中国儿童保健杂志,2015,23(6):613-617.
[16] Matson JLFJ. The treatment of food selectivity and other feeding problems in children with antism spectrum disorders.[J]. Res Autism Spect Dis,2009,34(9):2564-2571.
[17] Emond A,Emmett P,Steer C,et al. Feeding symptoms,dietary patterns,and growth in young children with autism spectrum disorders[J].Pediatrics,2010,126(2):e337-e342.
[18] Mari-Bauset S,Llopis-Gonzalez A,Zazpe-Garcia I,et al. Nutritional status of children with autism spectrum disorders (ASDs):a case-control study[J]. J Autism Dev Disord,2015,45(1):203-212.
[19] Kummer A,Barbosa IG,Rodrigues DH,et al.Frequency of overweight and obesity in children and adolescents with autism and attention deficit/hyperactivity disorder[J]. Rev Paul Pediatr,2016,34(1):71-77.
[20] Broder-Fingert S,Brazauskas K,Lindgren K,et al. Prevalence of overweight and obesity in a large clinical sample of children with autism[J]. Acad Pediatr,2014,14(4):408-414.
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