目的 了解眼动追踪偏向注视社会性人物的孤独症谱系障碍(ASD)儿童的眼动模式及临床行为特征,为辅助临床诊断提供客观的依据,并为早期干预提供指导。方法 回顾性分析2019年1-6月于深圳妇幼保健院儿童心理与康复科就诊的107例ASD儿童的眼动及行为量表结果,按眼动结果与临床诊断的一致性分组:一致组(几何注视时间＞人物注视时间,且临床诊断为ASD)、非一致组(几何注视时间＜人物注视时间,且临床诊断为ASD),采用独立样本t检验比较两组ASD儿童的差异,并采用二分类Logistic回归建立辅助临床诊断的模型。结果 1)一般情况:两组儿童年龄差异无统计学意义(P>0.05),但一致组ASD儿童的孤独症评定量表(CARS)分明显高于非一致组(t=2.39,P＜0.05);2)相关量表评估结果:一致组ASD儿童的精细动作评估、社会技能评估明显落后非一致组儿童(t=-1.61,-2.65,P＜0.05),其余评估两组间差异无统计学意义(P>0.05);3)眼动结果:两组儿童首次关注人脸的兴趣区域不同,其注视轨迹也不同。其中,一致组首次关注嘴巴区域,非一致组最开始关注其他区域;一致组ASD儿童对非核心区域的眼动注视时间明显高于非一致组,对眼睛及嘴巴的注视时间(FT)明显低于非一致组(t=2.47,-2.21、-3.51,P＜0.05),两组儿童对鼻子、其他区域的眼动FT差异无统计学意义(P>0.05);4)建立模型:Ln(P/1-P)=β₀+β₁X₁+₂X₂+β₃X₃+…+β_nX_n=0.09X_CARS分-0.07X_社会技能-0.05X_精细动作+0.01X_{首次注视时间}+0.01X_注视时间,此模型的判断一致的灵敏度为79.4%,特异度为74.2%,总判对率为75.9%。结论 偏向注视社会性人物的ASD儿童较偏向几何图形的ASD儿童在社会技能、精细动作能力方面强,且其病情程度轻,建立的辅助模型对临床诊断有一定的价值。

Objective To understand the eye track pattern and clinical behavior characteristics of autism spectrum disorder(ASD )children with eye track biased to look at social figures, and to provide an Objective basis for clinical diagnosis, thus to provide guidance for early intervention. Methods A retrospective analysis of the Results of eye track and behavioral scales of 107 ASD children in the department from January to June 2019 were conducted according to the consistency of eye movement Results and clinical diagnosis:consistent group (geometric gaze time > person gaze time, and clinical diagnosis of ASD), non-consistent group (geometric gaze time < character gaze time, and clinical diagnosis of ASD), using independent sample t test to compare differences between the two groups of ASD children. And a two-class Logistic regression was used to establish a model for assisted clinical diagnosis. Results 1)General situation:there was no significant difference in age between the two groups (P>0.05), but the Autism Rating Scale(CARS) score of children in the ASD group was significantly higher than that in the non-consistent group (t=2.39,P＜0.05).2)The Results of the relevant scales were consistent.The fine motor assessment and social skills assessment of children with ASD were significantly behind the non-consistent group (t=-1.61,-2.65,P＜0.05), and there was no significant difference between the two groups (P>0.05).3)Eye track results: two groups for the first time, children paid attention to the different areas of interest of their faces, and their gaze paths were different.Among them, the consistent group focused on the mouth area for the first time, and the non-consistent group initially focused on other areas; The eye track gaze time of the non-core area of the consistent group ASD children was significantly higher than that of the non-consistent group, and the fixation time(FT) of the eyes and mouth was significantly lower than that of the non-core group.In the consistent group (t=2.47,-2.21,-3.51,P＜0.05), there was no significant difference in eyetrack FT between the two groups in the nose and other areas (P>0.05).4)Establish the model:Ln(P/1-P)=β₀+β₁X₁+β₂X₂+β₃X₃+…+β_nX_n=0.09X_CARS-0.07X_Socialskills-0.05X_{Fine action}+0.01X_{First fixation time}+0.01X_{fixation time}, the sensitivity of this model was consistent with 79.4%, specificity with 74.2%, the total judgment rate was 75.9%. Conclusions ASD children biased towards social figures are more sensitive to social skills and fine motor skills than ASD children biased towards geometric figures, and their degree of disease is mild.The established auxiliary model has certain value for clinical diagnosis.