目的 了解不同年度孤独症谱系障碍(ASD)儿童发育及适应性行为水平情况的变化,为ASD早期识别、诊断及后期干预训练指导提供理论依据。方法 回顾性分析2015、2017年及2019年于重庆医科大学附属儿童医院儿保科初诊的1~5岁ASD患儿Gesell评估及婴儿-初中学生社会生活能力量表(S-M)结果。结果 2015、2017年及2019年ASD患儿在Gesell发育测评中总发育商(DQ)及S-M量表分数比较差异无统计学意义(F=0.920、0.495,P>0.05)。2015、2017及2019年ASD患儿各能区均表现为不同程度发育迟缓(DD),其中大运动能区DQ得分差异有统计学意义(F=9.683,P<0.05),不同年份大运动及精细运动能区发育迟缓的比例差异有统计学意义(χ2=22.583、11.596,P<0.05)。ASD女童的精细运动及个人-社会能区DQ高于男童(Z=2.023、2.837,P<0.05);不同年龄段ASD患儿各能区DQ及S-M分数比较,差异有统计学意义(H=56.557、185.824、37.935、8.038、68.752、32.657,P<0.05)。结论 本研究中近五年ASD患儿共患DD的水平及其适应性行为无明显变化;ASD儿童的发育水平及适应性行为存在一定性别及年龄差异,且大运动落后近年来愈加明显,对ASD患儿应尽早进行正式的发育及适应性行为评估,解读结果时亦应结合其性别及年龄,以全面评估病情及精准干预。
Abstract
Objective To investigate the changes of development and adaptive behavior in children with autism spectrum disorder (ASD) in different years, so as to provide theoretical basis for early identification, diagnosis and rehabilitation training of ASD. Methods The assessment results by Gesell Development Scale and S-M scores of ASD children aged 1 to 5 who were diagnosed for the first time in the Department of Child Health Care of Children's Hospital of Chongqing Medical University in 2015, 2017 and 2019 were retrospectively analyzed. Results There were no significant differences in total development quotient (DQ) of GDS and S-M scores of ASD children in the year 2015, 2017 and 2019 (F=0.920, 0.495,P>0.05). Children with ASD in different years had developmental delay(DD) on different levels, and there were significant differences in scores of DQ in gross motor area (F=9.683, P< 0.05), distribution of DQ in gross motor area and fine motor area (χ2＝22.583, 11.596, P<0.05). The DQ scores of fine motor and social behavior area of girls with ASD were higher than those of boys (Z＝2.023,2.837, P<0.05). There were significant differences in DQ and S-M score in ASD children at different age groups (H=56.557, 185.824, 37.935, 8.038, 68.752, 32.657, P<0.05). Conclusions No significant changes are seen in the level of DD and adaptive behavior for ASD children in recent five years. There are gender and age differences in the development level and social living skills of ASD children, and the retardation of gross motor development has become more and more obvious in recent years. Standardized assessment of development and adaptive behavior should be conducted as soon as possible for ASD children, and the results should be interpreted according to the gender and age of children in order to give comprehensive assessment and precise clinical intervention.
关键词
孤独症谱系障碍 /
发育商 /
适应性行为
Key words
autism spectrum disorder /
developmental quotient /
adaptive behavior
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参考文献
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基金
重庆市科卫联合医学研究项目(2020MSXM075)
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