目的 分析孤独症谱系障碍(ASD)儿童早期运动发育情况,为ASD的超早期识别提供临床依据。方法 采用1∶1配对病例对照研究方法分别选取2022年1月—2023年9月期间在义乌市妇幼保健院诊断为ASD 33例及同性别、年龄相差不超过1个月的健康儿童33例纳入研究。分析比较其婴儿期Peabody运动发育量表运动商及婴幼儿养育风险因素。结果 ASD组粗大运动商(GMQ)(t=2.068)、精细运动商(FMQ)(t=2.625)、总运动商(TMQ)(t=2.563)均低于对照组(P<0.05);其中粗大运动能区姿势项目(t=3.882),精细运动能区抓握项目(t=3.042)显著低于对照组(P<0.05),其他能区标准分差异均无统计学意义(P>0.05);ASD男童GMQ低于ASD女童(t=2.219,P<0.05),FMQ、TMQ差异无统计学意义(P>0.05);ASD组6月龄以内出现养育风险阳性的共计6例(18.18%),对照组2例(6.06%),差异无统计学意义(P>0.05)。结论 ASD患儿婴儿期存在粗大运动、精细运动发育指标延迟现象,基层医疗卫生机构承担初筛服务时需对运动发育指标延迟提高警惕,尤其伴有头部姿势控制、手部抓握异常,协助ASD的早期诊断。
Abstract
Objective To analyze the early motor development of children with autism spectrum disorder (ASD),in order to provide clinical basis for early identification of ASD. Methods A 1∶1 case-control study was conducted.A total of 33 ASD children and 33 healthy children with the same sex and with age difference less than 1 month were included in the study from Yiwu Maternal and Child Health Hospital from January 2022 to September 2023.The motor quotient of Peabody Developmental Motor Scale and the risk factors of parenting were analyzed and compared. Results Gross motor quotient (GMQ),fine motor quotient (FMQ),total motion quotient (TMQ) of ASD group were significantly lower than those of control group (t=2.068,2.625,2.563, P<0.05).Specifically,the postural items score of the gross motor (t=3.882) and the grip items score of the fine motor (t=3.042) were significantly lower than the control group (P＜0.05),and there were no significant differences in other area criteria(P>0.05).The GMQ of ASD boys was significantly lower than ASD girls (t=2.219,P<0.05),there were no significant differences in FMQ and TMQ (P>0.05).There were 6 cases (18.18%) in ASD children and 2 cases (6.06%) in control group having parenting risk within 6 months old,but the difference was not statistically significant (P>0.05). Conclusion As ASD children have delayed gross and fine motor development in infancy,primary healthcare professionals should be alert to the delayed motor development indicators,especially with abnormal head posture control and hand grasping,so as to assist in the early diagnosis of ASD when they undertake the primary screening service.
关键词
Peabody运动发育量表 /
运动发育 /
孤独症谱系障碍 /
婴儿
Key words
Peabody Motor Development Scale /
motor development /
autism spectrum disorder /
infants
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基金
浙江省金华市科研计划项目(2022-4-348);浙江省医药卫生科技计划项目(2024XY080 )
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