目的 探讨孤独症谱系障碍(ASD)儿童长期屏幕使用现状及其与核心症状的相关性,以期帮助儿童建立正确的屏幕使用习惯。方法 选取深圳市龙岗区妇幼保健院2022年3—11月确诊的2~5岁136例ASD儿童。采用自制屏幕使用问卷对ASD的屏幕使用情况进行调查。另通过儿童孤独症评定量表(CARS)、孤独症儿童行为量表(ABC)、社交沟通量表(SCQ)、0~6岁儿童神经心理发育量表分别评估ASD儿童核心症状及认知方面的情况。结果 62.2%(74/119)ASD儿童看电视/智能手机或平板;79.8%(95/119)ASD的儿童2岁以前开始接触屏幕;46.2%(55/119)ASD儿童最初接触屏幕时间＞2h/d。组间对比结果显示,屏幕暴露组(屏幕时间＞2h/d)和非屏幕暴露组(屏幕时间＜2h/d)儿童CARS、交往(ABC)、SCQ总分、社交互动(SCQ)得分差异具有统计学意义(t=2.231、2.475、2.131、2.076,P＜0.05)。高危风险组(＜2岁屏幕使用时间＞2h/d)和非高危风险组儿童CARS总分、ABC总分、运动(ABC)、自我照顾能力(ABC)、社交互动(SCQ)得分差异具有统计学意义(t=3.021、2.621、2.828、2.847、2.050,P<0.05)。线性回归分析显示,屏幕暴露与CARS、交往(ABC)、SCQ总分、社交互动(SCQ)呈正相关(b=1.41、3.05、2.53、1.56,P＜0.05)。高危风险与CARS、ABC总分、社交互动(SCQ)呈正相关(b=1.53、6.17、1.27,P＜0.05)。结论 新型冠状病毒感染常态化期间,学龄前ASD儿童存在屏幕使用时间较长的情况。早期长时间屏幕使用可能与ASD核心症状有关。
Abstract
Objective To investigate the status quo of long-term screen use in children with autism spectrum disorder (ASD) and its correlation with core symptoms,in order to help children establish correct screen use habits. Methods A total of 136 ASD children aged 2 to 5 diagnosed from March 2022 to November 2022 were selected into this study from Longgang District Maternal and Child Health Hospital of Shenzhen City.Status of screen time in ASD children was investigated by a self-made questionnaire.The core symptoms and cognitive status ofASD children were evaluated by the Children′s Autism Rating Scale (CARS),Autistic Children′s Behavior Scale (ABC),Social Communication Scale (SCQ),and Neuropsychological Development Scale for children aged 0 - 6 years. Results Totally 62.2% (74/119) of ASD children watched TV/smartphone or tablet,79.8%(95/119)of ASD children began to use screens before the age of 2,46.2% (55/119) of ASD children had screen exposure >2h/d initially.There were significant differences in CARS score,interaction dimension score of ABC,SCQ total score and social interaction dimension score of SCQ between the screen exposure group (screen time >2h/d) and the non-screen exposure group (screen time <2h/d) (t=2.231,2.475,2.131,2.076,P<0.05).There were statistically significant differences in the scores of CARS,ABC total score,exercise dimension score of ABC,self-care ability dimension score of ABC and social interaction dimension score of SCQ of children in high-risk group (screen use time >2h/d in children <2 years old) and non-high-risk group (t=3.021,2.621,2.828,2.847,2.050,P<0.05).Linear regression analysis showed that screen exposure was positively correlated with CARS,interaction score of ABC,SCQ total score,and social interaction score of SCQ (b=1.41,3.05,2.53,1.56,P<0.05).High risk was positively correlated with CARS,ABC score and social interaction score of SCQ (b=1.53,6.17,1.27,P<0.05). Conclusions During the normalization of COVID-19,preschoolers with ASD have longer screen time.Early prolonged screen time may be associated with core symptoms of ASD.
关键词
孤独症谱系障碍 /
屏幕使用 /
核心症状 /
儿童
Key words
autism spectrum disorder /
screen use /
core symptom /
children
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Lord C,Brugha TS,Charman T,et al.Autism spectrum disorder[J].Nat Rev Dis Primers,2020,6(1):5.
[2] Council on Communications and Media.Media and young minds[J]. Pediatrics,2016,138(5),e20162591.
[3] Spandole-Dinu S,Catrina AM,Voinea OC,et al.Pilot study of the long-term effects of radiofrequency electromagnetic radiation exposure on the mouse brain[J].Int J Environ Res Public Health,2023,20(4):3025.
[4] Narayanan SN,Jetti R,Kesari KK,et al.Radiofrequency electromagnetic radiation-induced behavioral changes and their possible basis[J].EnvironSci Pollut Res Int,2019,26(30):30693-30710.
[5] Kushima M,Kojima R,Shinohara R,et al.Association between screen time exposure in children at 1 year of age and autism spectrum disorder at 3 years of age:The Japan environment and children′s study[J].JAMA Pediatr,2022,176(4):384-391.
[6] Madigan S,Browne D,Racine N,et al.Association between screen time and children′s performance on a developmental screening test[J].JAMA Pediatr,2019,173(3):244-250.
[7] Heffler KF,Sienko DM,Subedi K,et al.Association of early-life social and digital media experiences with development of autism spectrum disorder-like symptoms[J].JAMA Pediatr.2020,174(7):690-696.
[8] Takeuchi H,Taki Y,Hashizume H,et al.The impact of television viewing on brain structures:Cross-sectional and longitudinal analyses[J].Cerebral Cortex,2015,25(5):1188-1197.
[9] 杨玉凤,王慧珊,洪琦,等.儿童发育行为心理评定量表[M].北京:人民卫生出版社,2016:203-206.
Yang YF,Wang HS,Hong Q,et al.Developmental behavioral psychological Rating Scale for children [M].Beijing:People′s Medical Publishing House,2016:203-206.(in Chinese)
[10] 卢建平,杨志伟,舒明耀,等.儿童孤独症量表评定的信度、效度分析[J].中国现代医学杂志,2004,14(13):119-121,123.
Lu JP,Yang ZW,Shu MY,et al.Reliability and validity analysis of autism scale assessment in children[J].Chinese Journal of Modern Medicine,2004,14(13):119-121,123.(in Chinese)
[11] 刘静.孤独症谱系障碍的早期筛查和孤独症患儿临床资料研究[D].上海:复旦大学,2011.
Liu J.Early screening of autism spectrum disorder and clinical data of children with autism[D].Shanghai:Shanghai Fudan University,2011.(in Chinese)
[12] 李瑞莉.《中国儿童发育量表》(4~6岁部分)信度与效度研究[J].中国儿童保健杂志,2015,23(9):934-936.
Li RL.Psychometric analysis of the" China Developmental Scale for Children"(aged 4-6 years old)[J].Chin J Child Health Care,2015,23(9):934-936.(in Chinese)
[13] 金春华,李瑞莉,张丽丽,等.《中国儿童发育量表》修订及效度研究[J],中国儿童保健杂志,2014,22(12):1242-1246.
Jin CH,Li RL,Zhang LL,et al.The revision and accord-ing validity research of 《China Developmental Scale for Children》[J].Chin J Child Heal Care,2014,22(12),1242-1246.(in Chinese)
[14] Guram S,Heinz P.Media use in children:American academy of pediatrics recommendations 2016[J].Arch Dis Child Educ Pract Ed,2018 103:99-101.
[15] Dong HY,Feng JY,Wang B,et al.Screen time and autism:Current situation and risk factors for screen time among pre-school children with ASD[J].Front Psychiatry,2021,12:675902.
[16] 潘婉,江流,耿梦龙.学龄前儿童视屏时间及户外活动对情绪的影响[J].中华流行病学杂志,2019,40(12):1569-1572.
Pan W,Jiang L,Geng ML,et al.Correlation between screen-watching time and emotional problems as well as combination effect of outdoor time among preschool children[J].Chin J Epid,2019,40:1569-1572.(in Chinese)
[17] Chonchaiya W,Nuntnarumit P,Pruksananonda C.Comparison of television viewing between children with autism spectrum disorder and controls[J].Acta Paediatr,2011,100:1033-1037.
[18] Almeida ML,Garon-Carrier G,Cinar E,et al.Prospective associations between child screen time and parenting stress and later inattention symptoms in preschoolers during the COVID-19 pandemic[J].Front Psychol,2023,14:1053146.
[19] Hartshorne JK,Huang YT,Lucio Paredes PM.Screen time as an index of family distress[J].Curr Res Behav Sci,2021,2:100023.
[20] Pall ML.Science has not proven that screen use impacts children′s brain development[J].JAMA Pediatr,2020,174(8):804.
[21] Takemoto K,Iwanari H,Tada H,et al.Optical inactivation of synaptic AMPA receptors erases fear memory[J].Nat Biotechnol,2017,35(1):38-47.
[22] Hermawati D,Rahmadi FA,Sumekar TA,et al.Early electronic screen exposure and autistic-like symptoms[J].Intractable Rare Dis Res,2018,7(1):69-71.
[23] Dong HY,Wang B,Li HH,et al.Correlation between screen time and autistic symptoms as well as development quotients in children with autism spectrum disorder[J].Front Psychiatry,2021,12:619994.
[24] Kushima M,Kojima R,Shinohara R,et al.Association between screen time exposure in children at 1 year of age and autism spectrum disorder at 3 years of age:The Japan environment and children′s study[J].JAMA Pediatr,2022,176(4):384-391.
[25] Chonchaiya W,Nuntnarumit P,Pruksananonda C.Comparison of television viewing between children with autism spectrum disorder and controls[J].Acta Paediatr,2011,100:1033-1037.
[26] Horowitz-Kraus T,Hutton JS.Brain connectivity in children is increased by the time they spend reading books and decreased by the length of exposure to screen-based media[J].Acta Paediatr,2018,107(4):685-693.
[27] Hutton JS,Dudley J,Horowitz-Kraus T,et al.Associations between screen-based media use and brain white matter integrity in preschool-aged children[J].JAMA Pediatr,2020,174(1):e193869.
基金
深圳市龙岗区医疗卫生科技计划项目(LGWJ2023-76);深圳市龙岗区医疗卫生科技计划项目(LGWJ2023-75);深圳市龙岗区科技创新专项资金医疗卫生技术攻关项目(LGKCYLWS2023006);龙岗区医疗卫生科技计划项目[LGWJ 2021-(55)];龙岗区医学重点学科建设单位专项经费(2023)
PDF(674 KB)
