目的 随访早期疑诊孤独症谱系障碍(ASD)儿童在学龄前期的诊断结局,并分析相关发育特征,为早期确诊提供依据。方法 选取2017年6月—2022年8月因语言问题就诊并疑诊ASD(n=95)与发育性语言障碍(DLD)(n=76)的幼儿,随访至4岁,初诊时用 Gesell 婴幼儿发育量表评估适应性、精细运动、大运动、言语和个人社交发育商(DQ),采用SPSS 26.0软件分析早期发育特征及语言、社交能力转归情况。结果 1)95例早期疑诊为ASD的儿童,4岁确诊为ASD 57例(60%),DLD 18例(18.95%),全面发育迟缓4例(4.21%),典型发育12例(12.63%),其他4例(4.21%);2)疑诊ASD组儿童,婴幼儿期 言语中度迟缓;非语言发育方面个人社交、适应性轻度迟缓,精细运动、大运动处于边缘状态。3)复诊时确诊为ASD儿童言语DQ的提高值较个人社交明显(t=-2.11,P＜0.05),而复诊DLD儿童言语、个人社交DQ的提高值之间差异无统计学意义(t=-0.862,P＞0.05)。结论 幼儿期疑诊ASD儿童,复诊时60%明确诊断为ASD,诊断稳定性较高;疑诊ASD的儿童,婴幼儿期语言能力落后明显,大运动及精细运动无明显落后;学龄前期ASD儿童语言与个人社交能力发展轨迹不同,语言能力提高明显,个人社交能力有持续的落后,而DLD儿童的语言与社交能力平行发展。
Abstract
Objective To follow up the diagnostic outcomes of children with early suspected autism spectrum disorder (ASD) during the preschool period, and to analyze their related developmental characteristics, so as to provide a basis for early diagnosis of ASD. Methods Children who visited the hospital due to language problems and were suspected of having ASD (n=95) or developmental language disorder (DLD) (n=76) between June 2017 and August 2022 were followed up until they were 4 years old. At the initial diagnosis, the Gesell Developmental Scales for infants and young children were used to assess developmental quotient of adaptability, fine motor, gross motor, language, and personal-social dimension. SPSS 26.0 software was used to analyze early developmental characteristics and outcomes in language and social skills. Results 1) Among the 95 children initially suspected of having ASD, 57 (60%) were confirmed to have ASD at age 4, 18 (18.95%) had DLD, 4 (4.21%) had global developmental delay, 12 (12.63%) were typically developed, and 4 (4.21%) had other diagnosis. 2) In the suspected ASD group, there was moderate delay in DQ of language during infancy, mild delays in DQ of personal-social and adaptability for non-verbal development, and borderline DQ of fine motor and gross motor skills. 3) At the follow-up visit, children diagnosed with ASD showed significantly greater improvement in DQ of language compared to DQ of personal-social (t=-2.11, P<0.05), while no significant difference was observed between the improvement in DQ of language and DQ of personal-social dimension among children diagnosed with DLD (t=-0.862, P>0.05). Conclusions Among children suspected of having ASD during infancy, 60% are definitively diagnosed with ASD at the follow-up, indicating high diagnostic stability. Children suspected of having ASD exhibit significant delays in language abilities during infancy, with no significant delays in gross motor or fine motor skills. In preschool children with ASD, the trajectories of language and personal-social skill development differ, with notable improvements in language abilities but persistent delays in personal-social skills, whereas children with DLD show parallel development in both language and personal-social skills.
关键词
孤独症谱系障碍 /
发育性语言障碍 /
发育特征
Key words
autism spectrum disorder /
developmental language disorder /
developmental characteristics
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