目的 分析不同性别、不同年龄孤独症谱系障碍(ASD)儿童发育水平与症状严重程度差异,以及症状严重程度与发育水平的相关性,为ASD的早期识别、诊断及干预提供理论依据。方法 选取2020年1月—2024年7月就诊于北京市朝阳区妇幼保健院发育行为门诊,初诊且首次诊断为ASD的236例18～72月龄患儿为研究对象,采用Gesell发育诊断量表评估患儿的发育水平,采用儿童孤独症评定量表(CARS)评估患儿症状的严重程度。比较不同性别和不同年龄组间患儿的发育水平和症状严重程度差异,并分析症状严重程度与发育水平的相关性。结果 不同性别ASD患儿的适应性、精细动作、语言、个人-社交发育商和CARS总分比较,差异无统计学意义(P＞0.05),女童大运动发育商显著高于男童(Z=2.059,P＜0.05)。 不同年龄段儿童适应性(H=18.108)、大运动(H=68.413)、精细动作(H=26.194)、个人-社交(H=44.728)发育商差异有统计学意义(P＜0.001),大运动、精细动作和个人-社交发育商均表现为＜2岁组最高,≥3岁组最低。男童和女童仅大运动的发育等级分布差异有统计学意义(χ2=11.539,P<0.01),且男童大运动发育迟缓率高于女童。不同年龄段儿童适应性(χ2=23.206)、大运动(χ2=74.583)、精细动作(χ2=41.321)、个人-社交(χ2=44.560)的发育等级分布差异有统计学意义(P＜0.001),均表现为≥3岁组发育迟缓率最高。CARS总分与适应性、大运动、精细动作、语言和个人-社交发育商均呈显著负相关(r=-0.341、-0.266、-0.336、-0.331、-0.399,P＜0.001)。结论 ASD儿童发育水平和症状严重程度无显著性别差异。ASD儿童年龄越大、症状越严重,发育水平越低。对ASD儿童进行干预时,应以发育评估结果及症状表现为基础,制定个体化的教育方案。
Abstract
Objective To examine gender- and age-related differences in developmental levels and symptom severity among children with autism spectrum disorder (ASD), and to analyze the correlation between symptom severity and developmental levels, in order to provide theoretical support for early ASD identification, diagnosis, and intervention. Methods A total of 236 children aged 18 - 72 months who were newly diagnosed with ASD at the Developmental-Behavioral Clinic of Beijing Chaoyang Maternal and Child Health Hospital were enrolled in this study between January 2020 and July 2024.Developmental quotients (DQs) were assessed using the Gesell Developmental Schedules, while symptom severity was evaluated with the Childhood Autism Rating Scale (CARS).Comparative analysis of developmental levels and symptom severity across genders and age groups were conducted, along with correlation analyses between symptom severity and developmental levels. Results No significant gender differences were observed in adaptive, fine motor, language, or personal-social DQs, nor in total CARS scores (P>0.05).However, girls demonstrated significantly higher gross motor DQs than boys (Z=2.059, P<0.05).Significant age-related differences were found in adaptability (H=18.108), gross motor (H=68.413), fine motor (H=26.194), and personal-social (H=44.728) DQs (P<0.001), with the <2-year-old group showing the highest scores and the ≥3-year-old group the lowest.The distribution of gross motor developmental level across genders showed significant variation (χ2＝11.539, P<0.01), and boys demonstrated significantly higher rate of gross motor developmental delay than girls. Age-stratified analyses revealed statistically significant differences in adaptive (χ2=23.206), gross motor (χ2=74.583), fine motor (χ2=41.321), and personal-social (χ2=44.560) development levels (P<0.001), with the ≥3-year-old group exhibiting the highest developmental delay rates.CARS scores showed significantly negative correlations with all developmental domains (adaptive: r=-0.341, gross motor: r=-0.266, fine motor: r=-0.336, language: r=-0.331, personal-social: r=-0.399, P<0.001). Conclusions ASD children show no marked gender differences in developmental levels or symptom severity.However, older age and greater symptom severity are associated with lower developmental levels.ASD intervention programs should be individualized based on comprehensive developmental assessments and symptom.
关键词
孤独症谱系障碍 /
性别 /
年龄 /
发育水平 /
儿童
Key words
autism spectrum disorder /
gender /
age /
development level /
children
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