目的 比较孤独症谱系障碍(ASD)和发育性语言障碍 (DLD)儿童适应性、大运动、精细动作、语言、个人-社交能力发育水平的差异,为鉴别诊断和康复训练提供依据。方法 选取2022年3月—2024年5月在武汉儿童医院儿童保健科就诊的268例ASD儿童和150例DLD儿童,对以上儿童均采用Gesell发育量表进行评估。结果 ASD和DLD组儿童在适应性、大运动、精细运动、语言、个人-社交5个领域的均值均低于正常水平,两者均为语言和社交领域的分值最低,且ASD组上述5个领域的发育水平均明显滞后于DLD组(t'=8.541、4.398、7.194、6.405、9.354,P＜0.001);语言商%×社交商%＜0.39时,鉴别诊断ASD的敏感性和特异性分别为69%和65%(OR=0.96,95%CI:0.94～0.97,P＜0.001)。结论 ASD和DLD儿童在5个领域的发育水平上均有受损,ASD组各能区受损更重,且两者均以语言和社交领域受损最重,这些差异有助于临床鉴别诊断和早期干预。
Abstract
Objective To compare the differences in developmental levels of adaptive behavior, gross motor skills, fine motor skills, language, and personal-social abilities between children with autism spectrum disorder (ASD) and developmental language disorder (DLD), in order to provide a basis for differential diagnosis and rehabilitation training. Methods A total of 268 children with ASD and 150 children with DLD who visited the Child Health Department of Wuhan Children's Hospital from March 2022 to May 2024 were selected.All children were assessed using the Gesell Developmental Scale. Results The mean scores of children in both the ASD and DLD groups were below the normal level in the five domains of adaptive behavior, gross motor skills, fine motor skills, language, and personal-social abilities.Both groups scored the lowest in the language and social domains.The developmental levels in all domains were significantly more delayed in the ASD group compared to the DLD group (t'=8.541, 4.398, 7.194, 6.405, 9.354, P<0.001).When the product of language quotient (%) and social quotient (%) was less than 0.39, the sensitivity and specificity for diagnosing ASD were 69% and 65%, respectively (OR=0.96, 95% CI: 0.94-0.97, P<0.001). Conclusions Children with ASD and children with DLD both have impairments in the five developmental domains, with the ASD group showing more severe deficits.Both groups exhibit the most significant impairments in the language and social domains.These differences are helpful for clinical differential diagnosis and early intervention.
关键词
孤独症谱系障碍 /
发育性语言障碍 /
Gesell发育量表
Key words
autism spectrum disorder /
developmental language disorders /
Gesell Developmental Scale
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基金
深圳深爱公益“孤独症专项研究基金”(SA202300108)
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