孤独症谱系障碍与发育性语言障碍2~3岁儿童Gesell测评结果分析

目的 分析2~3岁儿童孤独症谱系障碍(ASD)与发育性语言障碍(DLD)的Gesell发育特征,为早期诊断和干预提供依据。方法 回顾性分析2020年3月—2021年3月,明确诊断为ASD(n=78)、DLD(n=80)的2~3岁儿童,通过Gesell婴幼儿发育量表对每个儿童进行发育水平测评,并对两组儿童5个能区发育水平分布情况进行统计,分析ASD、DLD儿童的Gesell发育特征。结果 1)ASD组儿童平均发育商得分均低于DLD组儿童。除大运动能区外,ASD组儿童适应性、精细运动、语言、个人-社交能区间发育水平均低于DLD组,差异有统计学意义(t=16.043、6.208、14.219、10.811,P＜0.001)。2)语言、个人-社交发育比较:ASD组儿童的语言发育水平以重度、中度障碍为主(48.72%、33.33%),DLD组儿童的语言发育水平以轻度障碍为主(77.5%)。ASD组儿童50%的个人-社交分布在轻度障碍区域,无1例正常;DLD组儿童的个人-社交发育商68.75%分布在轻度障碍区域,30%处于正常或边缘水平。结论 除大运动能区外,ASD儿童其余能区平均发育水平均低于DLD儿童。熟悉ASD、DLD儿童的Gesell发育特征,对ASD、DLD儿童的早期识别、康复及教育计划的制定和预后具有重要的意义。

Results of Gesell Developmental Scale of 2- to 3- year-old children with autism spectrum disorder or developmental language disorder

Objective To compare the developmental characteristics of 2- to 3- year-old children with autism spectrum disorder(ASD) or developmental language disorder(DLD) by Gesell Developmental Scale(GDS),in order to provide evidence for early diagnosis and intervention. Method From March 2020 to March 2021,children with ASD(n=78) and DLD(n=80) were evaluated by GDS,their development characteristics were analyzed and compared retrospectively. Results 1) The average developmental quotient(DQ) of ASD children was lower than that of DLD children. Except for the gross motor,the DQs of adaptability,fine motor,language and personal-social in ASD children were significantly lower than those of DLD group(t=16.043,6.208,14.219,10.811,P<0.001). 2) The language development of ASD children was predominantly severely and moderately impaired(48.72%,33.33%),while the language development of DLD children was most mildly impaired(77.5%). Fifty percent of ASD children had a mild impairment in personal-social area and no one case was normal. However,68.75% of DLD children had a mild impairment in personal-social area,and 30% of personal-social DQ was at normal or borderline level. Conclusions Except for the gross motor energy area,the average DQs of other developmental areas in ASD children are lower than those in DLD children. Familiarity with the Gesell developmental characteristics of ASD children and DLD children is helpful for the early identification,rehabilitation and education plan development as well as the prognosis of children with ASD and DLD.