孤独症、全面发育迟缓及发育性语言延迟儿童早期语言发育特征

目的分析孤独症谱系障碍(ASD)、全面发育迟缓(GDD)及发育性语言延迟(DLD)儿童的语言发育特征及差异,为早期识别与干预提供依据。方法选取2017年3月-2018年12月确诊的18~36月龄的ASD、GDD、DLD儿童为研究对象,其中ASD组155例、GDD组92例、DLD组162例。测试者与家长共同完成《早期语言发育进程量表》,评估3组儿童语言发育水平。结果1)ASD、GDD与DLD语音和语言表达差值(P75-A分)、听觉感受和理解差值(P75-B分)、与视觉相关的理解和表达差值(P75-C分)及全量表总分差值(P75-总分)中位数分别为:17、10、3、31;16、9、1、26;14、7、0、21。2)除GDD与DLD组女童P75-A分差异无统计学意义(H=5.503,P=0.057),不同性别间ASD与DLD、GDD与DLD的各部分差值比较,差异均有统计学意义(P<0.05)。3)不同性别间ASD和GDD组内四部分差值比较,差异均无统计学意义(P>0.05),而DLD组内P75-A分和P75-总分存在性别差异(Z=-2.117、-2.010,P<0.05)。结论语言发育受损程度由重到轻为ASD、GDD、DLD;在听觉感受和理解及与视觉相关的理解与表达能力上ASD和GDD较DLD落后;DLD组内女童语言发育比男童好。

Characteristics of early language development in children with autism spectrum disorder,global development delay and developmental language delay

Objective To analyze the characteristics and differences of language development in children with autism spectrum disorder (ASD),global developmental delay (GDD) and developmental language delay (DLD),in order to provide evidence for early identification and intervention. Methods ASD,GDD and DLD children at the age of 18 to 36 months and diagnosed from March 2017 to December 2018 were included,and divided into ASD group (n=155),GDD group (n=92) and DLD group (n=162). The subjects and their parents completed the Early Language Development Process Scale to evaluate the language development level of children. Results 1) The median scores of ASD,GDD and DLD in P₇₅-A (speech and language expression),P₇₅-B (auditory perception and comprehension),P₇₅-C (visual-related comprehension and expression) and P₇₅-total (total score) were 17,10,3,31;16,9,1,26;14,7,0,21 respectively. 2) There was no significant difference on P₇₅-A scores between girls in the GDD and DLD groups (H=5.503,P=0.057),but the difference between ASD and DLD,GDD and DLD were statistically significant both in boys and girls (P<0.05). 3) There was no gender difference on scores of the four parts between ASD and GDD group,but there was gender difference on P₇₅-A score and P₇₅-total score in DLD group (Z=-2.117-2.010,P<0.05). Conclusions The degree of language development impairment in the three groups ranging from severe to light is ASD,GDD,and DLD.The ability of auditory perception and comprehension and vision-related comprehension and expression of ASD and GDD group perform worse than DLD group; and the language development of girls in DLD group is better than that of boys.