孤独症与语言发育迟缓儿童在年龄与发育进程问卷中的表现特征及差异

目的 了解孤独症谱系障碍(ASD)与语言发育迟缓 (LR)儿童在中文版年龄与发育进程问卷(ASQ)中的表现特征及其差异,为孤独症的早期筛查与鉴别提供指导。方法 以2016年9月-2017年2月就诊于佛山市妇幼保健院与广东省妇幼保健院儿童心理门诊并确诊为ASD和LR的16~30月龄儿童为研究对象,其中ASD儿童44例,LR儿童25例。研究人员与家长共同完成ASQ-3与ASQ-SE,筛查评估两组儿童在沟通、粗大动作、精细动作、解决问题、个人-社会、社交-情绪等能区的发展水平。结果 ASD儿童在ASQ-3五大能区及ASQ-SE中的筛查不通过率均高于LR,其中大动作、精细动作、个人-社会能区的差异有统计学意义(P<0.05)。调整性别、年龄等混杂因素后,ASD组在大动作(OR=2.52,95%CI:1.24~5.11)和个人-社会(OR=2.15,95%CI:1.18~3.94)能区的表现仍较LR组更差。结论 16~30月龄的ASD儿童,其大动作和个人-社会能区的发育比LR儿童更差。当存在语言发育迟缓的儿童在ASQ-3筛查中合并有大动作和个人-社会能区发育落后时,建议对其进行特异性的孤独症筛查与诊断评估。

Features and differences on the performance of children with autism and language retardation tested by Ages and Stages Questionnaires

Objective To compare different screening results of Chinese version of the Ages and Stages Questionnaires (ASQ) between children with autism spectrum disorder (ASD) and language retardation (LR),and to provide guidance for early screening and indentification of autism. Methods A total of 44 ASD and 25 LR children aged 16～30 months with the help of researchers and parents were enrolled to finish the screening of Ages and Stages Questionnaires-Third Edition (ASQ-3) and Ages and Stages Questionnaires:Social-Emotional (ASQ-SE).The 5 domains of ASQ-3 including communication (C),gross motor (GM),fine motor (FM),solving problem (SP),personal-social (PS) and the results of ASQ-SE between two groups were compared. Results Compared with LR group,ASD group had higher proportions of failing GM,FM and PS domains (all P<0.05).Adjusted for age and sex,the performance of ASD group in GM (OR=2.52,95%CI:1.24~5.11) and PS (OR=2.15,95%CI:1.18~3.94) domain were worse than those of LR group. Conclusion Children with ASD aged 16~30 months show poorer development in gross motor and personal-social area than those in children with LR.LR children with gross motor and personal-social development delay in the screening of ASQ should be evaluated for autism.