学龄前孤独症谱系障碍儿童诊疗相关问题及母亲心理健康状况的调查  

Diagnosis and treatment related problems of autism spectrum disorders in preschool children and the mental health states of their monthers

作　　者：孟群[1] 范杏红 黄肇华[1] 张菊玲[1] 管建粉[1] 申波[1] 

机构地区：[1]九江市妇幼保健院九江市儿童医院儿童发育行为专科,江西九江332000

出　　处：《中国儿童保健杂志》2016年第3期289-291,共3页Chinese Journal of Child Health Care

基　　金：九江市科技支撑项目[九财教(2013)64号]

摘　　要：目的了解本地区学龄前孤独症谱系障碍（ASD）儿童诊疗中相关问题及母亲心理健康状况的特征,分析不同年龄段的差异,为开展进一步工作提供部分参考。方法对诊断明确的235例学龄前ASD儿童按年龄段分为18~36月龄组（组1）98例,37~72月龄组（组2）137例,分别采用自拟调查问卷对两组儿童诊疗中相关问题进行调查,并使用症状自评量表（SCL-90）对其母亲进行心理健康的评定。结果比较首诊主诉症状,两组ASD儿童家长均关注语言问题或以语言落后为主诉就诊,组2较组1更多关注到社会交往障碍及行为异常（P〈0.05）;两组家长均把＂语言进步＂作为治疗首目标,其次为行为改善（包括会理人、看人、刻板动作减少、听话好带等）（P〉0.05）;其它诸如：家庭如何开展训练、是否能上幼儿园及上学、病因及生第二胎患病几率、训练费用、是否成为特才、训练时间长短等,比较差异部分有统计学意义（P〈0.05）;两组儿童家长的SCL-90总分差异无统计学意义（P〉0.05）,均高于文献中正常健康儿童父母的SCL-90得分（P〈0.05）;各因子分中抑郁和焦虑因子得分组2高于组1（P〈0.05）。结论语言障碍或进步仍然是本地区学龄前期ASD儿童家长在诊疗中关注的首问题,不同年龄段的ASD儿童诊疗及母亲心理健康状况存在差异。Objective To explore the related problems of diagnosis and treatment of preschool children with autism spectrum disorders（ASD）and the mental health states of their mothers,to analysis the differences in different ages and to provide some references for future work. Methods A total of 235 cases diagnosed with ASD were divided into two groups：98cases aged 18 ~ 36months（group 1）,and 137 cases aged 37 ~ 72months（group 2）.A self-designed general questionnaire was used to collect the clinic demand in the two groups,and the Symptom Check-List 90（SCL-90）was used to evaluate the mental health of the mothers. Results Delay or absence of spoken language was the most concern for parents in both groups,and parents in group 2paid more attention on social communication abnormal behaviors.Both parents in two groups regarded ＂language progress＂ as primary goal,followed by behavior modification（including eye contact people,to reduce restricted/repetitive behaviors,easier to take,etc.）（P0.05）.In addition,parents in group 1were more worried on whether children could go to kindergarten or school,etiology,and the risk of having a second child than the parents in group1（P0.05）,and the other aspects of concern had no statistical difference.The SCL-90 total scores in the parents of two groups were significantly higher than other parents with healthy children（P0.05）,and the positive number,the factor score of obsessive-compulsive symptoms,depression and anxietywere significantly higher in parents of group 2were higher than those in group 1（P0.05）. Conclusion In this region,the delay of spoken language is still the most concern for parents of preschool children with ASD,and there are differences in the related problems of diagnosis and treatment of preschool children with ASD in different age and also in the mental health states of their mothers.

关 键 词：学龄前 孤独症谱系障碍 诊疗相关问题 母亲 心理健康 

分 类 号：R179[医药卫生—妇幼卫生保健]