孤独症谱系障碍儿童运动功能与核心症状的关联  

Association between motor coordination and core symptoms in children with autism spectrum disorder

作　　者：金诚开 曹牧青 顾廷锋 李秀红[1] 静进[1] JIN Chengkai;CAO Muqing;GU Tingfeng;LI Xiuhong;JING Jin(Department of Maternal and Child Health,School of Public Health,Sun Yat-sen University,Guangzhou(510080),China)

机构地区：[1]中山大学公共卫生学院妇幼卫生系,广东广州510080

出　　处：《中国学校卫生》2023年第2期176-180,185,共6页Chinese Journal of School Health

基　　金：广州市残疾人联合会项目(K19-51000-052);广东省自然科学基金面上项目(2022A1515011224);国家社会科学基金重大项目(20&ZD296)。

摘　　要：目的了解孤独症谱系障碍(ASD)儿童运动功能和社交沟通障碍、重复刻板行为之间的关系,为ASD儿童的诊断和干预提供参考依据。方法在广州市孤独症儿童精准康复服务定点康复机构招募2~12岁ASD儿童123例,其中男童105例,女童18例。采用儿童发育性运动协调障碍问卷、社交沟通量表、重复刻板行为检查表分别评估儿童的运动功能、社交沟通能力和重复刻板行为,通过多重线性回归分析ASD儿童运动功能和核心症状的关系。结果2~5岁儿童中,非运动功能缺陷者社交互动领域(7.73±4.00)得分低于运动功能缺陷者(9.76±2.90)(Z=-2.29,P<0.05);6~12岁儿童中,非运动功能缺陷者的重复及刻板的行为模式领域(4.22±1.93)、重复感觉运动型(3.91±2.63)、坚持一致型(13.52±10.59)得分低于运动功能缺陷者(6.11±1.54,14.00±8.49,31.33±15.05)(Z值分别为-2.48,-3.83,-3.28,P值均<0.01)。多重线性回归分析显示,2~5和6~12岁ASD儿童的精细运动/书写能力和运动中的控制能力分别与社交沟通障碍、重复刻板行为严重程度均呈负相关(β=-0.85~-0.03,-2.98~-0.17,P值均<0.05)。结论ASD儿童运动功能缺陷者核心症状更严重。应将运动评估纳入ASD筛查、诊断和管理中,并积极促进运动干预在康复过程中的应用,以期改善其预后和生活质量。Objective To study the relationship between motor coordination,social communication impairment,and restricted/repetitive behaviors(RRBs)in children with autism spectrum disorder(ASD).Methods A total of 123 ASD children aged 2-12 were recruited from rehabilitation service institutions for autistic children in Guangzhou,including 105 boys and 18 girls.The Developmental Coordination Disorder Questionnaire,Social Communication Questionnaire,and Restrictive Behavior Scale-Revised were collected to measure motor coordination,social communication skills and RRBs,respectively.Multiple linear regression was used to explore the association between motor coordination and core symptoms.Results In children aged 2-5 years old,those without motor coordination deficits scored lower in social interaction(7.73±4.00)than others(9.76±2.90)(Z=-2.29,P<0.05).In children aged 6-12 years old,those without motor coordination deficits scored lower in restricted,repetitive,and stereotyped patterns of behavior(4.22±1.93),repetitive sensory-motor behaviors(3.91±2.63),and insistence on sameness(13.52±10.59)than those with motor coordination deficits(6.11±1.54,14.00±8.49,31.33±15.05)(Z=-2.48,-3.83,-3.28,P<0.01).Multiple linear regression analysis showed that fine motor/handwriting and control during movement were negatively correlated with the severity of social communication impairment and RRBs respectively among children aged 2-5 and 6-12(β=-0.85--0.03,-2.98--0.17,P<0.05).Conclusion Among autistic children,those with motor deficits suffered from more severe core symptoms.Motor assessment should be included in the ASD screening,diagnosis and management.Motor intervention should also be promoted in the rehabilitation in order to improve the prognosis and life quality.

关 键 词：孤独性障碍 运动活动 交流障碍 刻板行为 回归分析 儿童 

分 类 号：R748[医药卫生—神经病学与精神病学] R179[医药卫生—临床医学] G804.49[文化科学—运动人体科学]