孤独症谱系障碍和语言发育迟缓儿童早期语言发育特征及随访研究  

Early Developmental Characteristics and Follow-up Study of Children with Autism Spectrum Disorder and Language Development Delay

作　　者：高峰 刘金珍 徐雁 王雪云 黄亦明 GAO Feng;LIU Jinzhen;XU Yan;WANG Xueyun;HUANG Yiming(Maternal and Child Health Hospital of Jiang'an District,Wuhan,430010,China)

机构地区：[1]武汉市江岸区妇幼保健院,湖北武汉430010

出　　处：《中国社会医学杂志》2024年第2期191-194,共4页Chinese Journal of Social Medicine

基　　金：武汉市卫生计生委科研项目(WG16A01)。

摘　　要：目的探讨孤独症谱系障碍(autism spectrum disorder,ASD)和语言发育迟缓(language developmental delay,LDD)儿童的早期语言发育特征,以期对儿童语言发育进程中出现的异常信号早期识别,为疾病识别和诊断提供科学依据。方法采用队列研究的研究方法,选取2016年8月-2017年12月在武汉市江岸区妇幼保健院儿童保健科就诊儿童,以家长主诉语言发育落后并确诊为ASD和LDD的儿童为暴露组,以同期参加常规体检正常的儿童为非暴露组。采用Gesell发育诊断量表(Gesell Developmental Schedule,GDS)对儿童进行发育评估和语言商的评估。在两年后对暴露组和非暴露组儿童进行追踪随访。结果最终纳入LDD组112例,ASD组48例,正常儿童组115例。入组时,LDD组的语言能平均分数低于正常值,大运动、精细运动、应物能和应人能的平均得分均大于正常值;ASD组存在多个能区的发育异常,除了大运动的平均分数正常,精细运动、应物能、语言能和应人能的平均得分均低于正常,且发育异常的比例较高,分别为70.83%、77.08%、95.83%和93.75%。两年后,33.93%的LDD儿童在语言能实现了追赶,但仍有66.07%的LDD儿童表现出持续的语言困难;ASD组儿童语言能改变的差异无统计学意义(P>0.05)。结论LDD和ASD儿童在早期均表现出语言发育落后,识别两组儿童的早期语言发育特征,尽早发现患儿,定期进行儿童语言发育随访,采取有效的干预措施十分必要。Objective To explore the characteristics of early language development of children with autism spectrum disorder(ASD)and language development delay(LDD),and to identify the abnormal signals in the process of children's language development at an early stage,so as to provide scientific basis for disease identification and diagnosis.Methods We adopted a cohort research method,and selected children who attended the Child Health Department of Wuhan Jiang'an District Maternal and Child Health Hospital from August 2016 to December 2017.Children whose parents complained of delayed language development and were diagnosed with ASD and LDD were in the exposed group,while normal children who participated in the routine physical examination during the same period were in the non-exposed group.The Gesell Developmental Diagnostic Scale(GDS)was used to evaluate children's development and language quotient.After 2 years,the children in the exposure group and the non-exposed group were fo-llowed up.Results Finally,112 cases were included in the LDD group,48 cases in the ASD group and 115 cases in the TD group.At the time of enrollment,the average DQ of GDS language energy in the LDD group was lower than normal,and the average DQ of gross motor,fine motor,physical energy and human energy was higher than normal;there were developmental abnormalities in multiple energy areas in the ASD group,except for large motor.The average DQ of fine motor,physical ability,language ability and human ability were all lower than normal,and the proportion of abnormal development was 70.83%,77.08%,95.83%and 93.75%,respectively.Two years later,33.93%of LDD children achieved catch-up,but 66.07%of LDD children still showed persistent language difficulties;there was no significant difference in the language ability of children in the ASD group(P>0.05).Conclusion This study found that both LDD and ASD children showed delay in early language development.It is necessary to identify the early language development characteristics of the two groups of children

关 键 词：孤独症谱系障碍 语言发育迟缓 语言发育特征 儿童 追踪随访 

分 类 号：R749.94[医药卫生—神经病学与精神病学]