汕头市中心城区3～6岁儿童孤独症患病与功能障碍状况调查

Prevalence of autism and dysfunctions in autistic children aged 3 to 6 years in Shantou City

目的了解汕头市中心城区3～6岁儿童孤独症患病现状和功能障碍情况。方法依托汕头市残联登记在册的共11所康复机构，确定2007年1月1日-2010年12月31日出生且常住金平、龙湖两中心城区的孤独症儿童，结合市人口计划生育局统计的2013年7月1日两区3—6岁常住儿童人口数估计患病率。各康复机构采用中国残联编制的《孤独症儿童发展评估表》在入学时对孤独症儿童语言沟通、社会交往等8方面功能进行了评估，比较不同性别、不同年龄孤独症患病率。结果孤独症患病率为2．67‰，男童患病率（4．07‰）高于女童（1．14‰），最高为4岁男童患病率（6．54‰）。孤独症儿童常见功能障碍依次为语言沟通障碍（95．4％）、社会交往（93．1％）、认知（87．7％）、生活自理（84．6％）、感知觉（83．1％）、情绪与行为（75．3％）、精细动作（72．3％）和粗大动作障碍（68．4％）。结论除语言沟通和社会交往障碍外，绝大部分孤独症患儿还同时有多项其他功能障碍。利用已有资料获得的汕头市中心城区3～6岁儿童孤独症患病率与我国其他类似地区基于社区的抽样调查结果基本一致，提示在康复训练体系较完善地区，重视已有资料的整理和分析可为相关部门规划资源提供依据。

Objective To estimate the prevalence of autism and to characterize dysfunctions in autistic children aged 3 to 6 years in Shantou central city. Methods We included autistic children born between January 1, 2007 and December 31, 2010, who lived in Jinping and Dragon Lake District of Shantou and were institutionalized in 11 rehabilitation facilities registered at the Disabled Federation in Shantou. Demographic data for children aged 3-6 years on July 1, 2013 were used to estimate the prevalence. All cases had received comprehensive assessment on verbal communication ability assessment, social interaction ability assessment and other six aspects. Two researchers rated 5 to 1 points to each aspect based on the assessment information, Less than or equal to 3 points was identified as dysfunction. Results 139 children have been diagnosed with autism in 51 968 children aged 3 to 6 years old. Overall, the prevalence was 2.67 per 1 000. The prevalence of boys and girls were 4.07 per 1 000 and 1.14 per 1 000, respectively. The highest prevalence was 6.54 per 1 000 in 4 year-old boys. Main dysfunctions of autistic children included language communication （95. 4% ）, social interaction （ 93. 1% ）, cognition （ 87. 7% ）, self-care ability （ 84. 6% ）, sense of perception （83. 1% ）, mood and behavior （75.3%）, fine motor （72.3%）, and gross motor （68.4%）. Conclusion Besides dysfunctions of language communication and social interaction, most autistic children have two or more other dysfunctions. The prevalence of autism in Shantou shows no difference with published data obtained through community sample survey in other areas, suggesting that secondhand data collation and analysis in cities with good autistic rehabilitation training system is a cheap, quick and reliable method to estimate autism prevalence.