注意缺陷多动障碍儿童的孤独症特征分析

Investigating the autistic traits in children with attention deficit hyperactivity disorder

目的探讨注意缺陷多动障碍（attentiondeficithyperactivitydisorder，ADHD）学龄儿童的孤独症症状和特征，以促进针对性的干预。方法应用社交反应量表（socialresponsivenessscale，SRS）中文版分别对62名6～12岁高功能孤独症谱系障碍（autismspectrumdisorder，ASD）、ADHD和正常儿童进行孤独症症状评估，ADHD组儿童同时进行ADHD核心症状评估。结果SRS五个维度及总分均为ASD组〉ADHD组〉正常组（P〈0．01）。ASD组、ADHD组和正常组SRS总分分别为[（92．43±19．17）分、（65．66±19．86）分和（38．40±10．68）分]，其中ADHD组SRS总分超出正常组2．55个标准差，并以“社交交流”（2．00个标准差）和“孤独症行为方式”（2．71个标准差）两个维度偏离最显著。62名ADHD儿童中有14名（占22．58％）SRS总分≥85，比例显著高于正常组儿童（P〈0．01）。SRS总分≥85的ADHD儿童（ADHD＋）和〈85的ADHD儿童（ADHD-）在“注意缺陷”、“多动-冲动”得分及ADHD核心症状总分的差异无统计学意义（P〉0．01）。结论ADHD儿童比正常儿童存在显著增多的ASD症状，部分ADHD儿童其孤独症症状评分达到或超过SRS的诊断切点。

Objective To investigate the autistic symptoms or autistic trait in the children with attention deficit hyperactivity disorder（ADHD） for facilitating the development of appropriate interventions. Methods Six- ty-two 6-12-year-old high-functioned autism spectrum disorder （ASD） ,ADHD and typically developing （TD） chil- dren were assessed respectively using Chinese-version social responsiveness scale （SRS） , and ADHD core symptoms were assessed in the ADHD children at the same time. Results ASD group〉ADHD group〉 TD group on the SRS total raw score and the five dimensions scores as well（P〈0.01 ）. ASD, ADHD and TD group scored respective- ly 92.43±19.17,65.66±19.86 and 38.40±10.68 on the SRS total scale. The SRS total raw score of ADHD group exceeded the TD group for 2.55 standard deviant （SD） and with ＂social communication＂ （2.00 SD） and ＂autistic mannerism＂ （2.71 SD） deviating the most. 22.58% （ 14 out of 62） children with ADHD scored above the threshold on the SRS total raw score which was significantly higher than that in the TD group（P〈0.01 ）. There were nonsignificant differences in the ADHD core symptoms between ADHD＋ children （with the SRS total raw score 〉t 85 ） and ADHD-children（with the SRS total raw score〈85） （P〉0.01）. Conclusion Children with ADHD appear more ASD symptoms than the TD children and a considerable proportion of them reach the SRS diagnostic cut-off point.