不同年龄孤独症谱系障碍儿童认知功能与行为特征的性别差异

Sex differences in cognitive and behavioral characteristics in children with autism spectrum disorder indifferent age

目的 探讨不同年龄孤独症谱系障碍（autism spectrum disorder,ASD）儿童认知功能与行为特征的性别差异.方法 选取2013年6月至2015年6月确诊ASD儿童621例,其中男童503例,女童118例.采用心理教育评估第3版（PEP-3）副测验原积分评估ASD儿童认知功能与行为特征.根据年龄分成两组：＜4岁组和≥4岁组.分析不同年龄组ASD儿童认知功能、行为特征的男女性别差异.结果 ＜4岁组女童行为特征-非语言（CMB）、行为特征-语言（CVB）原积分与男童差异无统计学意义（均P＞0.05）;而≥4岁组女童CMB、CVB原积分较同组男童低[（21.56±7.33）分vs（24.09±4.80）分、（9.79±7.05）分抛（13.27±5.75）分],差异具有统计学意义（均P＜0.05）.～4Y组、～5Y组、～6Y组ASD女童认知（CVP）原积分均明显低于同组男童（均P＜0.05）,社会互动（SR）、CMB、CVB原积分亦明显低于同组男童（均P＜0.05）;而～3Y组、～7Y组ASD女童CVP、SR、CMB、CVB原积分与男童差异均无统计学意义（均P＞0.05）.结论 低年龄阶段ASD女童语言和非言语相关的特征性行为不明显,易于造成临床早期辨识困难.在3～5岁发育关键期,ASD女童认知能力发展落后于男童,同时合并更为严重的社交障碍和特征性行为,提示ASD儿童行为特征与认知发展密切相关.

Objective To explore sex differences in cognitive and behavioral characteristics in children with autism spectrum disorder （ASD） in different age.Methods The study involved 621 children（503 boys,118 girls） diagnosed with ASD from June 2013 to June 2015.Using raw scores to examine cognitive and behavioral characteristics in children with ASD based on the Psycho-Educational Profile-3rd Edition （PEP-3）.The subjects were divided into two groups according age：〈4Y group and ≥ 4Y group.The sex differences of cognitive and behavioral characteristics were analyzed in different age groups.Results No sex differences were found in characteristic motor behaviors （CMB） and characteristic verbal behaviors （CVB） raw scores in 〈4Y group（P〉0.05）,while girls with ASD had lower raw scores on CMB and CVB raw scores in 〉4Y group（（21.56±7.33） vs （24.09±4.80）,（9.79±7.05） vs （13.27±5.75） ; P〈0.05））.Girls with ASD had lower raw scores on cognitive verbal/preverbal （CVP）,CMB and CVB in ～ 4Y,～5Y,and ～6Y group （P〈0.05）.However,there was no sex difference on CVP,CMB and CVB in ～ 3Y and ～ 7Y group （P〉0.05）.Conclusions Characteristic verbal and motor behaviors may not be obvious in girls with ASD in early childhood,which may increase the difficulties of early clinical identification.The development of cognitive ability in girls with ASD is far behind that in boys in the crucial 3-5 years old,as well as social reciprocity and characteristic behaviors.It suggests that the behavior characteristics are closely related to cognitive development.