儿童孤独症谱系障碍的早期筛查

Early screening for child autism spectrum disorder

目的 分析2013~2015年儿童保健门诊确诊为孤独症谱系障碍（ASD）的6岁以下儿童的筛查量表及发育商,实现ASD患儿的早期诊断、早期干预。方法 对91例符合美国精神障碍诊断与统计手册第五版（DSM-Ⅴ）诊断标准的ASD儿童（ASD组）,及年龄、性别匹配的70例心理行为发育正常儿童（对照组）,运用DSM-Ⅴ、孤独症行为量表（ABC）、改良婴幼儿孤独症量表（M-CHAT）及Gesell发育量表对被试儿童进行临床评估。结果 M-CHAT阳性筛查结果与临床诊断标准一致性较好,差异无统计学意义（P〉0.1）。ASD组适应性、精细动作、大运动、语言、个人-社交5个能区的发育商较对照组降低,差异有统计学意义（P〈0.001）。ASD组1~3岁与3~6岁比较,随年龄增长,语言、个人-社交发育商差异无统计学意义（P〉0.05）。结论 ASD患儿社会沟通、社会交往能力缺陷,行为发育偏离,使用临床量表早期筛查,辅助ASD的临床诊断,实现早期干预,可改善预后,促进患儿早期回归社会。

Objective By analyzing clinical scale results of younger than 6 years old children with autism spectrum disorder （ ASD） from 2013~2015 in our child health clinic ,we tried to achieve early diagnosis and intervention for these children .Methods We compared 91 children with ASD （ ASD group ） who were accorded with the diagnostic criteria of American Mental Disorder Diagno-sis and Statistic Manuel （ DSM-Ⅴ,the 5th edition） with 70 age-and sex-matching children whose mental and behavioral development were normal （ control group ） .We applied DSM-Ⅴ,ABC,M-CHAT and GESELL scales to evaluate these children .Results M-CHAT positive screen results better agreed with the clinical diagnostic criteria （ P 〉0.1 ） when compared to ABC scale .The developmental quotient in the ASD group in five zones such as adaptability , big campaigns , sophisticated campaign , language and social interaction were lower than those in the normal control group （ P〈0.001 ） .In the ASD group ,there were no differences in language and personal-social development quotient when compared the children between 1~3 years old and 3~6 years old （ P〉0.05 ） .Conclusion Chil-dren with ASD have a defect in social communication and development deviation .Using clinical scale to screening could assist early di-agnosis,early intervention and improve prognosis to promote children return to the society early .