中山市学龄前儿童孤独症谱系障碍及其影响因素调查

A survey of autism spectrum disorder and its influencing factors among preschool children in Zhongshan City

目的调查中山市学龄前儿童孤独症谱系障碍(ASD)筛查阳性率及其影响因素。方法 2010年10月分层整群抽取中山市幼儿园在读儿童,由家长填写克氏孤独症行为量表(CABRS)、自编一般人口学资料问卷以及家庭环境量表中文版(FESCV),通过单因素分析及Logistic回归分析ASD筛查异常的影响因素。结果有11个镇区66所幼儿园儿童参与了调查,共发放问卷10 399份,收回有效问卷10 087份,问卷有效率为97.0%,ASD筛查阳性率为10.2‰。性别(男OR=0.322,P=0.000)、父亲文化程度(低文化程度)、母亲与孩子相处时间(每周少于4小时)、家庭主要管教方式(溺爱型OR=0.364,P=0.001)、母亲孕期营养(营养不良)是儿童患ASD的危险因素;而性别(女)、父亲文化程度(高文化程度OR=2.601~3.259,P=0.005~0.032)、母亲与孩子相处时间(每周多于7小时OR=3.081,P=0.004)、家庭主要管教方式(民主型)、母亲孕期营养(营养好OR=4.960~5.519,P=0.000~0.001)、家庭高亲密度(OR=1.218,P=0.000)、家庭高娱乐性(OR=1.144,P=0.006)是儿童患ASD的保护因素。结论本地区学龄前儿童ASD筛查阳性率为国内低限值;为防治ASD,需要注重保障母亲妊娠期间营养、增多母亲与孩子相处时间、家庭采取民主型管教方式、增强家庭的亲密度和娱乐性。

Objective To investigate the screening positive rate and influencing factors of autism spectrum disorder（ASD）in preschool children in Zhongshan City.Methods Stratified cluster sampling was used to select kindergarten children in Zhongshan City in October 2010,and their parents completed the Clancy Autism Behavior Rating Scale（CABRS）,self-designed demographic data questionnaire and family environment scale Chinese version（FES-CV）.Influencing factors were analyzed by single factor analysis and Logistic regression analysis.Results Totally 66 kindergarten children from 11 townships were involved in the investigation,10 399 questionnaires were issued,and 10 087 valid questionnaires were recovered,with effective rate of 97.0%.Positive rate of ASD was 10.2‰.Gender（male OR=0.322,P=0.000）,father＇s education level（low cultural degree）,time for mother to stay with child（less than 4 hours within a week）and family parenting style（indulgent style OR=0.364,P=0.001）,maternal pregnancy nutrition（malnutrition）were risk factors of ASD,while gender（female）,father＇s education level（higher education OR value ranged 2.601-3.259,Pvalue ranged 0.005-0.032）,time for mother to stay with child（more than 7 hours within a week）and family parenting style（democratic type）,maternal pregnancy nutrition（good nutrition OR =4.960 value ranged 5.519,P value ranged 0.000-0.001）,high family cohesion（OR =1.218,P =0.000）,high family active-recreational orientation（OR=1.218,P=0.000）were protective factors of ASD children.Conclusion Screening positive rate of local preschool children with ASD is at lower limit value.To prevent and treat ASD,attention should be paid to ensure good maternal nutrition,increase time for mother to stay with child,maintain democratic parenting style in family,and enhance family cohesion and activerecreational orientation.