孤独症谱系障碍儿童触觉异常特征与临床症状的关联

Correlation analysis of tactile abnormality and clinical symptoms of children in autism spectrum disorders

目的探索孤独症谱系障碍(ASD)儿童是否存在明显的触觉异常以及触觉异常与孤独症临床症状之间的相关性,为孤独症触觉异常的干预治疗提供科学依据。方法收集在黑龙江省孤独症定点康复机构接受康复训练的265例3.02~10.66岁ASD儿童作为病例组,并依据性别年龄匹配原则,在哈尔滨市幼儿园和小学招募223名3.15~10.99岁健康儿童作为对照组。采用简化版感觉特征问卷(SSP)评估儿童的触觉行为,同时采用社交反应量表(SRS)等评估ASD儿童的临床表现,应用Spearman相关性分析探索触觉行为与孤独症症状之间的关联。结果ASD组儿童SSP触觉得分[33(33,35)分]低于对照组[34(31,35)分],差异有统计学意义(Z=-2.73,P<0.05);ASD组触觉异常等级(可能异常、明显异常)比例(19.6%)高于对照组(11.7%)(χ^(2)=5.72,P<0.05)。两组男童SSP触觉得分差异有统计学意义(Z=-2.17,P<0.05)。ASD组SSP触觉得分与SRS社交认知、社交沟通和量表总分,儿童孤独症家长评定量表(ABC)、孤独症行为量表(CARS)、孤独症诊断访谈量表修订版(ADI-R)临床量表非语言沟通水平得分呈负相关(r值分别为-0.23,-0.28,-0.28,-0.35,-0.17,-0.27,P值均<0.05)。结论孤独症儿童较健康儿童存在更为明显的触觉异常表现,且在男童中更为显著。触觉异常与孤独症社交障碍等临床表现之间存在相关性。

Objective To explore whether children in autism spectrum disorders(ASD)have more obvious tactile abnormalities than healthy children,and to analyze the correlation between tactile abnormalities and clinical symptoms of autism,so as to provide a scientific basis for intervening and treating tactile abnormalities among the children with autism.Methods Totally 265 ASD children aged 3.02-10.66 years who received rehabilitation training in designated rehabilitation institutions for autism in Heilongjiang Province were collected as case group,and 223 healthy children aged 3.15-10.99 years were recruited as control group in Harbin kindergartens and primary schools according to the principle of gender and age matching.The Short Sensory Profile(SSP)was used to evaluate children’s tactile behavior,and the differences between the two groups,as well as the scores of different genders and ages were analyzed.At the same time,Social Responsiveness Scale(SRS)was used to evaluate the clinical manifestations of ASD children.Spearman correlation analysis was used to explore the correlation between tactile behavior and autism symptoms.Results The tactile score of SSP in ASD group[33(33,35)]was lower than that in control group[34(31,35)],and the difference was statistically significant(Z=-2.73,P<0.05);And the proportion of tactile abnormality grade(possible abnormality and obvious abnormality)in ASD group(19.6%)was higher than that in control group(11.7%)(χ^(2)=5.72,P<0.05).At the same time,the tactile sensation between the two groups of boys was significantly different(Z=-2.17,P<0.05).There was a negative correlation between SSP tactile scores in ASD group and clinical scale scores including SRS social cognition,social communication and scale scores,Autism Behavior Checklist(ABC),Childhood Autism Behavior Scale(CARS),non-verbal communication of Autism Diagnostic Interview-Revised(ADI-R)(r=-0.23,-0.28,-0.28,-0.35,-0.17,-0.27,P<0.05).Conclusion Autistic children show more obvious tactile abnormalities than healthy children,which is more significant in boys.And there is a correlation between tactile abnormalities and clinical manifestations such as autism social disorder.