孤独症谱系障碍儿童感觉特征与行为问题的相关性

Correlation between sensory characteristics and behavioral problems in children with autism spectrum disorder

目的 了解孤独症谱系障碍(autism spectrum disorder,ASD)儿童感觉特征情况,并探索其与行为问题的关联,为ASD儿童早期诊断、综合干预提供参考依据。方法 采用横断面调查,于2021年9月至2022年2月收集南通市康复机构训练的193名ASD儿童作为受试对象,采用简化版感觉特征问卷(SSP)、Conners父母用症状问卷(PSQ)对患儿进行问卷调查。结果 193名ASD儿童中感觉特征总分异常的儿童有106名,异常率为54.9%,其中可能异常45名(23.3%),明显异常61名(31.6%),7个维度中听觉过滤异常率最高,达到85.0%,其余依次为力量低下/虚弱、运动敏感、味觉/嗅觉敏感、低反应/寻求感觉、视觉/听觉敏感、触觉敏感,感觉异常总发生率为93.3%。不同感觉异常程度ASD儿童PSQ得分中品行问题、学习问题、心身障碍、冲动多动、焦虑和多动指数6个维度比较差异均有统计学意义(H值分别为38.89,38.90,19.53,46.34,34.54,54.90,P值均<0.01),并且随着ASD儿童感觉异常加重,PSQ各维度得分均提高;SSP总分与PSQ中品行问题、学习问题、心身障碍、冲动多动、焦虑和多动指数6个维度均呈负相关(r值分别为-0.53,-0.50,-0.32,-0.55,-0.43,-0.61,P值均<0.01)。结论 ASD儿童普遍存在感觉异常,且随着感觉异常的加重行为问题表现越明显,ASD儿童感觉异常与行为问题呈正相关,在今后的诊疗过程中要更多关注ASD儿童的感觉异常特征。

Objective To understand sensory characteristics and its correlation with behavioral problems among children with autism spectrum disorder(ASD),so as to provide reference basis for early diagnosis and comprehensive intervention of ASD children.Methods Using cross-sectional survey,193 ASD children trained by Nantong rehabilitation institutions were recruited from September 2021 to February 2022.All children were investigated with the Short Sensory Profile(SSP) and Parent Symptom Questionnaire(PSQ).Results Among the 193 ASD children,106(54.9%) children had abnormal sensory characteristics,including 45(23.3%) with possible abnormalities and 61(31.6%) with obvious abnormalities.The abnormal rate of auditory filtering was the highest in the seven dimensions,reaching 85.0%,followed by low strength/weakness,motor sensitivity,taste/smell sensitivity,low response/seeking sensation,vision/hearing sensitivity and tactile sensitivity.The total incidence of sensory abnormalities was 93.3%.There were significant differences in six dimensions of PSQ scale scores of ASD children with different degrees of sensory abnormalities,including conduct problems,learning problems,psychosomatic disorders,impulsive hyperactivity,anxiety and hyperactivity index(H=38.89,38.90,19.53,46.34,34.54,54.90,P<0.01).With the aggravation of sensory abnormalities in children with ASD,the scores of all dimensions of the PSQ scale increased significantly.The total score of SSP was negatively correlated with the six dimensions of conduct problems,learning problems,psychosomatic disorders,impulsive hyperactivity,anxiety and hyperactivity index in PSQ(r=-0.53,-0.50,-0.32,-0.55,-0.43,-0.61,P<0.01).Conclusion ASD children generally have sensory abnormalities,which coincide with severity of behavioral problems.There is a positive correlation between sensory abnormalities and behavioral problems in ASD children.More attention should be paid to the abnormal sensory characteristics of children with ASD in the future diagnosis and treatment process.