学龄前孤独症谱系障碍儿童感觉处理特征的研究

A study on sensory processing characteristics of preschool children with autism spectrum disorder

【目的】探讨学龄前孤独症谱系障碍(ASD)患儿的感觉处理特征,为ASD的早期筛查和干预训练提供理论依据。【方法】使用自行编制的基本情况问卷及感觉处理测量(SPM)问卷,采取儿童主要照顾者填写的方式,对215例ASD患儿和170名正常发育(TD)儿童开展调查,按年龄和性别分层,比较ASD患儿和TD儿童SPM问卷不同能区得分的差异,分析学龄前ASD患儿的感觉处理特征。【结果】ASD患儿在SPM的社会参与、视觉、听觉、触觉、味觉与嗅觉、本体觉、前庭功能、动作计划能区及整体感觉系统得分高于TD儿童(均P<0.01);ASD患儿在听觉能区的异常程度最高,味觉与嗅觉能区的异常程度最低。Spearman相关性分析结果显示在4、5岁ASD患儿中,SPM视觉(rs=−0.200,P=0.033)、听觉能区(rs=−0.194,P=0.040)得分随年龄的增长呈下降趋势,其他能区得分与年龄无相关性(均P>0.05)。在男童和女童中,ASD儿童SPM问卷的各能区得分高于TD儿童(均P<0.001),ASD男童和女童SPM问卷各能区得分差异无统计学意义(均P>0.05)。【结论】ASD患儿普遍存在感觉处理异常,与TD儿童存在多个感觉域差异,感觉处理异常有可能作为ASD早期筛查的指标,有必要针对ASD患儿的感觉处理异常进行相应干预训练。

[Objective]To explore the sensory processing characteristics of preschool children with autism spectrum disorder(ASD),and to provide a theoretical basis for early screening and intervention training of ASD.[Methods]A total of 215 preschool children with ASD and 170 typically developed(TD)children were investigated with a basic situation questionnaire and sensory processing measure(SPM).The two groups were stratified according to age and gender,and the differences of scores in sensory domains were compared to analyze the sensory processing characteristics of preschool children with ASD.[Results]The scores of social participation,vision,hearing,touch,taste and smell,body awareness,balance and motion,planning and ideas,and total sensory system in children with ASD were all higher than those in children with TD(all P<0.01).The highest degree of abnormality was found in hearing and the lowest degree in taste and smell in children with ASD.The results of Spearman correlation analysis showed that in the 4-year-old and 5-year-old children with ASD,the scores of vision(rs=−0.200,P=0.033)and hearing(rs=−0.194,P=0.040)decreased with age.There was no correlation between the scores of other developmental quotients and age(all P>0.05).Boys and girls with ASD had higher scores in all developmental quotients than TD children(P<0.01).However,there was no significant gender difference in any developmental quotients of ASD children(all P>0.05).[Conclusion]Sensory processing abnormalities are common in preschool children with ASD,which are different from those of TD children in multiple sensory domains.Sensory processing abnormalities may be used as an indicator for early screening of ASD,and it is necessary to conduct corresponding intervention training for sensory processing abnormalities in children with ASD.