孤独症谱系障碍儿童感觉异常特征及其与临床症状的相关分析

Correlation between abnormal sensory characteristics and clinical symptoms in children with autism spectrum disorders

目的了解孤独症谱系障碍(autism spectrum disorder, ASD)儿童异常感觉特征情况, 并探讨异常感觉与临床症状的关联, 为ASD早期诊断、干预治疗提供参考依据。方法采用横断面调查, 于2021年9~12月收集符合DSM-5中孤独症谱系障碍诊断的216名儿童作为研究对象, 采用简化版感觉特征问卷(short sensory profile, SSP)、孤独症行为评定量表(autism behavior checklist, ABC)、社交反应量表(social responsiveness scale, SRS)对所有患儿进行问卷调查。使用SPSS 21.0进行统计分析, 采用Pearson相关分析评定ASD儿童感觉特征与临床症状的相关性。结果 216例ASD儿童中SSP总分异常有120例, 异常率55.6%, 7个维度中听觉过滤异常率最高, 达到83.8%, 其次依次为力量低下/虚弱(60.2%)、运动敏感(43.5%)、低反应/寻求感觉(39.8%)、味觉/嗅觉敏感(37.5%)、视觉/听觉敏感(27.8%)、触觉敏感(17.6%), 感觉异常总发生率92.1%。不同感觉异常程度ASD儿童ABC量表总分及感觉、交往、躯体运动、语言、生活自理5个维度比较均差异具有统计学意义(F=39.15, 39.99, 46.02, 29.18, 50.98, 51.76, 均P<0.01), 不同感觉异常程度ASD儿童SRS量表总分及社交知觉、社交认知、社交沟通、社交动机、孤独症行为方式5个维度比较均差异具有统计学意义(F=19.33, 29.47, 24.82, 29.68, 31.48, 39.86, 均P<0.01), 且随着患儿感觉异常加重, ABC、SRS量表总分及各维度分数均增加。SSP总分与ABC量表中感觉、交往、躯体运动、语言、生活自理和ABC总分均呈负相关(r=-0.613, -0.631, -0.643, -0.558, -0.657, -0.679, 均P<0.01)。SSP总分与SRS量表中社交知觉、社交认知、社交沟通、社交动机、孤独症行为方式和SRS总分均呈负相关(r=-0.440, -0.527, -0.504, -0.522, -0.542, -0.595, 均P<0.01)。结论感觉异常在ASD儿童中普遍存在, 且随着感觉异常的加重ASD儿童核心症状和行为表现越明显。

Objective To understand the sensory characteristics of children with autism spectrum disorder(ASD),and to explore its relationship with the clinical symptoms and to provide a reference basis for early diagnosis and intervention treatment of ASD.Methods A cross-sectional survey was conducted to collect 216 children diagnosed with ASD according to DSM-5 from September 2021 to December 2021.All children were investigated with short sensory profile(SSP),autism behavior checklist(ABC)and social response scale(SRS).SPSS 21.0 was used for statistical analysis and the correlation between sensory characteristics and clinical symptoms of ASD children was analyzed by Pearson correlation.Results The results showed that 120 of 216 with ASD children had abnormal SSP total score,with an abnormal rate of 55.6%.Among the seven dimensions,the abnormal rate of auditory filtering was the highest,reaching 83.8%,followed by low strength/weakness(60.2%),motor sensitivity(43.5%),low response/sensation seeking(39.8%),taste/smell sensitivity(37.5%),vision/hearing sensitivity(27.8%)and tactile sensitivity(17.6%),and the total incidence of paresthesia was 92.1%.There were significant differences in the total score of ABC and the five dimensions of sensation,communication,body movement,language and life self-care of ASD children with different sensory characteristics(F=39.15,39.99,46.02,29.18,50.98,51.76 respectively,all P<0.01).There were significant differences in the total score of SRS and social perception,social cognition,social communication,social motivation among ASD children with different sensory characteristics(F=19.33,29.47,24.82,29.68,31.48,39.86 respectively,all P<0.01).With the aggravation of sensory abnormalities,the total scores of ABC and SRS and the scores of each dimension increased.The total score of SSP was negatively correlated with the scores of sensation,communication,body movement,language,self-care and the total score of ABC(r=-0.613,-0.631,-0.643,-0.558,-0.657,-0.679 respectively,all P<0.01).The total score of SSP was negatively correlated with social perception,social cognition,social communication,social motivation,autism behavior and the total score of SRS(r=-0.440,-0.527,-0.504,-0.522,-0.542,-0.595 respectively,all P<0.01).Conclusion Sensory abnormalities are common in ASD children,and with the aggravation of sensory abnormalities,the core symptoms and behavioral performance of ASD children are more obvious and positively correlated.