孤独症谱系障碍儿童重复刻板行为的特点及相关影响因素

Features of restricted,repetitive behavior in children with autism spectrum disorder and its related influencing factors

目的通过重复刻板行为检查量表(RBS-R)分析孤独症谱系障碍(ASD)儿童重复刻板行为的特点及其与疾病严重程度、发育水平和年龄等因素的相关性。方法选取2021年6月至12月就诊于西安市儿童医院的ASD儿童108例为研究对象,采用RBS-R量表分析ASD儿童重复刻板行为特点,采用儿童孤独症评定量表(CARS)及孤独症行为检查量表(ABC)评估ASD儿童症状的严重程度,采用Gesell发育诊断量表评估ASD儿童的发育水平。结果ASD儿童的RBS-R量表得分与CARS量表得分呈正相关(r=0.324,P<0.05),RBS-R量表得分与ABC量表得分呈正相关(r=0.538,P<0.01),且与ABC量表相关性更高;ASD儿童的RBS-R量表得分与Gesell发育诊断量表评估中应人能的发育商呈负相关(r=-0.400,P<0.01);ASD儿童的RBS-R量表得分与年龄无相关性(P>0.05),但>3岁组ASD儿童的仪式性行为得分显著高于≤3岁组(Z=-1.995,P<0.05)。结论RBS-R量表对ASD儿童的诊断具有一定的辅助作用;ASD儿童的重复刻板行为与其疾病的严重程度呈正相关,与应人能呈负相关,且大年龄的ASD儿童可能呈现出更多的仪式性行为。

Objective To investigate the features of restricted,repetitive behavior(RRB)in children with autism spectrum disorder(ASD)and the correlations between RRB and the severity of disease,developmental level,and age by using the Repetitive Behavior Scale-Revised(RBS-R).Methods The subjects of this study were 108 children who were diagnosed with ASD in Xi′an Children′s Hospital between June and December 2021.The RBS-R was applied to analyze the features of restricted,repetitive behavior in children with ASD.The Childhood Autism Rating Scale(CARS)and the Autism Behavior Checklist(ABC)were used for assessing the severity of relevant symptoms displayed by the ASD children.The Gesell Developmental Schedule was employed in the evaluation of the developmental level of ASD children.Results In ASD children,the RBS-R scores were positively correlated with the CARS scores(r=0.324,P<0.05),the RBS-R scores were positively correlated with the ABC scores(r=0.538,P<0.01),and it had higher correlation with ABC.In ASD children,the RBS-R scores showed a negative correlation with the developmental quotient for the personal-social domain in the Gesell Developmental Schedule(r=-0.400,P<0.01).The RBS-R score of ASD children was not age-related(P>0.05),but the group>3 years old scored significantly higher on ritualized behavior than the group≤3 years old(Z=-1.995,P<0.05).Conclusion RBS-R plays an auxiliary role in the diagnosis of children with ASD.Restricted,repetitive behavior of children with ASD shows a positive correlation with the severity of disease but a negative correlation with personal-social ability.Besides,ritualized behavior appears to be more prevalent among older children with ASD.