孤独症谱系障碍儿童就诊情况分析

Clinical visiting status of children with autism spectrum disorder

目的 分析我院儿童心理行为专科门诊首次诊断为孤独症谱系障碍(ASD)的儿童信息,以了解川东北地区ASD患儿就诊情况。方法 纳入2021年1—12月在我院儿童心理行为专科门诊首次诊断为ASD的儿童,对患儿病历资料进行回顾性分析。患儿就诊时采用儿童孤独症评定量表(CARS)对患儿病情进行评估,使用儿心量表2016版对患儿发育水平进行评估。结果 纳入ASD患儿339例,年龄3.1(2.7,3.6)岁,小于3岁的占38.3%。1、2月就诊的患儿数明显多于其他月份。儿保医师是促使大部分ASD患儿就诊的人员(52.5%),老师也是促使患儿就诊的重要原因(28.6%)。患儿最常见的主诉为“语言障碍”(48.7%),其次为“语言障碍合并不理人”(18.9%)以及“不理人”(18.6%)。重度ASD患儿首次诊断的年龄显著小于轻-中度患儿。儿心量表测评结果显示74.6%的ASD患儿合并发育障碍,语言能区发育障碍比例最高(79.1%),其次为社会行为能区(78.8%)。有总发育障碍或者语言或社会行为能区发育障碍的ASD儿童初诊年龄显著小于无相应发育障碍的ASD患儿。结论 川东北地区超过1/3的ASD患儿能在早期诊断,本地区人群对ASD有了一定的认识,但仍需加大宣传教育,进一步促进本地区ASD患儿的早期就诊和管理。

Objective To analyze the information of children who diagnosed as autism spectrum disorder(ASD)for the first time in our psychological and behavioral clinic,and to understand the clinical visiting status of ASD children in Northeast Sichuan.Methods Children who were diagnosed as ASD for the first time in our psychological and behavioral clinic from January to December in 2021 were included,and the medical records of these children were analyzed retrospectively.When visit,the symptoms of ASD were assessed with the Child Autism Rating Scale(CARS),and the developmental level of children was evaluated with the Children Neuropsychological and Behavioral Scale-Revision 2016(CNBS-R2016).Results A total of 339 children with ASD were included.The ASD children were 3.1(2.7,3.6)years old,and 38.3%were younger than 3 years.The number of ASD children who visited in January and February was significantly higher than that in other months.Most children(52.5%)who were diagnosed as ASD were urged to our special clinic by the child health care physician,and teachers were also an important reason for children's consultation(28.6%).The most common complaint of children was"language disorder"(48.7%),followed by"language disorder combined with ignoring people"(18.9%)and"ignoring people"(18.6%).The age of first diagnosis in children with severe ASD was significantly younger than that in children with mild-moderate ASD.The results of CNBS-R2016 showed that 74.6%of ASD children were complicated with developmental disorders,and the proportion of developmental disorders in language was the highest(79.1%),followed by personal-social(78.8%).The age of first diagnosis of ASD children with total developmental disorder or developmental disorder of language or social behavior was significantly younger than that of ASD children without these developmental disorders.Conclusion More than 1/3 ASD children in Northeast Sichuan can be diagnosed early.People in Northeast Sichuan have a certain understanding of ASD,but more publicity and education need to further promote early visit and management of ASD in this region.