孤独症谱系障碍幼儿感觉反应与自发性共同注意能力发展的关系

The relationship between sensory responsiveness and the development of initiating joint attention in toddlers with autism spectrum disorder

目的 分析异常感觉反应模式对幼儿自发性共同注意(IJA)能力发展的影响,进一步探究孤独症谱系障碍(ASD)的早期发展机制。方法 随访40例12月龄幼儿并在24月龄时根据临床诊断分为ASD组、发育迟缓(D/D)组与正常发育(TD)组,使用《幼儿感觉处理能力剖析量表第二版》(TSP-2)评估幼儿感觉反应异常程度,对互动视频进行编码以评估IJA能力,采用线性回归分析幼儿感觉反应异常与IJA能力的关系。结果 ASD幼儿12月龄的感觉寻求和感觉迟钝分数以及24月龄的感觉寻求分数与IJA频率呈负相关(rs=-0.735,P=0.015;rs=-0.635,P=0.048;rs=-0.680,P=0.030),12月龄感觉敏感和感觉回避分数与24月龄IJA频率的发展呈正相关(rp=0.674,P=0.047;rp=0.818,P=0.007)。结论 ASD幼儿更高的感觉寻求和感觉迟钝水平会影响当前的IJA能力,而更高的感觉敏感和感觉回避水平则预测IJA能力有更好的发展趋势。

Objective To evaluate the impact of atypical sensory response patterns on the development of initiating joint attention(IJA)abilities in toddlers,further exploring the early developmental mechanisms of autism spectrum disorder(ASD).Methods Forty infants at 12 months of age were followed up and divided into three groups at 24 months of age:ASD,developmental differences(D/D),and typical development(TD)groups.The Toddler Sensory Profile Second Edition(TSP-2)was used to assess the degree of atypical sensory response patterns.Interactive videos were coded to evaluate IJA abilities.Linear regression analysis was employed to assess the relationship between sensory responsiveness and IJA abilities.Results The sensory seeking and registration scores at 12 months of age and the sensory seeking score at 24 months of age in ASD toddlers were negatively correlated with IJA frequency(rs=-0.735,P=0.015;rs=-0.635,P=0.048;rs=-0.680,P=0.030),while the sensory sensitivity and avoiding scores at 12 months were positively correlated with the development of IJA frequency(rp=0.674,P=0.047;rp=0.818,P=0.007).Conclusions Higher levels of sensory seeking and registration in ASD toddlers will affect their current IJA abilities.However,higher levels of sensory sensitivity and avoiding predict a better developmental trend in IJA abilities.