孤独症谱系障碍儿童执行功能与心理理论之间的关系探讨

Relationship between executive function and theory of mind in children with autism spectrum disorder

目的探析孤独症谱系障碍(ASD)儿童执行功能与心理理论之间的关系。方法2020年4月至2022年4月经郑州大学附属儿童医院收治确诊为ASD儿童54例归入ASD组,同期按年龄、智商1∶1匹配、经该院招募54例正常发展(TD)儿童归入TD组,均进行执行功能[采用中文版学龄前儿童执行功能行为评定问卷(BRIEF-P)进行评估]、心理理论(通过意外内容任务、意外地点任务及隐藏情绪任务3个心理理论经典范式进行评估)测试并比较结果差异,采用Pearson分析检验ASD儿童执行功能与心理理论的相关性。结果ASD组BRIEF-P中抑制、转换、情感控制、工作记忆、组织计划及总分[(104.52±7.49)分比(78.39±4.43)分]均高于TD组(P<0.05);ASD组心理理论范式中意外内容任务、意外地点任务、隐藏情绪任务及总分[(0.87±0.85)分比(1.96±0.89)分]均低于TD组(P<0.05);经Pearson相关性分析结果显示,BRIEF-P总分与心理理论总分存在高度负相关(r=−0.75),其次BRIEF-P因子中抑制、工作记忆具有中度负相关(r=−0.44、−0.47)(P<0.05)。结论ASD儿童普遍存在执行功能及心理理论发展障碍,且两者常易共同发生,故针对ASD儿童行个体化教育计划时,应注重融合执行功能及心理理论干预方式。

Objective To explore the relationship between executive function and theory of mind in children with autism spectrum disorder(ASD).Methods Fifty-four children diagnosed with ASD admitted to Children's Hospital Affiliated to Zhengzhou University from April 2020 to April 2022 were included in the ASD group,and 54 children with normal development(TD)recruited from the hospital with matched age and IQ at 1∶1 were included in the TD group during the same period.All of them were tested by executive function[assessed by Chinese version of The Behavior Rating Inventory of Executive Function-Preschool Version(BRIEF-P)]and theory of mind[assessed by unexpected content task,unexpected place task and hidden emotion task],and the results were compared.Pearson correlation was used to analyze the relationship between executive function and theory of mind in children with ASD.Results Inhibition,conversion,affective control,working memory,organizational planning and total score of BRIEF P in ASD group were higher than those in TD group[(104.52±7.49)points vs.(78.39±4.43)points](P<0.05).The unexpected content task,unexpected location task,hidden emotion task and total score of ASD group were lower than those of TD group[(0.87±0.85)points vs.(1.96±0.89)points](P<0.05).Pearson correlation analysis results showed that the total score of BRIEF-P was highly correlated with the total score of theory of mind(r=−0.75),and there was a moderate correlation between BRIEF P factors such as inhibition and working memory and theory of mind(r=−0.44,−0.47)(P<0.05).Conclusions Executive function and theory of mind development disorders are common in children with ASD,and they often occur together.Therefore,the integrated intervention of executive function and theory of mind may be emphasized in implementing individualized education plan for children with ASD.