中国临床心理学杂志

孤独症谱系障碍临床特征分析

单位：1 温州医学院基因组医学研究院温州 325000
2 中南大学湘雅二医院精神卫生研究所长沙 410011
3 深圳市妇幼保健院深圳 518000
4 精神疾病诊疗技术湖南省工程实验室

关键词：孤独症谱系障碍|精神发育迟滞|儿童孤独症评定量表|Gesell发育诊断量表

分类号：R395.2

出版年,卷(期):页码：2013,21(2):244-247

摘要：

目的:探讨孤独症谱系障碍的临床特点,为诊断提供参考性建议。方法:分别对75例孤独症谱系障碍患儿及77例精神发育迟滞患儿进行Gesell发育诊断量表(GDDS)和儿童孤独症评定量表(CARS)的评估并进行比较;并将孤独症谱系障碍组按月龄分为0-36月组和37-72月组;对75例孤独症谱系障碍进行婴儿-初中学生社会生活能力量表(S-M量表)评定并与GDDS中的适应性得分进行比较。结果:①孤独症谱系障碍组和精神发育迟滞组患儿在GDDS中的得分没有明显差异,两组患儿语言均中度落后,其他条目均轻度落后;②在CARS的得分中孤独症谱系障碍组明显高于精神发育迟滞组;③孤独症谱系障碍0-36月组在视觉反应得分中高于37-72月组;而37-72月组在语言沟通、智力反应水平及一致性中得分高于0-36月组;④通过秩和检验,S-M量表得分与GDDS中适应性得分比较有显著差异。结论:孤独症谱系障碍患儿发育水平明显落后于同龄儿童,其中语言落后明显;孤独症谱系障碍患儿在言语沟通、社会互动等方面存在明显异常;孤独症谱系障碍患儿在智力反应水平及一致性方面存在不均衡性。

Objective: To study the clinical characteristics of autism spectrum disorders(ASD) and provide some recom mendations for the diagnosis. Methods: 152 outpatients(75 with autism spectrum disorders and 77 with mental retardations (MR) were examined with the childhood autism rating scale(CARS) and gesell developmental scales (GDDS). Compare the clinical characteristics between two groups. The autism spectrum disorders were divided into two subgroups according to chronological age: 0-36 months subgroup and 37-72 months subgroup, compare two scales scores between two group. Adaptive social abilities scores of GDDS and S-M scale were compared in ASD group using rank-sum test. Results: ①In GDDS test, the language level were moderate backward in both ASD and MR groups, and the others items of GDDS were in the mild backward. However, there are no significant differences in all items of GDDS between ASD group and MR group. ②In CARS test, the total score and all subscales scores are significant higher in ASD group compared with MR group. ③In the subgroup analysis of ASD, the score of visual response is higher in 0-36 months subgroup, while the scores of verbal communication, level and consistency of intellectual response were higher in 37-72 months subgroup. ④ Adaptive social abilities scores of GDDS and S-M scale which were compared in ASD group were significant different. Conclusion: Comparing to normal children, ASD have a significant lower level development, in which language level is in the moderate backward, and the others items were in the mild backward. ASD have a significant difference in verbal com munication, social interactions, and other behaviors relevant to autism spectrum disorders. The level of intelligence reac tion and consistency were imbalance among autism spectrum disorders.

基金项目：

国家自然科学基金(81271484,30900486);“973”课题(2012CB517904)资助

作者简介：

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