孤独症谱系障碍男童注意能力及社交发展特征的初步研究
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摘要
目的了解孤独症谱系障碍(ASD)男童注意能力特征,探索注意能力与社交发展的关系。方法收集2015年7月—2016年7月在上海交通大学医学院附属精神卫生中心儿少门诊就诊的ASD男童37例,采用孤独症行为量表(ABC)对男童症状进行评定,采用长处与困难问卷(SDQ)由父母对男童进行评定,运用孤独症诊断访谈量表修订版(ADI-R)中的社交发展和游戏部分,对ASD男童的自发性共同注意和社会特征进行评定。结果 ASD男童ABC量表的感觉能力、交往能力、运动能力、语言能力、自我照顾能力和症状严重度与SDQ量表的情绪问题、注意不能、同伴交往和总困难程度呈正相关(P<0.01);ADI-R社交发展和游戏部分的表情丰富程度、与同伴一起的想象性游戏、对其他儿童的兴趣、安慰他人、社会性主动提议和不恰当的面部表情得分和SDQ社会化行为因子分呈负相关(P<0.01)。结论 ASD男童在目光对视、社交性微笑、与同伴一起想像性游戏、引导别人注意等自发性共同注意能力存在缺陷,早期发现有助于ASD儿童的早期筛查、早期干预。
Objective To explore the characteristics of attention and social development of boys with autism spectrum disordes(ASD),and to analyze the correlation between them. Methods Totally 37 boys with ASD were recruited frompsychiatrist department for children and adolescents of Shanghai Mental Health Center from July 2015 to July 2016.Allparticipants were assessed by Autism Behavior Checklist(ABC),Strengths and Difficulties Questionnaire Parents′Version(SDQ),and the social development and play part of Autism Diagnostic Interview-Revised(ADI-R). Results In ASDgroup,the sensory,relating,body and object use,language and social/self help subscale scores of ABC were positively corre-lated with SDQ emotional problems,hyperactivity/inattention,peer problems and total difficulties score(P<0.01).Thescores of range of facial expression used to communicate,imitative social play,interest in children,offering comfort,quality ofsocial overture and inappropriate facial expressions were negatively correlated with prosocial behavior subscale of SDQ(P<0.01). Conclusions ASD boys have significant defect in social and play abilities such as direct gaze,social smiling,groupplay with peers,showing and directing attention,seeking to share enjoyment with others.Early detection is helpful for screening and intervention.
Objective To explore the characteristics of attention and social development of boys with autism spectrum disordes(ASD),and to analyze the correlation between them. Methods Totally 37 boys with ASD were recruited frompsychiatrist department for children and adolescents of Shanghai Mental Health Center from July 2015 to July 2016.Allparticipants were assessed by Autism Behavior Checklist(ABC),Strengths and Difficulties Questionnaire Parents′Version(SDQ),and the social development and play part of Autism Diagnostic Interview-Revised(ADI-R). Results In ASDgroup,the sensory,relating,body and object use,language and social/self help subscale scores of ABC were positively corre-lated with SDQ emotional problems,hyperactivity/inattention,peer problems and total difficulties score(P<0.01).Thescores of range of facial expression used to communicate,imitative social play,interest in children,offering comfort,quality ofsocial overture and inappropriate facial expressions were negatively correlated with prosocial behavior subscale of SDQ(P<0.01). Conclusions ASD boys have significant defect in social and play abilities such as direct gaze,social smiling,groupplay with peers,showing and directing attention,seeking to share enjoyment with others.Early detection is helpful for screening and intervention.
引文
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[15]Vivanti G,Paj F,Hocking DR,et al.Social Attention,joint attention and sustained attention in autism spectrum disorder and williams syndrome:convergences and Divergences[J].J Autism Dev Disord,2017,47(6):1866-1877.
[16]Thomas MS,Davis R,Karmiloff-Smith A,et al.The overpruning hypothesis of autism[J].Dev Sci,2016,19(2):284-305.
[17]Ninio A.Bids for joint attention by parent-child dyads and by dyads of young peers in interaction[J].J Child Lang,2016,43(1):135-156.
[18]Van Hecke AV,Mundy PC,Acra CF,et al.Infant joint attention,temperament,and social competence in preschool children[J].Child Dev,2007,78(1):53-69.
[19]杜亚松.孤独谱系障碍治疗、康复的研究进展[J].中国儿童保健杂志,2015,23(12):1233-1235.
[20]静进.孤独症谱系障碍儿童的康复教育现状及趋势[J].中国儿童保健杂志,2016,24(12):1233-1236.
[21]傅毅堃,周爱琴,戴琼,等.孤独症谱系障碍儿童综合干预年龄及持续时间对治疗效果影响的探讨[J].中国儿童保健杂志,2016,24(12):1312-1314.
[22]陈玉美,陈卓铭,林珍萍,等.孤独症谱系障碍儿童的共同注意力特点分析[J].临床儿科杂志,2017,35(2):102-105.
[23]Wieder S,Greenspan SI.Climbing the symbolic ladder in the DIR model through floor time/interactive play[J].Autism,2003,7(4):425-435.
[24]Hobson JA,Tarver L,Beurkens N,et al.The relation between severity of autism and caregiver-child interaction:a study in the context of relationship development intervention[J].J Abnorm Child Psychol,2016,44(4):745-755.
[2]张茜婷,李燕,魏华,等.核心症状对孤独症谱系障碍儿童健康相关生命质量的影响[J].中国儿童保健杂志,2016,24(3):318-321.
[3]Freeman SF,Gulsrud A,Kasari C.Brief report:linking early joint attention and play abilities to later reports of friendships for children with ASD[J].J Autism Dev Disord,2015,45(7):2259-2266.
[4]陈小燕,吴婕翎,李明,等.2~3岁孤独症谱系障碍儿童与正常儿童叫名反应的比较[J].中国儿童保健杂志,2017,25(9):931-934.
[5]Mundy P,Jarrold W.Infant joint attention,neural networks and social cognition[J].Neural Netw,2010,23(8):985-997.
[6]陈璐,张婷,李泉,等.孤独症儿童共同注意的神经基础及早期干预[J].心理科学进展,2015,23(7):1205-1215.
[7]Krug DA,Arick J,Almond P.Behavior checklist for identifying severely handicapped individuals with high levels of autistic behavior[J].J Child Psychol Psychiatry,1980,21(3):221-229.
[8]寇建华,夏黎明.儿童长处和困难问卷(父母版)上海常模的信度和效度[J].上海精神医学,2005,57(1):25-28.
[9]郭延庆,杨晓玲,刘靖,等.孤独症诊断访谈量表(修订本)的诊断效度及信度研究[J].中华精神科杂志,2002,35(1):42-45.
[10]Jones EA,Carr EG,Feeley KM.Multiple effects of joint attention intervention for children with autism[J].Behav Modif,2006,30(6):782-834.
[11]Sullivan M,Finelli J,Marvin A,et al.Response to joint attention in toddlers at risk for autism spectrum disorder:aprospective study[J].J Autism Dev Disord,2007,37(1):37-48.
[12]Hurwitz S,Watson LR.Joint attention revisited:Finding strengths among children with autism[J].Autism,2016,20(5):538-550.
[13]Sowden S,Koehne S,Catmur C,et al.Intact automatic imitation and typical spatial compatibility in autism spectrum disorder:challenging the broken mirror theory[J].Autism Res,2016,9(2):292-300.
[14]Wong C,Kasari C.Play and joint attention of children with autism in the preschool special education classroom[J].JAutism Dev Disord,2012,42(10):2152-2161.
[15]Vivanti G,Paj F,Hocking DR,et al.Social Attention,joint attention and sustained attention in autism spectrum disorder and williams syndrome:convergences and Divergences[J].J Autism Dev Disord,2017,47(6):1866-1877.
[16]Thomas MS,Davis R,Karmiloff-Smith A,et al.The overpruning hypothesis of autism[J].Dev Sci,2016,19(2):284-305.
[17]Ninio A.Bids for joint attention by parent-child dyads and by dyads of young peers in interaction[J].J Child Lang,2016,43(1):135-156.
[18]Van Hecke AV,Mundy PC,Acra CF,et al.Infant joint attention,temperament,and social competence in preschool children[J].Child Dev,2007,78(1):53-69.
[19]杜亚松.孤独谱系障碍治疗、康复的研究进展[J].中国儿童保健杂志,2015,23(12):1233-1235.
[20]静进.孤独症谱系障碍儿童的康复教育现状及趋势[J].中国儿童保健杂志,2016,24(12):1233-1236.
[21]傅毅堃,周爱琴,戴琼,等.孤独症谱系障碍儿童综合干预年龄及持续时间对治疗效果影响的探讨[J].中国儿童保健杂志,2016,24(12):1312-1314.
[22]陈玉美,陈卓铭,林珍萍,等.孤独症谱系障碍儿童的共同注意力特点分析[J].临床儿科杂志,2017,35(2):102-105.
[23]Wieder S,Greenspan SI.Climbing the symbolic ladder in the DIR model through floor time/interactive play[J].Autism,2003,7(4):425-435.
[24]Hobson JA,Tarver L,Beurkens N,et al.The relation between severity of autism and caregiver-child interaction:a study in the context of relationship development intervention[J].J Abnorm Child Psychol,2016,44(4):745-755.