背景:在这项前瞻性队列研究中,我们确定了回归性自闭症谱系障碍(ASD)儿童的表型特征,并探讨了康复效果.
方法:我们招募了370名年龄在1.5-7岁的ASD儿童。根据回归补充表格,儿童被分为两组:回归和非回归.使用自闭症诊断观察计划(ADOS)在行为干预前后1年评估ASD的核心症状和神经发育水平,社会反应量表(SRS),儿童自闭症评定量表(CARS),和格塞尔发展量表(GDS)。
结果:在370名ASD儿童中,28.38%(105/370)经历了回归。回归主要在社交和语言技能中观察到。与非回归ASD的儿童相比,回归ASD的儿童表现出更高的SRS和CARS评分和更低的GDS评分。行为干预1年后,所有ASD患儿的症状量表评分均显著下降;然而,回归性ASD患儿的改善程度低于非回归性ASD患儿.此外,4岁以下退化性ASD患儿症状评分明显下降,而4岁以上人群的评分没有显著改善.患有退化性ASD的儿童表现出更高的核心症状评分和更低的神经发育水平。然而,行为干预后,在4岁以下的消退性ASD儿童中,一些症状有显著改善.
结论:应考虑对ASD儿童进行早期干预,特别是对于那些有回归性ASD的人。
BACKGROUND: In this prospective cohort
study, we determined the phenotypic characteristics of children with regressive autism spectrum disorder (ASD) and explored the effects of rehabilitation.
METHODS: We recruited 370 children with ASD aged 1.5-7 years. Based on the Regression Supplement Form, the children were assigned to two groups: regressive and non-regressive. The core symptoms and neurodevelopmental levels of ASD were assessed before and after 1 year of behavioral intervention using the Autism Diagnostic Observation Schedule (ADOS), Social Response Scale (SRS), Children Autism Rating Scale (CARS), and Gesell Developmental Scale (GDS).
RESULTS: Among the 370 children with ASD, 28.38% (105/370) experienced regression. Regression was primarily observed in social communication and language skills. Children with regressive ASD exhibited higher SRS and CARS scores and lower GDS scores than those with non-regressive ASD. After 1 year of behavioral intervention, the symptom scale scores significantly decreased for all children with ASD; however, a lesser degree of improvement was observed in children with regressive ASD than in those with non-regressive ASD. In addition, the symptom scores of children with regressive ASD below 4 years old significantly decreased, whereas the scores of those over 4 years old did not significantly improve. Children with regressive ASD showed higher core symptom scores and lower neurodevelopmental levels. Nevertheless, after behavioral intervention, some symptoms exhibited significant improvements in children with regressive ASD under 4 years of age.
CONCLUSIONS: Early intervention should be considered for children with ASD, particularly for those with regressive ASD.