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目的:比较倒退型与非倒退型孤独障碍儿童的临床特征。方法:121例符合《美国精神障碍诊断和统计手册》第4版(修订版)孤独障碍诊断标准的2~5岁孤独障碍儿童,使用自编一般情况调查表调查患儿的一般情况及相关信息;采用贝利婴幼儿发展量表进行发育商测量;用儿童孤独症评定量表(CARS)评定孤独障碍严重程度;使用《倒退情况补充核查表》结合孤独症诊断访谈量表(修订本)根据起病形式分为倒退型和非倒退型两组,对比分析两组一般情况及临床特征。结果:121例孤独障碍儿童中倒退型30例(32.97%),孤独障碍儿童技能倒退起病的平均年龄为23.81个月。倒退型和非倒退型孤独障碍儿童的性别差异无统计学意义(χ~2=2.97,P=0.09);发育商差异无统计学意义(t=1.04,P=0.30);CARS量表总分倒退型组显著高于非倒退型组(t=-2.47,P=0.02)。主要的倒退类型是语言、社交、语言合并社交。倒退型孤独障碍儿童其倒退时发生的前3位生活事件为:主要照管者的改变、生病、家庭冲突;在倒退型孤独障碍儿童中有73.33%的家长反映有技能重获,技能重获的相关事件为:行为训练(30.00%)和父母陪伴时间长(10.00%)。结论:孤独障碍儿童中约1/3在起病形式上属于倒退型。倒退型较非倒退型孤独障碍儿童的症状更严重,家庭环境及躯体疾病可能与其倒退发生有关。训练、父母陪伴有助于孤独障碍儿童技能丧失后的重获。
Objective: To compare the clinical features of children with and without regressive disorder. Methods: A total of 121 children aged 2 ~ 5 years old with autism spectrum disorder who meet the diagnostic criteria of the fourth edition of the American Psychiatric Disorders Diagnostic and Statistical Manual (revised version) were used to investigate the general situation and related information of the children ; Using the Bailey Infant Scale for Developmental Measurements; using the Children’s Autism Rating Scale (CARS) to assess the severity of the lone disorder; using the “Checklist for Reversal Supplementation” in conjunction with the Autism Diagnostic Interview (Revised) The form of onset is divided into two types of retrograde and non-retrograde type, comparative analysis of two groups of general conditions and clinical features. Results: Among the 121 children with autism, 30 were retrograde (32.97%), and the average age of children with autism was 23.81 months. There was no significant difference in sex between children with and without recidivism (χ ~ 2 = 2.97, P = 0.09); There was no significant difference between children with and without developmental dysfunction (t = 1.04, P = 0.30) The regression type group was significantly higher than the non-regression type group (t = -2.47, P = 0.02). The main type of regression is language, social, language merge social. The first 3 life events of retrograde-type children with ADHD were retrograde: changes in primary caregivers, illness and family conflict; 73.33% of children with retrogressive dyslexia reported having skills recovery, skill recovery Related events were: behavioral training (30.00%) and parental involvement (10.00%). Conclusions: About one third of children with ASD are retrograde in onset form. The symptoms of retrograde type are more serious than those of non-retrogressive type of autistic disorder, and family environment and somatic diseases may be related to their regression. Training and parental support can help regain the skills of children with lonely disabilities.