学龄前孤独症谱系障碍儿童诊疗相关问题及母亲心理健康状况的调查

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目的了解本地区学龄前孤独症谱系障碍(ASD)儿童诊疗中相关问题及母亲心理健康状况的特征,分析不同年龄段的差异,为开展进一步工作提供部分参考。方法对诊断明确的235例学龄前ASD儿童按年龄段分为18~36月龄组(组1)98例,37~72月龄组(组2)137例,分别采用自拟调查问卷对两组儿童诊疗中相关问题进行调查,并使用症状自评量表(SCL-90)对其母亲进行心理健康的评定。结果比较首诊主诉症状,两组ASD儿童家长均关注语言问题或以语言落后为主诉就诊,组2较组1更多关注到社会交往障碍及行为异常(P<0.05);两组家长均把“语言进步”作为治疗首要目标,其次为行为改善(包括会理人、看人、刻板动作减少、听话好带等)(P>0.05);其它诸如:家庭如何开展训练、是否能上幼儿园及上学、病因及生第二胎患病几率、训练费用、是否成为特才、训练时间长短等,比较差异部分有统计学意义(P<0.05);两组儿童家长的SCL-90总分差异无统计学意义(P>0.05),均高于文献中正常健康儿童父母的SCL-90得分(P<0.05);各因子分中抑郁和焦虑因子得分组2高于组1(P<0.05)。结论语言障碍或进步仍然是本地区学龄前期ASD儿童家长在诊疗中关注的首要问题,不同年龄段的ASD儿童诊疗及母亲心理健康状况存在差异。 Objective To understand the diagnosis and treatment of preschool-aged children with autism spectrum disorder (ASD) and the characteristics of their maternal mental health status in this region. To analyze the differences among different age groups and provide some references for further work. Methods A total of 235 well-diagnosed pre-ASD children were divided into two groups according to their ages: 98 cases in 18 ~ 36 months group (group 1) and 137 cases in 37 ~ 72 months group (group 2) Group of children diagnosed the problems related to the investigation and the use of Symptom Checklist 90 (SCL-90) to assess their mothers mental health. Results Compared with the first chief complaint, parents of ASD children in both groups were mainly concerned with language problems or complained of language backwardness. Group 2 was more concerned with social communication disorders and behavioral disorders than Group 1 (P <0.05) “Language progress ” as the primary goal of treatment, followed by behavior improvement (including the manager, watching people, reduced stereotyped movements, obedient band, etc.) (P> 0.05); other such as: how to train the family, Kindergarten and school, the etiology and the second child birth risk, training costs, become a special talent, the length of training time, the difference was statistically significant (P <0.05); two groups of children’s SCL-90 score (P <0.05), which were higher than SCL-90 scores of parents in normal healthy children (P <0.05); scores of depression and anxiety score in each factor group 2 were higher than those in group 1 (P <0.05) ). Conclusions The language barrier or improvement is still the primary concern of the parents of preschool-aged ASD children in the diagnosis and treatment of children with ASD. There are differences in the diagnosis and treatment of mothers with ASD in different age groups and their mothers’ mental health status.
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