自闭症谱系障碍儿童的弟弟妹妹的早期社交沟通与认知发展

Early social-communicative and cognitive development of younger siblings of children with autism spectrum disorders.

作者信息

Stone Wendy L, McMahon Caitlin R, Yoder Paul J, Walden Tedra A

机构信息

Kennedy Center, Department of Pediatrics, Vanderbilt University, Nashville, TN 37203, USA.

出版信息

Arch Pediatr Adolesc Med. 2007 Apr;161(4):384-90. doi: 10.1001/archpedi.161.4.384.

DOI:10.1001/archpedi.161.4.384

PMID:17404136

Abstract

OBJECTIVE

To compare the early social-communicative development of younger siblings of children with autism spectrum disorders (ASDs) with that of younger siblings of children with typical development, using parental report and child-based measures.

DESIGN

Group comparison.

SETTING

Vanderbilt University, between July 1, 2003, and July 31, 2006.

PARTICIPANTS

Younger siblings of children with ASD (n = 64) and younger siblings of children with typical development (n = 42) between the ages of 12 and 23 months (mean, 16 months). Main Exposure Having a sibling with an ASD.

OUTCOME MEASURES

Child-based measures included a cognitive assessment; an interactive screening tool assessing play, imitation, and communication; and a rating of autism symptoms. Parental report measures were an interview of social-communicative interactions and a questionnaire assessing language and communication skills.

RESULTS

Younger siblings of children with ASD demonstrated weaker performance in nonverbal problem solving (mean difference [MD], 5.91; 95% confidence interval [CI], 2.48-9.34), directing attention (MD, 0.52; 95% CI, 0.07-0.97), understanding words (MD, 33.30; 95% CI, 3.11-63.48), understanding phrases (MD, 4.56; 95% CI, 1.85-7.27), gesture use (MD, 1.49; 95% CI, 0.51-2.47), and social-communicative interactions with parents (MD, 1.32; 95% CI, 0.27-2.37), and had increased autism symptoms (MD, 2.54; 95% CI, 1.05-4.03), relative to control siblings. A substantial minority of the ASD sibling group exhibited lower performance relative to controls. Significant correlations between child-based measures and parental reports assessing similar constructs were found (r = -0.74 to 0.53; P range, .000-.002).

CONCLUSION

The weaker performance found for children in the ASD sibling group may represent early-emerging features of the broader autism phenotype, thus highlighting the importance of developmental surveillance for younger siblings.

摘要

目的

采用家长报告和基于儿童的测量方法，比较自闭症谱系障碍（ASD）患儿的弟弟妹妹与发育正常儿童的弟弟妹妹在社交沟通方面的早期发育情况。

设计

组间比较。

地点

范德比尔特大学，2003年7月1日至2006年7月31日。

参与者

年龄在12至23个月（平均16个月）之间的ASD患儿的弟弟妹妹（n = 64）和发育正常儿童的弟弟妹妹（n = 42）。主要暴露因素为有一个患ASD的兄弟姐妹。

观察指标

基于儿童的测量方法包括认知评估；评估玩耍、模仿和沟通的互动筛查工具；以及自闭症症状评分。家长报告的测量方法包括社交沟通互动访谈和评估语言及沟通技能的问卷。

结果

与对照组的兄弟姐妹相比，ASD患儿的弟弟妹妹在非语言问题解决方面表现较差（平均差[MD]，5.91；95%置信区间[CI]，2.48 - 9.34），引导注意力方面（MD，0.52；95% CI，0.07 - 0.97），理解单词方面（MD，33.30；95% CI，3.11 - 63.48），理解短语方面（MD，4.56；95% CI，1.85 - 7.27），手势使用方面（MD，1.49；95% CI，0.51 - 2.47），以及与父母的社交沟通互动方面（MD，1.32；95% CI，0.27 - 2.37），并且自闭症症状有所增加（MD，2.54；95% CI，1.05 - 4.03）。ASD患儿兄弟姐妹组中相当一部分人的表现相对于对照组较低。发现基于儿童的测量方法与评估相似结构的家长报告之间存在显著相关性（r = -0.74至0.53；P值范围，0.000 - 0.002）。