Munson Jeffrey, Faja Susan, Meltzoff Andrew, Abbott Robert, Dawson Geraldine
University of Washington Autism Center and Center on Human Development and Disability, Seattle, Washington 98195, USA.
J Int Neuropsychol Soc. 2008 Nov;14(6):956-66. doi: 10.1017/S1355617708081393.
Currently, the heterogeneity in the developmental trajectories of autism spectrum disorders (ASD) is poorly understood. Preschool children with ASD participating in a longitudinal study received a battery of neurocognitive tasks that measured the learning of reward associations (Lrn-Rew), spatial working memory (SpatWM), and imitation from memory and novelty preference (Mem/Nov), as well as a measure of nonverbal problem-solving ability (NVDQ). Growth curve analyses via HLM were used to predict the variability in growth rates between age 4 to age 6.5 in Vineland Socialization and Communication scores. Individual differences in both Lrn-Rew and Mem/Nov were significantly related to Socialization and Communication growth rates above and beyond NVDQ, whereas SpatWM was not. Thus, specific aspects of neurocognitive functioning appear to be important predictors of developmental variability during the preschool years in children with ASD. We speculate that these findings support the combined role of ventromedial prefrontal and medial temporal lobe systems in the early pathogenesis of ASD and may be useful in predicting developmental trajectory. The benefits and challenges of assessing specific neurocognitive functions in children with autism is discussed with regard to general cognitive/developmental ability and the behavioral requirements of most assessment settings.
目前,人们对自闭症谱系障碍(ASD)发展轨迹的异质性了解甚少。参与一项纵向研究的患有ASD的学龄前儿童接受了一系列神经认知任务,这些任务测量了奖励关联学习(Lrn-Rew)、空间工作记忆(SpatWM)、记忆模仿和新奇偏好(Mem/Nov),以及一项非语言问题解决能力测量(NVDQ)。通过分层线性模型(HLM)进行的生长曲线分析被用于预测4岁至6.5岁之间在《温兰德社会适应与沟通量表》得分上的增长率差异。Lrn-Rew和Mem/Nov方面的个体差异与高于NVDQ的社交和沟通增长率显著相关,而SpatWM则不然。因此,神经认知功能的特定方面似乎是患有ASD的儿童学龄前发育差异的重要预测因素。我们推测这些发现支持了腹内侧前额叶和内侧颞叶系统在ASD早期发病机制中的联合作用,并且可能有助于预测发育轨迹。针对一般认知/发育能力以及大多数评估环境的行为要求,讨论了评估自闭症儿童特定神经认知功能的益处和挑战。