Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada.
J Child Psychol Psychiatry. 2009 Dec;50(12):1459-67. doi: 10.1111/j.1469-7610.2009.02123.x. Epub 2009 Jul 22.
The objective of this study was to chart the developmental trajectories of high-functioning children with autism spectrum disorders (ASD) from early childhood to adolescence using the presence and absence of structural language impairment (StrLI) as a way of differentiating autism from Asperger syndrome (AS).
Sixty-four high-functioning children with ASD were ascertained at 4-6 years of age from several different regional diagnostic and treatment centers. At 6-8 years of age, the ADI-R and the Test of Oral Language Development were used to define an autism group (those with StrLI at 6-8 years of age) and an AS group (those without StrLI). Growth curve analysis was then used to chart the developmental trajectories of these children on measures of autistic symptoms, and adaptive skills in communication, daily living and socialization.
Differentiating the ASD group in terms of the presence/absence of StrLI provided a better explanation of the variation in growth curves than not differentiating high-functioning ASD children. The two groups had similar developmental trajectories but the group without StrLI (the AS group) was functioning better and had fewer autistic symptoms than the group with StrLI (the autism group) on all measures across time. The differences in outcome could not be explained by non-verbal IQ or change in early language skills.
Distinguishing between autism and Asperger syndrome based on the presence or absence of StrLI appears to be a clinically useful way of classifying ASD sub-types.
本研究旨在通过是否存在结构性语言障碍（StrLI）来区分自闭症与阿斯伯格综合征（AS），从而描绘高功能自闭症谱系障碍（ASD）儿童从幼儿期到青春期的发展轨迹。
从几个不同的区域诊断和治疗中心确定了 64 名 4-6 岁的高功能 ASD 儿童。在 6-8 岁时，使用孤独症诊断访谈量表修订版（ADI-R）和口语语言发展测试来定义自闭症组（6-8 岁时存在 StrLI）和 AS 组（不存在 StrLI）。然后使用增长曲线分析来描绘这些儿童在自闭症症状和沟通、日常生活和社交适应技能方面的发展轨迹。
根据是否存在 StrLI 对 ASD 组进行区分，比不区分高功能 ASD 儿童能更好地解释增长曲线的变化。这两个组具有相似的发展轨迹，但在所有时间点的所有测量指标上，没有 StrLI（AS 组）的组功能更好，自闭症症状更少，而存在 StrLI（自闭症组）的组则功能更差，自闭症症状更多。结果的差异不能用非语言智商或早期语言技能的变化来解释。
根据是否存在 StrLI 来区分自闭症和阿斯伯格综合征似乎是一种临床上有用的自闭症亚类分类方法。
