Department of Child and Adolescent Psychiatry, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
Res Dev Disabil. 2010 Jan-Feb;31(1):1-8. doi: 10.1016/j.ridd.2009.07.012. Epub 2009 Aug 26.
Many studies have shown that children with autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD) have had early indicators of language delay. The aim of the present study was to examine the cognitive profile of school age children referred to a specialist clinic for ASD, ADHD, or both, and relate this profile specifically to the age at which these children were first flagged up (or not) as suspected from language delay during the preschool years. Forty clinic children with ASD, ADHD, or the combination of the two (without clinical suspicion of learning disability) were assessed cognitively and as regards language development and language function at a mean age of 7.3 years. They were contrasted with a group of 21 children from the community who had been flagged at 2.5 years as suspected of language delay, and who had been followed up neuropsyhiatrically/neuropsychologically and in respect of language at a mean age of 7.9 years. Mean WISC-III full scale IQ was lower than population norms (in spite of the exclusion in both samples of cases with obvious learning disability) and similar across diagnostic groups (ASD and ADHD), and across settings (clinic and community). WISC-III Kaufman factor profiles separated the diagnostic groups as regards Perceptual Organisation. Early concern about language delay was a strong predictor of lower IQ and of distinguishing between "pure" cases of ASD and ADHD. School age clinic children who present with ASD and ADHD have a similar cognitive and early language development profile as do those children from the community, followed prospectively, who present with a suspicion of early preschool language delay and are shown at school age to suffer from ASD or ADHD. Concern about early language delay in the preschool age should prompt assessments (psychiatric and cognitively) for ASD and ADHD in a multidisciplinary setting much more often than is currently the case. In many cases early language delay, even in the absence of clear learning disability should be taken as a signal that - regardless of specific diagnosis - intellectual functioning might be in the low average range.
许多研究表明，自闭症谱系障碍（ASD）和注意力缺陷/多动障碍（ADHD）的儿童在语言延迟方面有早期迹象。本研究的目的是检查被转诊到 ASD、ADHD 或两者专科诊所的学龄儿童的认知特征，并将这种特征与这些儿童在学前期间因语言延迟而首次被标记（或未被标记）的年龄具体相关联。40 名患有 ASD、ADHD 或两者结合（无学习障碍的临床怀疑）的诊所儿童在平均年龄为 7.3 岁时接受了认知评估以及语言发展和语言功能评估。他们与 21 名来自社区的儿童进行了对比，这些儿童在 2.5 岁时因语言延迟而被标记为可疑，并在平均年龄为 7.9 岁时进行了神经精神病学/神经心理学随访和语言随访。WISC-III 全量表智商低于人口正常值（尽管两个样本都排除了明显有学习障碍的病例），且在诊断组（ASD 和 ADHD）和环境（诊所和社区）之间相似。WISC-III Kaufman 因子分析在知觉组织方面将诊断组分开。早期对语言延迟的关注是 IQ 较低的有力预测指标，也是区分“纯”ASD 和 ADHD 病例的有力预测指标。在 ASD 和 ADHD 方面，具有相似认知和早期语言发展特征的学龄期诊所儿童与前瞻性随访的社区儿童相似，这些儿童在学前时期被怀疑有早期语言延迟，在学龄期被诊断为患有 ASD 或 ADHD。在学龄前时期对早期语言延迟的关注应该促使在多学科环境中更频繁地进行 ASD 和 ADHD 的评估（精神病学和认知方面），而不是目前的情况。在许多情况下，即使没有明显的学习障碍，早期语言延迟也应被视为信号，即无论特定诊断如何，智力表现可能处于平均水平以下。
