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自闭症儿童同胞婴儿早期发育轨迹的潜在类别分析。

Latent class analysis of early developmental trajectory in baby siblings of children with autism.

机构信息

Center for Autism and Related Disorders, Kennedy Krieger Institute, Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD 21211, USA.

出版信息

J Child Psychol Psychiatry. 2012 Sep;53(9):986-96. doi: 10.1111/j.1469-7610.2012.02558.x. Epub 2012 May 10.

Abstract

BACKGROUND

Siblings of children with autism (sibs-A) are at increased genetic risk for autism spectrum disorders (ASD) and milder impairments. To elucidate diversity and contour of early developmental trajectories exhibited by sibs-A, regardless of diagnostic classification, latent class modeling was used.

METHODS

Sibs-A (N = 204) were assessed with the Mullen Scales of Early Learning from age 6 to 36 months. Mullen T scores served as dependent variables. Outcome classifications at age 36 months included: ASD (N = 52); non-ASD social/communication delay (broader autism phenotype; BAP; N = 31); and unaffected (N = 121). Child-specific patterns of performance were studied using latent class growth analysis. Latent class membership was then related to diagnostic outcome through estimation of within-class proportions of children assigned to each diagnostic classification.

RESULTS

A 4-class model was favored. Class 1 represented accelerated development and consisted of 25.7% of the sample, primarily unaffected children. Class 2 (40.0% of the sample), was characterized by normative development with above-average nonverbal cognitive outcome. Class 3 (22.3% of the sample) was characterized by receptive language, and gross and fine motor delay. Class 4 (12.0% of the sample), was characterized by widespread delayed skill acquisition, reflected by declining trajectories. Children with an outcome diagnosis of ASD were spread across Classes 2, 3, and 4.

CONCLUSIONS

Results support a category of ASD that involves slowing in early non-social development. Receptive language and motor development is vulnerable to early delay in sibs-A with and without ASD outcomes. Non-ASD sibs-A are largely distributed across classes depicting average or accelerated development. Developmental trajectories of motor, language, and cognition appear independent of communication and social delays in non-ASD sibs-A.

摘要

背景

自闭症儿童的兄弟姐妹(sibs-A)患自闭症谱系障碍(ASD)和轻度障碍的遗传风险增加。为了阐明 sibs-A 所表现出的早期发育轨迹的多样性和轮廓,无论诊断分类如何,都使用潜在类别建模。

方法

从 6 到 36 个月的年龄,使用 Mullen 早期学习量表对 sibs-A(N=204)进行评估。Mullen T 分数作为因变量。36 个月时的结果分类包括:ASD(N=52);非 ASD 社交/沟通延迟(广泛自闭症表型;BAP;N=31);和未受影响(N=121)。使用潜在类别增长分析研究儿童特定的表现模式。然后,通过估计每个诊断分类中分配给每个诊断分类的儿童的比例,将潜在类别成员与诊断结果相关联。

结果

一个 4 类模型是有利的。类 1 代表加速发展,占样本的 25.7%,主要是未受影响的儿童。类 2(样本的 40.0%)的特点是正常发展,具有高于平均水平的非语言认知结果。类 3(样本的 22.3%)的特点是接受性语言以及粗大和精细运动延迟。类 4(样本的 12.0%)的特点是广泛的技能获取延迟,表现为下降轨迹。具有 ASD 结果诊断的儿童分布在 2、3 和 4 类中。

结论

结果支持一种涉及早期非社交发展迟缓的 ASD 类别。接受性语言和运动发育在 ASD 和非 ASD 结果的 sibs-A 中容易出现早期延迟。非 ASD 的 sibs-A 主要分布在描绘平均或加速发展的各个类别中。在非 ASD 的 sibs-A 中,运动、语言和认知的发展轨迹与沟通和社会延迟无关。

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