Corbett Blythe A, Swain Deanna M, Newsom Cassandra, Wang Lily, Song Yanna, Edgerton Dale
Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Department of Psychology, Vanderbilt University, Nashville, TN, USA; Vanderbilt Kennedy Center, Vanderbilt University, Nashville, TN, USA.
J Child Psychol Psychiatry. 2014 Aug;55(8):924-34. doi: 10.1111/jcpp.12184. Epub 2013 Dec 12.
Children with autism spectrum disorder (ASD) are impaired in social communication and interaction with peers, which may reflect diminished social motivation. Many children with ASD show enhanced stress when playing with other children. This study investigated social and stress profiles of children with ASD during play.
We utilized a peer interaction paradigm in a natural playground setting with 66 unmedicated, prepubertal, children aged 8-12 years [38 with ASD, 28 with typical development (TD)]. Salivary cortisol was collected before and after a 20-min playground interaction that was divided into periods of free and solicited play facilitated by a confederate child. Statistical analyses included Wilcoxon rank-sum tests, mixed effects models, and Spearman correlations to assess the between-group differences in social and stress functioning, identify stress responders, and explore associations between variables, respectively.
There were no differences between the groups during unsolicited free play; however, during solicited play by the confederate, significant differences emerged such that children with ASD engaged in fewer verbal interactions and more self-play than the TD group. Regarding physiological arousal, children with ASD as a group showed relatively higher cortisol in response to social play; however, there was a broad range of responses. Moreover, those with the highest cortisol levels engaged in less social communication.
The social interaction of children with ASD can be facilitated by peer solicitation; however, it may be accompanied by increased stress. The children with ASD that have the highest level of cortisol show less social motivation; yet, it is unclear if it reflects an underlying state of heightened arousal or enhanced reactivity to social engagement, or both.
自闭症谱系障碍（ASD）儿童在社交沟通和与同伴互动方面存在缺陷，这可能反映出社交动机减弱。许多患有ASD的儿童在与其他儿童玩耍时会表现出更大的压力。本研究调查了患有ASD的儿童在玩耍期间的社交和压力状况。
我们在自然操场环境中采用同伴互动范式，研究对象为66名未用药的青春期前8至12岁儿童[38名患有ASD，28名发育正常（TD）]。在20分钟的操场互动前后收集唾液皮质醇，互动分为由一名同伴儿童协助的自由玩耍和主动玩耍阶段。统计分析包括Wilcoxon秩和检验、混合效应模型和Spearman相关性分析，分别用于评估社交和压力功能的组间差异、识别压力反应者以及探索变量之间的关联。
在主动自由玩耍期间，两组之间没有差异；然而，在同伴主动发起的玩耍过程中，出现了显著差异，即与TD组相比，患有ASD的儿童进行的言语互动较少，自我玩耍较多。关于生理唤醒，患有ASD的儿童作为一个群体在社交玩耍时表现出相对较高的皮质醇水平；然而，反应范围较广。此外，皮质醇水平最高的儿童社交沟通较少。
同伴的主动发起可以促进患有ASD的儿童的社交互动；然而，这可能伴随着压力增加。皮质醇水平最高的患有ASD的儿童社交动机较低；然而，尚不清楚这是反映了潜在的唤醒增强状态还是对社交参与的反应性增强，或者两者兼而有之。
