Veness Carly, Prior Margot, Eadie Patricia, Bavin Edith, Reilly Sheena
Hearing, Language and Literacy Group, Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.
J Paediatr Child Health. 2014 Sep;50(9):693-700. doi: 10.1111/jpc.12614. Epub 2014 Jun 9.
The aim of this study is to identify social communication skills in infancy which predict autism spectrum disorder (ASD) diagnosis by 7 years as compared with children with other developmental difficulties or typical development from within a population sample.
Children with an ASD (n = 41), developmental delay (n = 28), language impairment (n = 47) and typical development (n = 41) were drawn from a large, longitudinal community sample following children from 8 months to 7 years of age, the Early Language in Victoria Study. At 7 years of age, early social communication skills at 8, 12 and 24 months from the Communication and Symbolic Behavior Scales Infant-Toddler Checklist and the MacArthur-Bates Communicative Development Inventory: Words and Gestures were compared between groups and used to predict ASD diagnosis.
Significant predictors of ASD diagnosis were found from 8 months, predominantly focused on gesture use and communicative behaviours, such as requesting and joint attention. While comparisons between children with ASD and children with language impairment and typical development revealed differences from 8 months of age, the developmental delay group did not differ significantly from ASD on any measure until 24 months of age. At 24 months, children with ASD had lower Communication and Symbolic Behavior Scales Use of Communication scores as compared with all other groups.
The capacity to identify early markers of ASD should facilitate awareness of the risk of an ASD as compared with other developmental problems and point to the need for further developmental assessment, monitoring and provision of early intervention if indicated.
本研究旨在确定婴儿期的社交沟通技能，与人群样本中患有其他发育困难或发育正常的儿童相比，这些技能可预测7岁时的自闭症谱系障碍（ASD）诊断。
患有ASD（n = 41）、发育迟缓（n = 28）、语言障碍（n = 47）和发育正常（n = 41）的儿童来自一个大型纵向社区样本，该样本跟踪从8个月至7岁的儿童，即维多利亚早期语言研究。在7岁时，比较了各组在8、12和24个月时使用《沟通与象征行为量表婴幼儿检查表》以及《麦克阿瑟-贝茨沟通发展量表：单词和手势》所测得的早期社交沟通技能，并用于预测ASD诊断。
从8个月起就发现了ASD诊断的显著预测因素，主要集中在手势使用和沟通行为上，如请求和共同注意。虽然ASD儿童与语言障碍儿童及发育正常儿童之间的比较显示从8个月大时就存在差异，但发育迟缓组在24个月之前在任何测量指标上与ASD组均无显著差异。在24个月时，与所有其他组相比，ASD儿童的《沟通与象征行为量表沟通使用》得分较低。
识别ASD早期标志物的能力应有助于提高对ASD风险的认识，与其他发育问题相比，并指出如有必要，需要进一步进行发育评估、监测和提供早期干预。
