Bal Vanessa Hus, Kim So-Hyun, Cheong Daniel, Lord Catherine
University of California, San Francisco, USA
Yale University, USA.
Autism. 2015 Oct;19(7):774-84. doi: 10.1177/1362361315575840. Epub 2015 Apr 28.
Daily living skills (DLS), such as personal hygiene, meal preparation, and money management, are important to independent living. Research suggests that many individuals with autism spectrum disorder exhibit impairments in daily living skills relative to their cognitive skills. This study examined predictors of daily living skills attainment and trajectories of daily living skills in a longitudinal sample referred for possible autism spectrum disorder and followed from 2 to 21 years of age. Consistent with previous studies, participants with autism spectrum disorder and nonspectrum diagnoses showed continual development of daily living skills throughout childhood and adolescence. Early childhood nonverbal mental age was the strongest predictor of daily living skills attainment for both diagnostic groups. Group-based modeling suggested two distinct trajectories of daily living skills development for participants with autism spectrum disorder. Skill levels for both groups of young adults with autism spectrum disorder remained considerably below age level expectations. Whereas the "High-DLS" group gained approximately 12 years in daily living skills from T2 to T21, the "Low-DLS" group's daily living skills improved 3-4 years over the 16- to 19-year study period. Nonverbal mental age, receptive language, and social-communication impairment at 2 years predicted High- versus Low-DLS group membership. Receiving greater than 20 h of parent-implemented intervention before age 3 was also associated with daily living skills trajectory. Results suggest that daily living skills should be a focus of treatment plans for individuals with autism spectrum disorder, particularly adolescents transitioning to young adulthood.
日常生活技能(如个人卫生、膳食准备和财务管理)对于独立生活很重要。研究表明,许多自闭症谱系障碍患者在日常生活技能方面相对于其认知技能存在缺陷。本研究在一个可能患有自闭症谱系障碍且年龄从2岁到21岁的纵向样本中,考察了日常生活技能获得的预测因素以及日常生活技能的发展轨迹。与先前的研究一致,患有自闭症谱系障碍和非谱系诊断的参与者在整个童年和青少年时期日常生活技能都在持续发展。幼儿期的非言语心理年龄是两个诊断组日常生活技能获得的最强预测因素。基于组的模型表明,自闭症谱系障碍参与者的日常生活技能发展有两种不同的轨迹。两组患有自闭症谱系障碍的年轻人的技能水平仍远低于年龄预期水平。在从T2到T21的时间段内,“高日常生活技能”组在日常生活技能方面提高了约12年,而“低日常生活技能”组在16至19年的研究期间日常生活技能提高了3至4年。2岁时的非言语心理年龄、接受性语言和社交沟通障碍可预测高日常生活技能组与低日常生活技能组的归属。在3岁前接受超过20小时的家长实施干预也与日常生活技能轨迹相关。结果表明,日常生活技能应成为自闭症谱系障碍患者治疗计划的重点,尤其是对于正从青少年过渡到青年期的患者。