Department of Psychiatry, Center for Autism and the Developing Brain, Weill Cornell Medicine, White Plains, NY, USA.
Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
J Child Psychol Psychiatry. 2018 Mar;59(3):258-267. doi: 10.1111/jcpp.12808. Epub 2017 Sep 26.
This study examined early predictors of and changes in school-age academic achievement and class placement in children referred for autism spectrum disorder (ASD) at age 2.
Of 111 ASD referrals, 74 were diagnosed with ASD at age 18. Regression analyses were performed to identify age 3 predictors of achievement in arithmetic, passage comprehension, word reading, and spelling at ages 9 and 18. Linear Mixed Models were used to examine predictors of academic growth between ages 9 and 18.
Academic skills varied widely at 9 and 18, but were mostly commensurate with or higher than expected given cognitive levels. However, 22% (age 9) and 32% (age 18) of children with average/above average IQ showed below/low average achievement in at least one academic domain. Children who remained in general education/inclusion classrooms had higher achievement than those who moved to special education classrooms. Stronger cognitive skills at age 3 and 9 predicted better academic achievement and faster academic growth from age 9 to 18. Parent participation in intervention by age 3 predicted better achievement at age 9 and 18.
Many children with ASD achieve basic academic skills commensurate with or higher than their cognitive ability. However, more rigorous screening for learning difficulties may be important for those with average cognitive skills because a significant minority show relative academic delays. Interventions targeting cognitive skills and parent participation in early treatment may have cascading effects on long-term academic development.
本研究旨在探讨 2 岁时被诊断为自闭症谱系障碍（ASD）的儿童在学龄期学术成就和班级安置的早期预测因素及其变化。
在 111 名 ASD 转诊儿童中，有 74 名在 18 岁时被诊断为 ASD。回归分析用于确定 3 岁时的预测因素，以预测 9 岁和 18 岁时的算术、阅读理解、单词阅读和拼写成绩。线性混合模型用于检验 9 至 18 岁期间学术增长的预测因素。
9 岁和 18 岁时的学术技能差异很大，但大多数与认知水平相当或更高。然而，22%（9 岁）和 32%（18 岁）的平均/高于平均智商的儿童在至少一个学术领域的成绩低于/低于平均水平。仍在普通教育/融合教室的儿童的成绩高于转入特殊教育教室的儿童。3 岁和 9 岁时更强的认知技能预测了从 9 岁到 18 岁更好的学术成就和更快的学术增长。3 岁时家长参与干预的情况预测了 9 岁和 18 岁时的更好成绩。
许多 ASD 儿童的基本学术技能与他们的认知能力相当或更高。然而，对于那些具有平均认知技能的儿童，更严格的学习困难筛查可能很重要，因为少数儿童存在相对的学业延迟。针对认知技能和家长参与早期治疗的干预措施可能对长期学术发展产生级联效应。
