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自闭症谱系障碍中适应行为的发展轨迹:高风险的同胞队列研究。

Developmental trajectories of adaptive behavior in autism spectrum disorder: a high-risk sibling cohort.

机构信息

Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.

Autism Research Centre, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada.

出版信息

J Child Psychol Psychiatry. 2019 Jun;60(6):697-706. doi: 10.1111/jcpp.12985. Epub 2018 Oct 8.

Abstract

BACKGROUND

Children with autism spectrum disorder (ASD) often experience impairments in adaptive behavior.

METHODS

Developmental trajectories of adaptive behavior in ASD were examined in children from high-risk (siblings of children diagnosed with ASD, n = 403) and low-risk (no family history of ASD, n = 163) families. Children were assessed prospectively at 12, 18, 24, and 36 months of age using the Vineland Adaptive Behavior Scales and underwent a blind independent diagnostic assessment for ASD at 36 months of age.

RESULTS

The semi-parametric group-based modeling approach using standard scores on the Adaptive Behavior Composite revealed three distinct developmental trajectories: (a) Group 1 (21.2% of sample) showed average performance at 12 months and a declining trajectory; (b) Group 2 (52.8% of the sample) showed average performance at 12 months with a slightly declining trajectory; and (c) Group 3 (26.0% of the sample) showed a higher level of adaptive behavior at 12 months and a stable trajectory. The Mullen Scales of Early Learning Early Learning Composite and the Autism Observation Scale for Infants total score at 6 and 12 months predicted trajectory membership.

CONCLUSIONS

The results emphasize heterogeneous development associated with ASD and the need for interventions tailored to individual presentations.

摘要

背景

自闭症谱系障碍(ASD)儿童通常在适应行为方面存在障碍。

方法

本研究在高风险(ASD 患儿的兄弟姐妹,n=403)和低风险(无 ASD 家族史,n=163)家庭的儿童中,考察了 ASD 儿童适应行为的发展轨迹。在 12、18、24 和 36 个月时,使用 Vineland 适应行为量表对儿童进行前瞻性评估,并在 36 个月时对儿童进行盲法独立 ASD 诊断评估。

结果

使用适应行为综合标准分数的半参数群组基模方法显示了三种不同的发展轨迹:(a)第 1 组(样本的 21.2%)在 12 个月时表现出平均水平,随后呈下降趋势;(b)第 2 组(样本的 52.8%)在 12 个月时表现出平均水平,呈略微下降趋势;(c)第 3 组(样本的 26.0%)在 12 个月时表现出较高的适应行为水平和稳定的轨迹。6 个月和 12 个月时的 Mullen 早期学习综合量表和自闭症婴儿观察量表总分预测了轨迹的归属。

结论

研究结果强调了与 ASD 相关的异质发展,并需要针对个体表现进行量身定制的干预措施。

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