自闭症谱系障碍中的运动障碍与发育性协调障碍不同吗？来自 SPARK 研究的报告。
Is Motor Impairment in Autism Spectrum Disorder Distinct From Developmental Coordination Disorder? A Report From the SPARK Study.
机构信息
A.N. Bhat, PT, PhD, Department of Physical Therapy, University of Delaware, 540 South College Avenue, Newark, DE 19713 (USA); and Biomechanics & Movement Science Program, University of Delaware; and Department of Psychological & Brain Sciences, University of Delaware.
出版信息
Phys Ther. 2020 Apr 17;100(4):633-644. doi: 10.1093/ptj/pzz190.
BACKGROUND
Motor impairments are pervasive in Autism Spectrum Disorder (ASD); however, children with ASD rarely receive a dual diagnosis of Developmental Coordination Disorder (DCD). The Simons Foundation SPARK study engaged families affected by ASD through an online study.
OBJECTIVES
The DCD parent questionnaire (DCDQ) was used to assess the prevalence of a risk for motor impairment or DCD in children with ASD between 5 and 15 years of age.
DESIGN
This study utilizes parent reports from a large database of children with ASD.
METHODS
A total of 16,705 parents of children with ASD completed the DCDQ. We obtained our final SPARK dataset (n = 11,814) after filtering out invalid data, using stronger cut-offs to confirm ASD traits, and excluding children with general neuromotor impairments/intellectual delays. We compared DCDQ total and subscale scores from the SPARK dataset with published norms for each age between 5 and 15 years.
RESULTS
The proportion of children with ASD at risk for a motor impairment was very high at 86.9%. Children with ASD did not outgrow their motor impairments and continued to present with a risk for DCD even into adolescence. Yet, only 31.6% of children were receiving physical therapy services.
LIMITATIONS
Our analysis of a large database of parent-reported outcomes using the DCDQ did not involve follow-up clinical assessments.
CONCLUSIONS
Using a large sample of children with ASD, this study shows that a risk for motor impairment or DCD was present in most children with ASD and persists into adolescence; however, only a small proportion of children with ASD were receiving physical therapist interventions. A diagnosis of ASD must trigger motor screening, evaluations, and appropriate interventions by physical and occupational therapists to address the functional impairments of children with ASD while also positively impacting their social communication, cognition, and behavior. Using valid motor measures, future research must determine if motor impairment is a fundamental feature of ASD.
背景
运动障碍在自闭症谱系障碍（ASD）中普遍存在；然而，患有 ASD 的儿童很少同时被诊断为发育性协调障碍（DCD）。西蒙斯基金会 SPARK 研究通过一项在线研究让受 ASD 影响的家庭参与进来。
目的
使用 DCD 家长问卷（DCDQ）评估 5 至 15 岁 ASD 儿童运动障碍或 DCD 的风险患病率。
设计
本研究利用来自 ASD 儿童大型数据库的家长报告。
方法
共有 16705 名 ASD 儿童的家长完成了 DCDQ。在剔除无效数据、使用更强的截断值来确认 ASD 特征以及排除有一般性神经运动障碍/智力迟缓的儿童后，我们获得了最终的 SPARK 数据集（n=11814）。我们将 SPARK 数据集的 DCDQ 总分和分量表得分与每个 5 至 15 岁年龄组的已发表标准进行了比较。
结果
患有 ASD 的儿童有运动障碍风险的比例非常高，为 86.9%。患有 ASD 的儿童的运动障碍并没有随着年龄的增长而消失，即使进入青春期，他们仍存在 DCD 的风险。然而，只有 31.6%的儿童接受了物理治疗服务。
局限性
我们使用 DCDQ 对大型家长报告结果数据库进行分析，但没有进行后续的临床评估。
结论
本研究使用 ASD 儿童的大样本显示，大多数 ASD 儿童都存在运动障碍或 DCD 的风险，且这种风险持续到青春期；然而，只有一小部分 ASD 儿童接受了物理治疗师的干预。ASD 的诊断必须触发对运动障碍的筛查、评估和物理治疗师、职业治疗师的适当干预，以解决 ASD 儿童的功能障碍问题，同时对他们的社会沟通、认知和行为产生积极影响。使用有效的运动测量方法，未来的研究必须确定运动障碍是否是 ASD 的一个基本特征。
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