Ye QianYing, Liu LinRu, Lv ShaoLi, Cheng SanMei, Zhu HuiLin, Xu YanTing, Zou XiaoBing, Deng HongZhu
Child Development and Behavior Center, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Front Psychol. 2021 Jan 28;12:604542. doi: 10.3389/fpsyg.2021.604542. eCollection 2021.
Deficits in gestures act as early signs of impairment in social interaction (SI) and communication in children with autism spectrum disorder (ASD). However, the pieces of literature on atypical gesture patterns in ASD children are contradictory. This investigation aimed to explore the atypical gesture pattern of ASD children from the dimensions of quantity, communicative function, and integration ability; and its relationship with social ability and adaptive behavior. We used a semi-structured interactive play to evaluate gestures of 33 ASD children (24-48 months old) and 24 typically developing (TD) children (12-36 months old). And we evaluated the social ability, adaptive behavior, and productive language of ASD and TD children by using the Adaptive Behavior Assessment System version II (ABAS-II) and Chinese Communication Development Inventory (CCDI). No matter the total score of CCDI was corrected or not, the relative frequency of total gestures, behavior regulation (BR) gestures, SI gestures, and joint attention (JA) gestures of ASD children were lower than that of TD children, as well as the proportion of JA gestures. However, there was no significant group difference in the proportion of BR and SI gestures. Before adjusting for the total score of CCDI, the relative frequency of gestures without vocalization/verbalization integration and vocalization/verbalization-integrated gestures in ASD children was lower than that in TD children. However, after matching the total score of CCDI, only the relative frequency of gestures without vocalization/verbalization integration was lower. Regardless of the fact that the total score of CCDI was corrected or not, the relative frequency and the proportion of eye-gaze-integrated gestures in ASD children were lower than that in TD children. And the proportion of gestures without eye-gaze integration in ASD children was higher than that in TD children. For ASD children, the social skills score in ABAS-II was positively correlated with the relative frequency of SI gesture and eye-gaze-integrated gestures; the total score of ABAS-II was positively correlated with the relative frequency of total gestures and eye-gaze-integrated gestures. In conclusion, ASD children produce fewer gestures and have deficits in JA gestures. The deficiency of integrating eye gaze and gesture is the core deficit of ASD children's gesture communication. Relatively, ASD children might be capable of integrating vocalization/verbalization into gestures. SI gestures and the ability to integrate gesture and eye gaze are related to social ability. The quantity of gestures and the ability to integrate gesture with eye gaze are related to adaptive behavior. www.ClinicalTrials.gov, identifier ChiCTR1800019679.
手势缺陷是自闭症谱系障碍（ASD）儿童社交互动（SI）和沟通障碍的早期迹象。然而，关于ASD儿童非典型手势模式的文献相互矛盾。本研究旨在从数量、沟通功能和整合能力维度探索ASD儿童的非典型手势模式；及其与社交能力和适应性行为的关系。我们采用半结构化互动游戏评估了33名ASD儿童（24 - 48个月大）和24名发育正常（TD）儿童（12 - 36个月大）的手势。并且我们使用第二版适应性行为评估系统（ABAS - II）和中文沟通发展量表（CCDI）评估了ASD和TD儿童的社交能力、适应性行为和表达性语言。无论CCDI总分是否校正，ASD儿童的总手势、行为调节（BR）手势、SI手势和联合注意（JA）手势的相对频率均低于TD儿童，JA手势的比例也是如此。然而，BR和SI手势的比例在两组间无显著差异。在校正CCDI总分之前，ASD儿童中无发声/言语整合的手势和发声/言语整合手势的相对频率低于TD儿童。然而，在匹配CCDI总分后，只有无发声/言语整合的手势相对频率较低。无论CCDI总分是否校正，ASD儿童中眼神注视整合手势的相对频率和比例均低于TD儿童。并且ASD儿童中无眼神注视整合的手势比例高于TD儿童。对于ASD儿童，ABAS - II中的社交技能得分与SI手势和眼神注视整合手势的相对频率呈正相关；ABAS - II总分与总手势和眼神注视整合手势的相对频率呈正相关。总之，ASD儿童产生的手势较少且JA手势存在缺陷。眼神注视与手势整合不足是ASD儿童手势沟通的核心缺陷。相对而言，ASD儿童可能有能力将发声/言语整合到手势中。SI手势以及手势与眼神注视的整合能力与社交能力有关。手势数量以及手势与眼神注视的整合能力与适应性行为有关。 www.ClinicalTrials.gov，标识符ChiCTR1800019679
