Hu Chaoqun, Yang Fan, Yang Ting, Chen Jie, Dai Ying, Jia Feiyong, Wu Lijie, Hao Yan, Li Ling, Zhang Jie, Ke Xiaoyan, Yi Mingji, Hong Qi, Chen Jinjin, Fang Shuanfeng, Wang Yichao, Wang Qi, Jin Chunhua, Li Tingyu, Chen Li
Growth, Development and Mental Health Center of Children and Adolescents, Chongqing Key Laboratory of Childhood Nutrition and Health, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
Department of Developmental and Behavioral Pediatric, The First Hospital of Jilin University, Changchun, China.
Front Psychiatry. 2022 Mar 9;13:796554. doi: 10.3389/fpsyt.2022.796554. eCollection 2022.
This study aimed to investigate the prevalence of developmental regression in children with Autism Spectrum Disorder (ASD) and to explore its relationship with disease severity.
We finally included 1,027 ASD children aged 2-5 years from 13 cities in China: 138 with regressive ASD and 889 with non-regressive ASD. The Social Responsiveness Scale (SRS), Autism Behavior Checklist (ABC), Child Autism Rating Scale (CARS), and Children Neuropsychological and Behavioral Scale-Revision 2016 (CNBS-R2016) were used to evaluate the core symptoms and developmental status of children in the two groups.
Among the 1,027 ASD children eventually included, 138 (13.44%) cases showed regressive behavior and the average regression occurring age was 24.00 (18.00-27.00) months. Among the regressive children, 105 cases (76.09%) had language regression, 79 cases (57.25%) had social regression, and 4 cases (2.90%) had motor regression. The total scores of ABC and the sub-score of sensory and stereotypic behavior (β = 5.122, 95% CI: 0.818, 9.426, < 0.05; β = 1.104, 95% CI: 0.120, 2.089, < 0.05; β = 1.388, 95% CI: 0.038, 2.737, < 0.05), the SRS total scores and the sub-score of autistic mannerisms (β = 4.991, 95% CI: 0.494, 9.487, < 0.05; β = 1.297, 95% CI: 0.140, 2.453, < 0.05) of children in the regressive group were all higher than the non-regressive group. The total developmental quotient (DQ) of CNBS-R2016 and the DQ of gross motor, fine motor, adaptive behavior, language (β = -5.827, 95% CI: -11.529, -0.125, < 0.05) and personal society in the regressive group were lower than the non-regressive group and the proportion of children with intelligent developmental impairment was higher the non-regressive group.
Regressive autism is mainly manifested as language and social regression. Children with regressive ASD have more severe core symptoms, lower neurodevelopmental level DQ, and more serious disease degree than children with non-regressive ASD, which requires further etiological examinations and more clinical attention.
本研究旨在调查自闭症谱系障碍（ASD）儿童中发育倒退的患病率，并探讨其与疾病严重程度的关系。
我们最终纳入了来自中国13个城市的1027名2至5岁的ASD儿童：138名患有退行性ASD，889名患有非退行性ASD。使用社会反应量表（SRS）、自闭症行为检查表（ABC）、儿童自闭症评定量表（CARS）和儿童神经心理与行为量表-2016修订版（CNBS-R2016）评估两组儿童的核心症状和发育状况。
在最终纳入的1027名ASD儿童中，138例（13.44%）表现出退行性行为，平均倒退发生年龄为24.00（18.00 - 27.00）个月。在退行性儿童中，105例（76.09%）有语言倒退，79例（57.25%）有社交倒退，4例（2.90%）有运动倒退。退行性组儿童的ABC总分以及感觉和刻板行为子分数（β = 5.122，95%CI：0.818，9.426，P < 0.05；β = 1.104，95%CI：0.120，2.089，P < 0.05；β = 1.388，95%CI：0.038，2.737，P < 0.05）、SRS总分以及自闭症行为习惯子分数（β = 4.991，95%CI：0.494，9.487，P < 0.05；β = 1.297，95%CI：0.140，2.453，P < 0.05）均高于非退行性组。退行性组CNBS-R2016的总发育商（DQ）以及大运动、精细运动、适应行为、语言（β = -5.827，95%CI：-11.529，-0.125，P < 0.05）和个人社交方面的DQ均低于非退行性组，且智力发育障碍儿童的比例高于非退行性组。
退行性自闭症主要表现为语言和社交倒退。与非退行性ASD儿童相比，退行性ASD儿童的核心症状更严重，神经发育水平DQ更低，疾病程度更严重，这需要进一步进行病因学检查并给予更多临床关注。
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