Brunetti Sara, Rossi Andrea, Galli Jessica, Gitti Filippo, Nardocci Nardo, Giordano Lucio, Accorsi Patrizia, Calza Stefano, Fazzi Elisa
Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy -
Child and Adolescent Neurology and Psychiatry Unit, Children Hospital, ASST Spedali Civili of Brescia, Brescia, Italy.
Minerva Pediatr (Torino). 2022 May 5. doi: 10.23736/S2724-5276.22.06835-5.
Repetitive and Stereotyped Behaviors (ST) are one of the key features of autism spectrum disorder (ASD) and they frequently occur in children with developmental delay/intellectual disability or sensory deprivation, but they are also described in children otherwise typical. This study aims to describe and compare ST in children with different neurodevelopmental disorders and in children having stereotypies but no other medical diagnosis (primary stereotypies).
The study sample comprised children with autism spectrum disorder (ASD) developmental delay (DD), severe visual impairment (VI) and primary stereotypies (PS), aged between 2 and 12 years old. The characteristics of the ST (age of onset, frequency, duration, triggers, phenomenology) were collected from their clinical history. The children's caregivers completed the Repetitive Behavior Scalerevised (RBS-R) and the Child Behavior Checklist (CBCL) to assess the ST and to screen for behavioral problems, respectively. Data concerning family history and comorbidity were also collected.
87 children (ASD [n=23]; DD [n=21]; VI [n=20]; PS [n=23]) were assessed. Mean age of ST onset was before 24 months in the whole sample. Symptoms usually occurred more than once a day in all groups, but Self-Injurious Behavior (SIB) and ST were reported at higher scores on the RBS-R in Secondary group. Stereotypies lasted less than 5 minutes in all but VI sample, in which lasted longer. Stereotypies of locomotion were mostly reported in ASD, self-injurious behaviors in VI, upper limb stereotypies in PS and DD. Parents reported several repetitive behaviors on the RBS-R, while attention deficit and withdrawn behavior appeared to be the main findings of the sample in the CBCL. Finally, a high number of comorbidities and family history for neurodevelopmental disorders was found in all groups.
The study showed that some specific patterns of stereotypies could be identified in most groups of disorders. At the same time the behavioral profile of children with stereotypies shows a significant overlap among different groups. These preliminary results suggest that stereotypies are strongly linked to neurodevelopmental disorders, but their association needs to be clarified with further studies.
重复刻板行为（ST）是自闭症谱系障碍（ASD）的关键特征之一，常见于发育迟缓/智力残疾或感觉剥夺的儿童，但在其他方面正常的儿童中也有描述。本研究旨在描述和比较不同神经发育障碍儿童以及有刻板行为但无其他医学诊断（原发性刻板行为）儿童的ST情况。
研究样本包括年龄在2至12岁之间的自闭症谱系障碍（ASD）、发育迟缓（DD）、严重视力障碍（VI）和原发性刻板行为（PS）儿童。从他们的临床病史中收集ST的特征（发病年龄、频率、持续时间、触发因素、现象学）。儿童的照顾者分别完成重复行为量表修订版（RBS-R）和儿童行为检查表（CBCL），以评估ST和筛查行为问题。还收集了家族史和共病的数据。
对87名儿童（ASD [n = 23]；DD [n = 21]；VI [n = 20]；PS [n = 23]）进行了评估。整个样本中ST的平均发病年龄在24个月之前。所有组中症状通常每天出现不止一次，但在继发性组中，自我伤害行为（SIB）和ST在RBS-R上的得分较高。除VI样本外，所有样本中刻板行为持续时间均少于5分钟，VI样本中持续时间更长。运动性刻板行为在ASD中最常被报告，自我伤害行为在VI中最常被报告，上肢刻板行为在PS和DD中最常被报告。父母在RBS-R上报告了几种重复行为，而注意力缺陷和退缩行为似乎是样本在CBCL中的主要发现。最后，在所有组中都发现了大量的共病和神经发育障碍家族史。
研究表明，在大多数疾病组中可以识别出一些特定的刻板行为模式。同时，有刻板行为儿童的行为特征在不同组之间存在显著重叠。这些初步结果表明，刻板行为与神经发育障碍密切相关，但其关联需要进一步研究来阐明。
