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自闭症谱系障碍中的运动刻板行为:临床随机研究及分类建议。

Motor stereotypies in autism spectrum disorder: Clinical randomized study and classification proposal.

作者信息

Melo Cláudia, Ribeiro Tiago Pinto, Prior Catarina, Gesta Camila, Martins Vânia, Oliveira Guiomar, Temudo Teresa

机构信息

Centro Hospitalar do São João, Portugal.

University of Porto, Portugal.

出版信息

Autism. 2023 Feb;27(2):456-471. doi: 10.1177/13623613221105479. Epub 2022 Jun 28.

Abstract

Motor stereotypies are one of the most frequent features in children with a diagnosis of autism spectrum disorder. They may disrupt children's functioning and development and be a potential source of stress for families. Several factors, including sex, age, cognitive ability, and severity of autism spectrum disorder, may influence the presence and intensity of stereotypies. The present study aimed to identify the prevalence of motor stereotypies in a group of children with autism spectrum disorder. In addition, it sought to investigate whether sex, age, cognitive ability, verbal language, neurological comorbidities, and severity of autism spectrum disorder were associated with an increased probability and higher number, duration, and variability of stereotypies. A total of 134 participants aged 2.3-17.6 years underwent a clinical protocol with standardized video-recorded sessions. Stereotypies were identified and classified by two independent evaluators. The prevalence of stereotypies was 56.7%, and a total of 1198 motor stereotypies were captured. Children who were younger, nonverbal, and had higher severity of autism spectrum disorder had an increased probability of presenting stereotypies. Being nonverbal or having higher severity of autism spectrum disorder was also associated with presenting a higher number of stereotypies. Children with developmental delay, intellectual disability, or epilepsy displayed longer stereotypies, and children with developmental delay or intellectual disability additionally presented more diverse stereotypies. As part of the study, the authors present a clinical classification model, a glossary, and video samples of motor stereotypies. The findings of this study suggest that children who are younger, nonverbal, have lower cognitive ability, and have higher severity of autism spectrum disorder may have a higher burden of stereotypies. Earlier intervention and monitoring of these children have the potential to improve their long-term outcomes.

摘要

运动刻板行为是自闭症谱系障碍患儿最常见的特征之一。它们可能会干扰儿童的功能和发育,成为家庭潜在的压力来源。包括性别、年龄、认知能力和自闭症谱系障碍严重程度在内的几个因素,可能会影响刻板行为的出现和强度。本研究旨在确定一组自闭症谱系障碍儿童中运动刻板行为的患病率。此外,研究还试图调查性别、年龄、认知能力、语言能力、神经共病以及自闭症谱系障碍的严重程度是否与刻板行为的发生概率增加、数量增多、持续时间延长及变异性增大有关。共有134名年龄在2.3至17.6岁之间的参与者接受了一项包含标准化视频记录环节的临床方案。由两名独立评估人员对刻板行为进行识别和分类。刻板行为的患病率为56.7%,共捕捉到1198次运动刻板行为。年龄较小、无语言能力且自闭症谱系障碍严重程度较高的儿童出现刻板行为的可能性增加。无语言能力或自闭症谱系障碍严重程度较高也与出现更多的刻板行为有关。患有发育迟缓、智力障碍或癫痫的儿童刻板行为持续时间更长,而患有发育迟缓或智力障碍的儿童还表现出更多样化的刻板行为。作为研究的一部分,作者提出了一个临床分类模型、一份术语表以及运动刻板行为的视频样本。本研究结果表明,年龄较小、无语言能力、认知能力较低且自闭症谱系障碍严重程度较高的儿童可能承受着更高的刻板行为负担。对这些儿童进行早期干预和监测有可能改善他们的长期预后。

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