Carey Helen, Tanner Kelly, Ratliff-Schaub Karen, Baldino Maria, Kelly Nicholas, Andridge Rebecca R
College of Health Sciences (Dr Carey), University of Indianapolis, Indianapolis, Indiana; Division of Clinical Therapies (Dr Tanner), Nationwide Children's Hospital, Columbus, Ohio; College of Medicine (Dr Ratliff-Schaub), University of South Carolina, Greenville, South Carolina; Phoenix Children's Hospital (Ms Baldino), Phoenix, Arizona; Center for Advanced Technology and Robotic Rehab (Dr Kelly), Children's Healthcare of Atlanta, Atlanta, Georgia; College of Public Health (Dr Andridge), The Ohio State University, Columbus, Ohio.
Pediatr Phys Ther. 2023 Jan 1;35(1):28-34. doi: 10.1097/PEP.0000000000000965. Epub 2022 Sep 12.
We hypothesized that clinical data from a neonatal intensive care unit (NICU) infant developmental follow-up clinic would identify early manifestations of autism spectrum disorder (ASD).
One hundred forty-four infants were identified; 72 later diagnosed with ASD and 72 controls. Retrospective chart review provided data from the Test of Infant Motor Performance (TIMP) and the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), between 8 and 26 months of age.
Between-group comparisons indicated no significant group difference in TIMP scores; however, Bayley-III scaled scores differed between the groups at 2 administration times. The within-group Bayley-III change scores declined significantly more for the ASD group in cognitive and communication subtests.
High-risk neonates, due to prematurity or morbidity, later diagnosed with ASD demonstrated statistically significant differences, including a more precipitous drop in Bayley-III scores over time. Early, longitudinal developmental surveillance for neonates at risk of ASD is critical. What this adds to the evidence: Early identification of ASD is critical to optimize developmental outcomes in young children, including infants born prematurely or with neonatal morbidity, who are perceived to have an increased risk for ASD. Despite these findings, minimal research has been conducted to evaluate the utility of commonly administered norm-referenced developmental surveillance instruments to identify possible early signs of ASD in this high-risk population due to prematurity or neonatal morbidity and not familial association. The present study analyzed retrospectively collected clinical data from a NICU developmental follow-up clinic for 144 infants, 72 of which were later diagnosed with ASD and 72 sex- and gestational age-matched controls. Results demonstrated statistically significant poorer Bayley-III outcomes for the ASD group compared with controls at 2 different study time points, including a more precipitous drop in Bayley-III scaled scores over time. This study highlights the importance of early and longitudinal developmental surveillance for high-risk neonates at risk of ASD.
我们假设新生儿重症监护病房（NICU）婴儿发育随访诊所的临床数据能够识别自闭症谱系障碍（ASD）的早期表现。
确定了144名婴儿；其中72名后来被诊断为ASD，72名作为对照。回顾性病历审查提供了婴儿运动能力测试（TIMP）以及贝利婴幼儿发展量表第三版（贝利-III）在8至26个月龄之间的数据。
组间比较表明，TIMP评分在两组之间无显著差异；然而，在两次施测时，两组之间的贝利-III量表评分有所不同。在认知和沟通子测试中，ASD组的组内贝利-III变化分数下降得更为显著。
由于早产或患病而后来被诊断为ASD的高危新生儿表现出统计学上的显著差异，包括贝利-III评分随时间下降更为急剧。对有ASD风险的新生儿进行早期、纵向的发育监测至关重要。本研究的新增证据：ASD的早期识别对于优化幼儿的发育结局至关重要，这些幼儿包括早产或患有新生儿疾病的婴儿，他们被认为患ASD的风险增加。尽管有这些发现，但针对早产或新生儿疾病而非家族关联的高危人群，评估常用的常模参照发育监测工具以识别ASD可能早期迹象的效用的研究却很少。本研究回顾性分析了NICU发育随访诊所144名婴儿的临床数据，其中72名后来被诊断为ASD，72名是性别和胎龄匹配的对照。结果表明，在两个不同的研究时间点，ASD组的贝利-III结果与对照组相比在统计学上显著更差，包括贝利-III量表评分随时间下降更为急剧。本研究强调了对有ASD风险的高危新生儿进行早期和纵向发育监测的重要性。
