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低龄自闭症儿童语言及社交沟通差异的特征与相关因素

Profiles and correlates of language and social communication differences among young autistic children.

作者信息

Reetzke Rachel, Singh Vini, Hong Ji Su, Holingue Calliope B, Kalb Luther G, Ludwig Natasha N, Menon Deepa, Pfeiffer Danika L, Landa Rebecca J

机构信息

Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, United States.

Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, United States.

出版信息

Front Psychol. 2022 Sep 6;13:936392. doi: 10.3389/fpsyg.2022.936392. eCollection 2022.

Abstract

Delays in early language development are characteristic of young autistic children, and one of the most recognizable first concerns that motivate parents to seek a diagnostic evaluation for their child. Although early language abilities are one of the strongest predictors of long-term outcomes, there is still much to be understood about the role of language impairment in the heterogeneous phenotypic presentation of autism. Using a person-centered, Latent Profile Analysis, we first aimed to identify distinct patterns of language and social communication ability in a clinic-based sample of 498 autistic children, ranging in age from 18 to 60 months ( = 33 mo, = 12 mo). Next, a multinomial logistic regression analysis was implemented to examine sociodemographic and child-based developmental differences among the identified language and social communication profiles. Three clinically meaningful profiles were identified from parent-rated and clinician-administered measures: Profile 1 (48% of the sample) "Relatively Low Language and Social Communication Abilities," Profile 2 (34% of the sample) "Relatively Elevated Language and Social Communication Abilities," and Profile 3 (18% of the sample) "Informant Discrepant Language and Relatively Elevated Social Communication Abilities." Overall, young autistic children from the lowest-resource households exhibited the lowest language and social communication abilities, and the lowest non-verbal problem-solving and fine-motor skills, along with more features of attention-deficit/hyperactivity disorder and atypical auditory processing. These findings highlight the need for effective community-based implementation strategies for young autistic children from low-resource households and underrepresented communities to improve access to individualized quality care.

摘要

早期语言发育迟缓是自闭症幼儿的特征之一,也是促使家长为孩子寻求诊断评估的最明显的首要担忧之一。尽管早期语言能力是长期预后的最强预测指标之一,但关于语言障碍在自闭症异质性表型表现中的作用仍有许多有待了解之处。我们首先采用以个体为中心的潜在剖面分析,旨在确定498名年龄在18至60个月(平均 = 33个月,标准差 = 12个月)的自闭症门诊患儿的语言和社会沟通能力的不同模式。接下来,进行多项逻辑回归分析,以检验所确定的语言和社会沟通概况之间的社会人口统计学和基于儿童的发育差异。从家长评定和临床医生实施的测量中确定了三种具有临床意义的概况:概况1(占样本的48%)“语言和社会沟通能力相对较低”,概况2(占样本的34%)“语言和社会沟通能力相对较高”,以及概况3(占样本的18%)“信息提供者存在差异的语言和相对较高的社会沟通能力”。总体而言,来自资源最少家庭的自闭症幼儿表现出最低的语言和社会沟通能力、最低的非语言问题解决能力和精细运动技能,以及更多的注意力缺陷/多动障碍和非典型听觉处理特征。这些发现凸显了为来自资源匮乏家庭和代表性不足社区的自闭症幼儿制定有效的基于社区的实施策略的必要性,并改善获得个性化优质护理的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9be/9485602/b19cc4c9a676/fpsyg-13-936392-g001.jpg

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