Growth, Development and Mental Health Center of Children and Adolescents, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, 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.
BMC Psychiatry. 2024 Jul 19;24(1):514. doi: 10.1186/s12888-024-05955-1.
In this prospective cohort study, we determined the phenotypic characteristics of children with regressive autism spectrum disorder (ASD) and explored the effects of rehabilitation.
We recruited 370 children with ASD aged 1.5-7 years. Based on the Regression Supplement Form, the children were assigned to two groups: regressive and non-regressive. The core symptoms and neurodevelopmental levels of ASD were assessed before and after 1 year of behavioral intervention using the Autism Diagnostic Observation Schedule (ADOS), Social Response Scale (SRS), Children Autism Rating Scale (CARS), and Gesell Developmental Scale (GDS).
Among the 370 children with ASD, 28.38% (105/370) experienced regression. Regression was primarily observed in social communication and language skills. Children with regressive ASD exhibited higher SRS and CARS scores and lower GDS scores than those with non-regressive ASD. After 1 year of behavioral intervention, the symptom scale scores significantly decreased for all children with ASD; however, a lesser degree of improvement was observed in children with regressive ASD than in those with non-regressive ASD. In addition, the symptom scores of children with regressive ASD below 4 years old significantly decreased, whereas the scores of those over 4 years old did not significantly improve. Children with regressive ASD showed higher core symptom scores and lower neurodevelopmental levels. Nevertheless, after behavioral intervention, some symptoms exhibited significant improvements in children with regressive ASD under 4 years of age.
Early intervention should be considered for children with ASD, particularly for those with regressive ASD.
在这项前瞻性队列研究中,我们确定了退行性自闭症谱系障碍(ASD)儿童的表型特征,并探讨了康复的效果。
我们招募了 370 名 1.5-7 岁的 ASD 儿童。根据回归补充表,将儿童分为两组:退行性和非退行性。在进行为期 1 年的行为干预之前和之后,使用孤独症诊断观察量表(ADOS)、社会反应量表(SRS)、儿童孤独症评定量表(CARS)和盖塞尔发展量表(GDS)评估 ASD 的核心症状和神经发育水平。
在 370 名 ASD 儿童中,28.38%(105/370)出现退行。退行主要发生在社会沟通和语言技能方面。退行性 ASD 儿童的 SRS 和 CARS 评分较高,GDS 评分较低,而非退行性 ASD 儿童的评分较低。经过 1 年的行为干预,所有 ASD 儿童的症状量表评分均显著下降;然而,退行性 ASD 儿童的改善程度低于非退行性 ASD 儿童。此外,退行性 ASD 儿童中年龄在 4 岁以下的儿童的症状评分显著下降,而年龄在 4 岁以上的儿童的评分没有显著改善。退行性 ASD 儿童的核心症状评分较高,神经发育水平较低。然而,经过行为干预,4 岁以下退行性 ASD 儿童的一些症状有了明显改善。
对于 ASD 儿童,特别是退行性 ASD 儿童,应考虑早期干预。