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早期感觉模式对自闭症和非自闭症儿童学龄期适应性、适应不良及参与结果的发育影响。

Developmental Impacts of Early Sensory Patterns on School-Age Adaptive, Maladaptive, and Participation Outcomes in Autistic and Non-autistic Children.

作者信息

Chen Yun-Ju, Sideris John, Watson Linda R, Crais Elizabeth R, Baranek Grace T

机构信息

Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street CHP 133, Los Angeles, CA, 90089, USA.

Program for Early Autism Research, Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

出版信息

J Autism Dev Disord. 2024 Aug 2. doi: 10.1007/s10803-024-06494-0.

Abstract

Early sensory differences may cascade into later social-communication difficulties in autism, yet their impacts on broader functional outcomes have remained understudied. This study aimed to conduct a comprehensive investigation into the longitudinal impacts of sensory patterns, including sensory hyperresponsiveness, hyporesponsiveness, and sensory repetitions/seeking behavior, on various school-age outcome domains among a community sample of children with autistic and non-autistic conditions. We prospectively followed 1,517 children with caregiver-reported sensory questionnaires across three timepoints from infancy to school age. A subsample (n = 389; 88 with reported autism diagnosis/concerns) was further assessed with adaptive, maladaptive and participation outcome measures at age 6-7. Structural equation modeling approaches were used to evaluate the multivariate associations between latent growth parameters (i.e., intercepts and slopes) of sensory patterns and school-age outcomes. Increasing sensory hyperresponsiveness was directly associated with poorer adaptive/maladaptive outcomes and indirectly with lower participation in activities with higher functional demands across settings at school age. Elevated sensory hyporesponsiveness was associated with lower adaptive functioning, more externalizing problems, and lower classroom participation. Trajectories of sensory patterns accounted for more unique variances in adaptive functioning and participation in daily life settings with higher functional and environmental demands among autistic children compared to their non-autistic peers.

摘要

早期的感觉差异可能会在自闭症患者后期引发社交沟通困难,然而它们对更广泛功能结果的影响仍未得到充分研究。本研究旨在全面调查感觉模式(包括感觉反应过度、反应不足以及感觉重复/寻求行为)对社区中患有自闭症和非自闭症儿童样本在各个学龄期结果领域的纵向影响。我们前瞻性地跟踪了1517名儿童,在从婴儿期到学龄期的三个时间点通过照顾者报告的感觉问卷进行调查。对一个子样本(n = 389;88名报告有自闭症诊断/担忧)在6 - 7岁时进一步采用适应性、适应不良和参与结果测量方法进行评估。使用结构方程建模方法来评估感觉模式的潜在增长参数(即截距和斜率)与学龄期结果之间的多变量关联。感觉反应过度增加与较差的适应性/适应不良结果直接相关,并且与学龄期跨环境中对功能要求较高的活动参与度较低间接相关。感觉反应不足升高与较低的适应性功能、更多的外化问题以及较低的课堂参与度相关。与非自闭症同龄人相比,感觉模式轨迹在自闭症儿童的适应性功能以及参与功能和环境要求较高的日常生活环境方面解释了更多独特的方差。

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