Güler Hasan Ali, Orpay Afife Nur, Kılınç Kübra, Yılmaz Çiğdem, Türkoğlu Serhat
Department of Child and Adolescent Psychiatry, Faculty of Medicine, Selcuk University, Konya, Turkey.
Int J Dev Disabil. 2024 Aug 20;70(7):1297-1304. doi: 10.1080/20473869.2024.2392973. eCollection 2024.
This study investigated the utility of specific predictive and discriminative items within the Social Communication Questionnaire (SCQ) for distinguishing between autism spectrum disorder (ASD), intellectual disability (ID), and co-occurring ASD + ID in children.
A total of 137 children aged 4 to 12 years (52 typically developing (TD), 34 ASD, 26 ID, 25 ASD + ID) were included in the study. Cognitive development assessments were conducted for the ASD, ID, and ASD + ID groups in suitable cases. SCQ items were evaluated both in terms of total and subscale scores and individual items across groups.
The TD group had the lowest scores on the SCQ, while the ID group had significantly lower total and communication subscale scores on the SCQ compared to the ASD group. Additionally, there were no significant differences in SCQ scores between the ASD group and the co-occurring ASD + ID group. The ID group had lower scores on both the communication subscale and the total SCQ compared to the co-occurring ASD + ID group. The Receiver Operating Characteristic (ROC) analysis of SCQ total scores for differentiating the ASD + ID group from the ID group revealed an AUC of 0.834 for the total score, with a cutoff of 16.50 (sensitivity: 76%, specificity: 80.8%). Logistic regression identified 29 significant predictors distinguishing ASD + ID from ID, with absence of 'Group play' ( = 0.003, OR = 4.010) being the most predictive being in the ASD + ID group. Among the top items in the ROC analysis for the ID and ASD + ID groups, 'Friends (absence of close or best friends)', 'Range of facial expression (absence of normal facial expressions)', and absence of 'Head shaking to mean no' were identified as the highest discriminative factors.
This study highlights the potential of using the SCQ alongside clinical assessments to diagnose ASD in individuals with ID, emphasizing non-verbal communication, participation in group play, presence of close or best friends, and range of facial expression as key distinguishing factors. Further research with larger samples and comparisons of educational interventions based on these indicators is essential for developing tailored educational programs for the ASD + ID group.
本研究调查了社会沟通问卷（SCQ）中特定的预测性和区分性项目在区分儿童自闭症谱系障碍（ASD）、智力残疾（ID）和同时存在的ASD+ID方面的效用。
本研究共纳入137名4至12岁的儿童（52名发育正常（TD）、34名ASD、26名ID、25名ASD+ID）。在适当情况下，对ASD、ID和ASD+ID组进行了认知发展评估。对SCQ项目从总分、分量表分数以及各项目跨组情况进行了评估。
TD组在SCQ上得分最低，而ID组在SCQ上的总分和沟通分量表得分显著低于ASD组。此外，ASD组和同时存在的ASD+ID组在SCQ得分上没有显著差异。与同时存在的ASD+ID组相比，ID组在沟通分量表和SCQ总分上得分更低。用于区分ASD+ID组和ID组的SCQ总分的受试者工作特征（ROC）分析显示，总分的曲线下面积（AUC）为0.834，临界值为16.50（敏感性：76%，特异性：80.8%）。逻辑回归确定了29个区分ASD+ID和ID的显著预测因素，其中“团体游戏缺失”（=0.003，OR=4.010）是ASD+ID组中最具预测性的因素。在ID组和ASD+ID组的ROC分析的首要项目中，“朋友（没有亲密或最好的朋友）”、“面部表情范围（没有正常面部表情）”以及“摇头表示不”的缺失被确定为最高区分因素。
本研究强调了将SCQ与临床评估相结合用于诊断ID个体中的ASD的潜力，强调非言语沟通、参与团体游戏、存在亲密或最好的朋友以及面部表情范围是关键区分因素。基于这些指标进行更大样本的进一步研究以及教育干预的比较，对于为ASD+ID组制定量身定制的教育计划至关重要。
