Araya Paula, Phillips Katrina, Waldie Karen, Underwood Lisa
School of Psychology, Faculty of Science, University of Auckland, Auckland, New Zealand.
School of Physiotherapy, Faculty of Medicine, University of Valparaiso, Valparaiso, Chile.
Autism Res. 2025 Feb;18(2):437-448. doi: 10.1002/aur.3304. Epub 2025 Jan 20.
This study explored gross motor development (GMD) trajectories among 6359 children, with and without autism, from the Growing Up in New Zealand longitudinal cohort study. By the age of 8, 173 children had either an autism diagnosis (n = 108) or parent-reported autism concerns (n = 65). Gross motor milestones were reported by mothers when children were 9, 24, and 54 months of age. We found that irrespective of autism diagnosis, GMD delays at 24 months of age were more likely among girls, children born preterm, and those whose mothers identified as European. A mixed-effect logistic regression model, controlling for antenatal maternal and child covariates, revealed that the proportion of children with GMD delay (relative to their peers) increased significantly from 9 to 54 months for all three groups, but the increase was greater for those with autism concerns (OR = 1.28, 95% CI = 1.08-1.52) or an autism diagnosis (OR = 1.26, 95% CI = 1.10-1.43) compared to the no autism group (OR = 1.06, 95% CI = 1.02-1.10). Differences in the changes in GMD performance among children with an autism diagnosis compared to those without autism occurred between 9 and 24 months (OR = 2.16, 95% CI = 1.13-4.13). No significant GMD delay differences were found at any time between children with an autism diagnosis versus those with autism concerns. Children with a GMD delay should be screened for autism at 24 m. Early identification is the first step toward knowledge-based, effective intervention of developmental difficulties.
这项研究从新西兰成长纵向队列研究中，对6359名患有和未患自闭症的儿童的大肌肉运动发展（GMD）轨迹进行了探索。到8岁时，173名儿童被诊断患有自闭症（n = 108）或家长报告有自闭症相关担忧（n = 65）。母亲们报告了孩子在9个月、24个月和54个月大时的大肌肉运动里程碑。我们发现，无论是否被诊断为自闭症，24个月大时出现GMD延迟的情况在女孩、早产儿童以及母亲为欧洲裔的儿童中更为常见。一个控制了产前母亲和儿童协变量的混合效应逻辑回归模型显示，所有三组儿童中，GMD延迟儿童（相对于同龄人）的比例从9个月到54个月都显著增加，但与无自闭症组（OR = 1.06，95% CI = 1.02 - 1.10）相比，有自闭症相关担忧的儿童（OR = 1.28，95% CI = 1.08 - 1.52）或被诊断为自闭症的儿童（OR = 1.26，95% CI = 1.10 - 1.43）增加幅度更大。与无自闭症的儿童相比，被诊断为自闭症的儿童在9个月至24个月之间GMD表现变化存在差异（OR = 2.16，95% CI = 1.13 - 4.13）。在任何时候，被诊断为自闭症的儿童与有自闭症相关担忧的儿童之间均未发现显著的GMD延迟差异。应在24个月时对有GMD延迟的儿童进行自闭症筛查。早期识别是对发育困难进行基于知识的有效干预的第一步。
