Lin Yu-Ju, Wu Yu-Yu, Tsai Wen-Che, Chang Jung-Chi, Shang Chi-Yuan, Gau Susan Shur-Fen
Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
Department of Psychiatry, College of Medicine, Taipei, Taiwan.
Psychol Med. 2025 Jul 21;55:e202. doi: 10.1017/S0033291725000133.
Limited longitudinal research examining developmental changes in visuospatial working memory (WM) among children and adolescents with autism spectrum disorder (ASD) has prompted our investigation.
We assessed 123 autistic children and adolescents and 145 typically developing controls (TDC) using the Cambridge Neuropsychological Test Automated Battery at baseline (Time 1 [mean age ± SD]: ASD: 13.04 ± 2.86; TDC: 11.53 ± 2.81) and 2-9 years later (Time 2: ASD: 18.08 ± 3.17; TDC: 16.41 ± 3.09) to measure changes of visuospatial (working) memory over time. The linear mixed model was used to compare the differences between ASD and TDC and estimate the effect of changes over time, age, ASD diagnosis, and interactions of Time×Age×ASD. The overall Age×ASD effect was calculated in the spline regression.
Autistic children and adolescents exhibited significantly poorer performance on all spatial tasks and some visual tasks than their TDC counterparts at Time 1 and Time 2, after adjusting for sex, age, attention deficit/hyperactivity disorder (ADHD), and full-scale intelligence quotient. There was an overall improvement from Time 1 to Time 2 across all tasks with significant Age×Time interactions. Significant Age×ASD interactions were observed in the delayed matching to sample, pattern recognition memory (PRM), spatial span (SSP), and spatial working memory (SWM) tasks with no significant Time×ASD interactions. In the quadratic nonlinear model, Age×ASD interactions were significant in PRM and SSP.
Despite significant improvements during the follow-up period, autistic children and adolescents continue to experience persistent deficits in SWM, with a weaker age-related improvement in visuospatial WM than TDC.
针对自闭症谱系障碍（ASD）儿童和青少年视觉空间工作记忆（WM）发育变化的纵向研究有限，这促使我们展开此项调查。
我们使用剑桥神经心理测试自动成套系统对123名自闭症儿童和青少年以及145名发育正常的对照儿童（TDC）进行了评估，在基线时（时间1 [平均年龄±标准差]：ASD组：13.04±2.86；TDC组：11.53±2.81）以及2至9年后（时间2：ASD组：18.08±3.17；TDC组：16.41±3.09）测量视觉空间（工作）记忆随时间的变化。采用线性混合模型比较ASD组和TDC组之间的差异，并估计时间、年龄、ASD诊断以及时间×年龄×ASD交互作用的影响。在样条回归中计算总体年龄×ASD效应。
在调整了性别、年龄、注意力缺陷多动障碍（ADHD）和全量表智商后，自闭症儿童和青少年在时间1和时间2的所有空间任务以及一些视觉任务上的表现均显著低于其TDC对照组。从时间1到时间2，所有任务总体上都有改善，存在显著的年龄×时间交互作用。在延迟匹配样本、模式识别记忆（PRM）、空间广度（SSP）和空间工作记忆（SWM）任务中观察到显著的年龄×ASD交互作用，而时间×ASD交互作用不显著。在二次非线性模型中，年龄×ASD交互作用在PRM和SSP中显著。
尽管在随访期间有显著改善，但自闭症儿童和青少年在SWM方面仍持续存在缺陷，与TDC相比，其视觉空间WM的年龄相关改善较弱。
