Continuity and change in the social competence of children with autism, Down syndrome, and developmental delays
Continuity and change in the social competence of children with autism, Down syndrome, and developmental delays
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DOI：
10.1111/1540-5834.00002
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发表时间：
1999-01-01
影响因子：
9.5
通讯作者：
Ruskin, E
中科院分区：
文献类型：
--
作者：
Sigman, M;Ruskin, E
这项纵向研究的目的是：(1) 评估患有自闭症、唐氏综合症和其他发育迟缓的儿童在诊断、智力和语言技能方面的连续性和变化，(2) 明确这些儿童在社交能力和语言技能方面的缺陷，以及 (3) 确定学龄前阶段语言技能和中学时期同伴交往能力进步的前兆。最初的样本包括 70 名自闭症儿童、93 名唐氏综合症儿童、59 名发育迟缓儿童和 108 名正常发育儿童，前三组儿童的研究年龄为 2 至 6 岁。随访时，对 51 名自闭症儿童、71 名唐氏综合症儿童和 33 名发育迟缓儿童进行了评估，平均年龄约为 10-13 岁。长期随访显示，自闭症的诊断几乎没有变化，但自闭症组的智力和语言能力有相当大的改善，这种模式在唐氏综合症儿童中没有看到。自闭症儿童在共同注意力、某些形式的表征游戏、对他人情绪的反应以及同伴参与方面存在独特的缺陷，而患有唐氏综合症的儿童似乎仅在语言方面存在特定缺陷。联合注意力技能与所有群体的语言能力同时相关，并预测自闭症儿童表达语言的长期收益。自闭症儿童，无论其功能水平如何，与其他发育障碍儿童相比，与同学的社交互动较少，因为他们很少发起和接受游戏请求，而不是因为他们被同龄人拒绝。早期非语言沟通和游戏技能是唐氏综合症儿童开始同伴游戏的频率以及自闭症儿童同伴参与程度的预测因素。这些结果表明，早期沟通和游戏技能的提高可能会对这些儿童群体后期的语言和社交能力产生长期影响。
The aims of this longitudinal study were: (1) to assess the continuity and change in diagnosis, intelligence, and language skills in children with autism, Down syndrome, and other developmental delays, (2) to specify the deficits in social competence and language skills in these children, and (3) to identify precursors in the preschool period of gains in language skills and of peer engagement in the mid-school years. The initial sample consisted of 70 children with autism, 93 children with Down syndrome, 59 children with developmental delays, and 108 typically developing children, with the first three groups of children studied when they were between 2 and 6 years of age. At follow-up, 51 children with autism, 71 children with Down syndrome, and 33 children with developmental delays were assessed at mean ages around 10-13 years. The long-term follow-up showed little change in the diagnosis of autism but sizeable improvements in intellectual and language abilities within the autistic group, a pattern that was not seen in the children with Down syndrome. Unique deficits in joint attention, some forms of representational play, responsiveness to the emotions of others, and initiation of peer engagement were identified in the autistic children, whereas the children with Down syndrome seemed to have a specific deficit only in language. Joint attention skills were concurrently associated with language abilities in all groups and predicted long-term gains in expressive language for the children with autism. Children with autism, regardless of their level of functioning, were less socially engaged with classmates than the other developmentally disabled children because they infrequently initiated and accepted play bids, not because they were rebuffed by peers. Early nonverbal communication and play skills were predictors of the frequency of initiations of peer play for the children with Down syndrome as well as the extent of peer engagement of the children with autism. These results suggest that improvements in early communication and play skills may have long-term consequences for later language and social competence in these groups of children.