A Prospective Study of the Emergence of Early Behavioral Signs of Autism
A Prospective Study of the Emergence of Early Behavioral Signs of Autism
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DOI：
10.1016/j.jaac.2009.11.009
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发表时间：
2010-03-01
影响因子：
13.3
通讯作者：
Young, Gregory S.
中科院分区：
文献类型：
--
作者：
Ozonoff, Sally;Iosif, Ana-Maria;Young, Gregory S.
目的：前瞻性地研究自闭症低风险和高风险婴儿在出生后第一年出现自闭症行为体征的情况。方法：采用前瞻性纵向设计，将25名后来被诊断为自闭症谱系障碍（ASD）的婴儿与25名后来被确定为具有典型发育的性别匹配的低风险儿童进行比较。参与者在6、12、18、24和36个月大时接受评估。频率的凝视的脸，社会的微笑，和定向发声编码的视频和评估的考官。结果如下：在6个月大的时候，两组之间对面部的凝视、共享微笑和发声的频率非常相似，但在后来被诊断为ASD的那组中，随着时间的推移，轨迹明显下降。在大多数变量上，到12个月龄时组间差异显著。尽管反复评估记录了大多数ASD婴儿的技能丧失，但大多数父母并没有报告他们孩子的发育出现倒退。结论：这些结果表明，自闭症的行为体征并不像Kanner曾经提出的那样在出生时就存在，而是随着时间的推移通过关键社交行为的减少而出现。更多的儿童可能会出现比以前认为的倒退过程，但家长报告的方法没有捕捉到这种现象。发病分类系统和临床筛选的影响进行了讨论。J. Am. Acad.儿童青少年。精神病学，2010;49（3）：256-266.
Objective: To examine prospectively the emergence of behavioral signs of autism in the first years of life in infants at low and high risk for autism. Method: A prospective longitudinal design was used to compare 25 infants later diagnosed with an autism spectrum disorder (ASD) with 25 gender-matched low-risk children later determined to have typical development. Participants were evaluated at 6, 12, 18, 24, and 36 months of age. Frequencies of gaze to faces, social smiles, and directed vocalizations were coded from video and rated by examiners. Results: The frequency of gaze to faces, shared smiles, and vocalizations; to others were highly comparable between groups at 6 months of age, but significantly declining trajectories over time were apparent in the group later diagnosed with ASD. Group differences were significant by 12 months of age on most variables. Although repeated evaluation documented loss of skills in most infants with ASD, most parents did not report a regression in their child's development. Conclusions: These results suggest that behavioral signs of autism are not present at birth, as once suggested by Kanner, but emerge over time through a process of diminishment of key social communication behaviors. More children may present with a regressive course than previously thought, but parent report methods do not capture this phenomenon well. Implications for onset classification systems and clinical screening are also discussed. J. Am. Acad. Child Adolesc. Psychiatry, 2010;49(3):256-266.