Early social-communicative and cognitive development of younger siblings of children with autism spectrum disorders
Early social-communicative and cognitive development of younger siblings of children with autism spectrum disorders
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DOI：
10.1001/archpedi.161.4.384
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发表时间：
2007-04-01
影响因子：
--
通讯作者：
Walden, Tedra A.
中科院分区：
文献类型：
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作者：
Stone, Wendy L.;McMahon, Caitlin R.;Walden, Tedra A.
目的：采用父母报告和基于儿童的测量方法，比较自闭症谱系障碍(ASDS)儿童的弟弟妹妹和发育正常儿童的弟弟妹妹的早期社交能力发育。设计：群体比较。地点：范德比尔特大学，2003年7月1日至2006年7月31日。参与者：12~23个月(平均16个月)的自闭症谱系障碍儿童的弟弟妹妹(n=)和典型发育儿童(n=42)的弟弟妹妹。主要暴露：有ASD的兄弟姐妹包括认知评估；评估游戏、模仿和交流的交互式筛查工具；以及自闭症症状的评级。结果：ASD儿童在非语言问题解决(平均差值5.91；95%可信区间2.48-9.34)、定向注意(MD，0.52；95%CI，0.07-0.97)、理解词(MD，33.30；95%CI，3.11-63.48)、理解短语(MD，4.56；95%CI，1.85-7.27)，手势使用(MD，1.49；95%CI，0.51-2.47)，以及与父母的社交互动(MD，1.32；95%CI，0.27-2.37)，与对照兄弟姐妹相比，自闭症症状增加(MD，2.54；95%CI，1.05-4.03)。与对照组相比，ASD兄弟姐妹组中相当少数的患者表现出较低的表现。以儿童为基础的测量与父母评估类似结构的报告之间存在显著的相关性(r=-0.74至0.53；P范围为0.000至0.002)。结论：在ASD兄弟姐妹组中发现的儿童表现较弱可能代表了更广泛的自闭症表型的早期特征，从而强调了对年幼兄弟姐妹进行发育监测的重要性。
Objective: To compare the early social-communicative development of younger siblings of children with autism spectrum disorders (ASDs) with that of younger siblings of children with typical development, using parental report and child-based measures.Design: Group comparison.Setting: Vanderbilt University, between July 1, 2003, and July 31, 2006.Participants: Younger siblings of children with ASD (n=64) and younger siblings of children with typical development (n=42) between the ages of 12 and 23 months ( mean, 16 months).Main Exposure: Having a sibling with an ASD.Outcome Measures: Child-based measures included a cognitive assessment; an interactive screening tool assessing play, imitation, and communication; and a rating of autism symptoms. Parental report measures were an interview of social-communicative interactions and a questionnaire assessing language and communication skills.Results: Younger siblings of children with ASD demonstrated weaker performance in nonverbal problem solving (mean difference [MD], 5.91; 95% confidence interval [CI], 2.48-9.34), directing attention (MD, 0.52; 95% CI, 0.07-0.97), understanding words (MD, 33.30; 95% CI, 3.11-63.48), understanding phrases (MD, 4.56; 95% CI, 1.85-7.27), gesture use (MD, 1.49; 95% CI, 0.51-2.47), and social-communicative interactions with parents (MD, 1.32; 95% CI, 0.27-2.37), and had increased autism symptoms (MD, 2.54; 95% CI, 1.05-4.03), relative to control siblings. A substantial minority of the ASD sibling group exhibited lower performance relative to controls. Significant correlations between child-based measures and parental reports assessing similar constructs were found (r=-0.74 to 0.53; P range,.000-.002).Conclusion: The weaker performance found for children in the ASD sibling group may represent early-emerging features of the broader autism phenotype, thus highlighting the importance of developmental surveillance for younger siblings.