Development in infants with autism spectrum disorders: a prospective study
Development in infants with autism spectrum disorders: a prospective study
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DOI：
10.1111/j.1469-7610.2006.01531.x
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发表时间：
2006-06-01
影响因子：
7.6
通讯作者：
Garrett-Mayer, Elizabeth
中科院分区：
文献类型：
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作者：
Landa, Rebecca;Garrett-Mayer, Elizabeth
背景：尽管有证据表明神经生物学过程在产前就存在异常，但自闭症很少在三岁前被确诊。对于自闭症患儿在生命的头两年中发育何时以及如何受到干扰，我们知之甚少。此类信息对于促进早期发现和早期干预是必要的。
方法：这项针对自闭症谱系障碍（ASD）的前瞻性研究使用穆伦早期学习量表（MSEL）对87名婴儿在6个月、14个月和24个月的目标年龄进行了发育检测。参与者来自高风险（自闭症患儿的兄弟姐妹）和低风险（无自闭症家族史）两组婴儿。根据24个月时的语言测试分数、自闭症诊断观察量表以及临床判断，参与者被分为：未受影响组、自闭症组或语言发育迟缓组（LD）。对MSEL原始分数应用纵向线性回归和方差分析模型，并在三个诊断组之间比较估计值。
结果：在6个月时未检测到具有统计学意义的组间差异。到14个月时，自闭症组在除视觉接受能力外的所有量表上的表现均显著差于未受影响组。到24个月时，自闭症组在所有领域的表现均显著差于未受影响组，并且在大运动、精细运动和接受性语言方面差于语言发育迟缓组。自闭症组的发育轨迹比其他组慢，并且在一岁到两岁之间发育出现显著下降。
结论：到24个月时，使用一种综合发育测量方法，在许多自闭症患儿中可检测到与正常发育和语言发育迟缓不同的情况。自闭症患儿在14个月到24个月之间出现了异常的发育减缓。
Background: Autism is rarely diagnosed before three years of age despite evidence suggesting prenatal abnormalities in neurobiological processes. Little is known about when or how development becomes disrupted in the first two years of life in autism. Such information is needed to facilitate early detection and early intervention. Methods: This prospective study of autism spectrum disorders (ASD) examined development using the Mullen Scales of Early Learning (MSEL) in 87 infants tested at target ages 6, 14, and 24 months. Participants came from infants at high risk (siblings of children with autism) and low risk (no family history of autism) groups. Based on language test scores, Autism Diagnostic Observation Schedule, and clinical judgment at 24 months of age, participants were categorized as: unaffected, ASD, or language delayed (LD). Longitudinal linear regression and ANOVA models were applied to MSEL raw scores, and estimates were compared between the three diagnostic groups. Results: No statistically significant group differences were detected at 6 months. By 14 months of age, the ASD group performed significantly worse than the unaffected group on all scales except Visual Reception. By 24 months of age, the ASD group performed significantly worse than the unaffected group in all domains, and worse than the language delayed group in Gross Motor, Fine Motor, and Receptive Language. The developmental trajectory of the ASD group was slower than the other groups', and showed a significant decrease in development between the first and second birthdays. Conclusions: Variations from typical and language delayed development are detectable in many children with ASD using a measure of general development by 24 months of age. Unusual slowing in performance occurred between 14 and 24 months of age in ASD.