孤独症谱系障碍儿童运动功能与核心症状的关联

金诚开; 曹牧青; 顾廷锋; 李秀红; 静进

doi:10.16835/j.cnki.1000-9817.2023.02.004

孤独症谱系障碍儿童运动功能与核心症状的关联

doi: 10.16835/j.cnki.1000-9817.2023.02.004

中山大学公共卫生学院妇幼卫生系, 广东广州 510080

基金项目:

广州市残疾人联合会项目 K19-51000-052

广东省自然科学基金面上项目 2022A1515011224

国家社会科学基金重大项目 20&ZD296

详细信息

作者简介:
金诚开(1997-), 男, 江苏省人, 在读硕士, 主要研究方向为儿童心理行为发育

通讯作者:
静进, E-mail: jingjin@mail.sysu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R748 R179 G804.49
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出版历程
- 收稿日期: 2022-07-11
- 修回日期: 2022-09-20
- 网络出版日期: 2023-03-02
- 刊出日期: 2023-02-25

Association between motor coordination and core symptoms in children with autism spectrum disorder

Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou(510080), China

摘要

摘要: 目的了解孤独症谱系障碍(ASD)儿童运动功能和社交沟通障碍、重复刻板行为之间的关系，为ASD儿童的诊断和干预提供参考依据。方法在广州市孤独症儿童精准康复服务定点康复机构招募2~12岁ASD儿童123例，其中男童105例，女童18例。采用儿童发育性运动协调障碍问卷、社交沟通量表、重复刻板行为检查表分别评估儿童的运动功能、社交沟通能力和重复刻板行为，通过多重线性回归分析ASD儿童运动功能和核心症状的关系。结果 2~5岁儿童中，非运动功能缺陷者社交互动领域(7.73±4.00)得分低于运动功能缺陷者(9.76±2.90)(Z=-2.29，P < 0.05)；6~12岁儿童中，非运动功能缺陷者的重复及刻板的行为模式领域(4.22±1.93)、重复感觉运动型(3.91±2.63)、坚持一致型(13.52±10.59)得分低于运动功能缺陷者(6.11±1.54，14.00±8.49，31.33±15.05)(Z值分别为-2.48，-3.83，-3.28，P值均 < 0.01)。多重线性回归分析显示，2~5和6~12岁ASD儿童的精细运动/书写能力和运动中的控制能力分别与社交沟通障碍、重复刻板行为严重程度均呈负相关(β=-0.85~-0.03，-2.98~-0.17，P值均 < 0.05)。结论 ASD儿童运动功能缺陷者核心症状更严重。应将运动评估纳入ASD筛查、诊断和管理中，并积极促进运动干预在康复过程中的应用，以期改善其预后和生活质量。
- 孤独性障碍 /
- 运动活动 /
- 交流障碍 /
- 刻板行为 /
- 回归分析 /
- 儿童
Abstract: Objective To study the relationship between motor coordination, social communication impairment, and restricted/repetitive behaviors (RRBs) in children with autism spectrum disorder (ASD). Methods A total of 123 ASD children aged 2-12 were recruited from rehabilitation service institutions for autistic children in Guangzhou, including 105 boys and 18 girls. The Developmental Coordination Disorder Questionnaire, Social Communication Questionnaire, and Restrictive Behavior Scale-Revised were collected to measure motor coordination, social communication skills and RRBs, respectively. Multiple linear regression was used to explore the association between motor coordination and core symptoms. Results In children aged 2-5 years old, those without motor coordination deficits scored lower in social interaction (7.73±4.00) than others (9.76±2.90)(Z=-2.29, P < 0.05). In children aged 6-12 years old, those without motor coordination deficits scored lower in restricted, repetitive, and stereotyped patterns of behavior (4.22±1.93), repetitive sensory-motor behaviors (3.91±2.63), and insistence on sameness (13.52±10.59) than those with motor coordination deficits (6.11±1.54, 14.00±8.49, 31.33±15.05)(Z=-2.48, -3.83, -3.28, P < 0.01)。Multiple linear regression analysis showed that fine motor/handwriting and control during movement were negatively correlated with the severity of social communication impairment and RRBs respectively among children aged 2-5 and 6-12(β=-0.85--0.03, -2.98--0.17, P < 0.05). Conclusion Among autistic children, those with motor deficits suffered from more severe core symptoms. Motor assessment should be included in the ASD screening, diagnosis and management. Motor intervention should also be promoted in the rehabilitation in order to improve the prognosis and life quality.
- Autistic disorder /
- Motor activity /
- Communication disorders /
- Stereotyped behavior /
- Regression analysis /
- Child
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表 1 不同年龄组ASD儿童是否运动功能缺陷组间核心症状得分比较(x±s)

Table 1. Difference in severity of core symptoms between autistic children with and without motor coordination in different age groups(x±s)

年龄/岁	是否运动功能缺陷	人数	统计值	CARS总分	SCQ				RBS-R
年龄/岁	是否运动功能缺陷	人数	统计值	CARS总分	总分	重复及刻板的行为模式领域	社交互动领域	沟通领域	总分	重复感觉运动型	坚持一致型
2~5	否	37		33.41±6.95	16.97±6.42	3.27±2.06	7.73±4.00	5.43±2.17	20.14±12.94	5.30±4.01	14.84±10.39
	是	54		38.86±6.97	20.54±5.71	4.00±2.02	9.76±2.90	5.96±2.29	22.24±15.69	6.44±4.22	15.80±13.68
			Z值	-8.08	-2.54	-1.66	-2.29	-1.42	-0.37	-1.40	-0.40
			P值	< 0.01	0.01	0.10	0.02	0.16	0.71	0.16	0.69
6~12	否	23		31.33±6.64	16.43±5.71	4.22±1.93	6.78±3.41	4.83±2.17	17.43±12.26	3.91±2.63	13.52±10.59
	是	9		42.72±7.68	22.44±4.28	6.11±1.54	9.11±2.57	6.11±2.15	45.33±22.61	14.00±8.49	31.33±15.05
			Z值	-4.34	-2.60	-2.48	-1.67	-1.49	-3.61	-3.83	-3.28
			P值	< 0.01	0.01	0.01	0.10	0.14	< 0.01	< 0.01	< 0.01

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表 2 不同年龄ASD儿童运动功能与核心症状的关系(β值)

Table 2. Association between motor coordination and core symptoms in children with ASD aged 2-12 years old(β)

年龄/岁	自变量	CARS总分	SCQ				RBS-R
年龄/岁	自变量	CARS总分	总分	重复及刻板的行为模式领域	社交互动领域	沟通领域	总分	重复感觉运动型	坚持一致型
2~5	运动中的控制能力	-0.46^**	-0.43^**	-0.03	-0.26^**	-0.12^**	-0.11	-0.10	-0.01
(n=91)	精细运动/书写能力	-0.85^**	-0.53^*	-0.06	-0.35^*	-0.11	-0.15	-0.37	0.22
	粗大运动/计划能力	-0.02	0.14	0.03	0.05	0.04	0.34	0.05	0.30
	总体协调能力	-0.27	-0.03	-0.06	0.04	-0.04	-0.76	-0.08	-0.68
	总分	-0.03^**	-0.16^*	-0.02	-0.10^**	-0.04	-0.05	-0.05	0.01
6~12	精细运动/书写能力	-0.73^*	-0.60	-0.28^*	-0.23	-0.03	-2.98^**	-1.00^**	-1.98^**
(n=32)	协调功能	-0.08	-0.16	-0.05	-0.01	-0.07	-0.62	-0.18	-0.44
	运动中的控制能力	-0.35	-0.51^*	-0.17^*	-0.22^*	-0.08	-2.06^**	-0.64^**	-1.42^**
	总分	-0.16	-0.20^*	-0.07^*	-0.07	-0.04	-0.86^**	-0.27^**	-0.59^**
注：P < 0.05，*P < 0.01。

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