目的 研究孤独症谱系障碍(ASD)儿童、发育迟滞儿童和正常儿童共同注意行为的差异,以及ASD儿童共同注意行为的特点。方法 选择2015年10月至2016年2月本院28名ASD儿童,15名发育迟滞(DD)儿童以及25名正常对照(TD)儿童为研究对象,运用半结构化的共同注意行为试验进行观察,记录并分析受试者自发性共同注意(IJA)、响应性共同注意(RJA)。结果 ASD组IJA低水平、高水平的频数和RJA得分均显著低于TD组(Z>3.063, P<0.001)。ASD组IJA高水平频数、RJA得分低于DD组(Z>2.925, P<0.017);ASD组IJA低水平频数较DD组低,但无显著性差异(Z=-2.118, P>0.017)。DD组与TD组间IJA、RJA得分相比均无显著性差异(Z<1.328, P>0.017)。ASD儿童IJA低水平频数(r=-0.552, P=0.002)、高水平频数(r=-0.805, P<0.001)以及RJA得分(r=-0.857, P<0.001)与孤独症诊断观察量表得分均呈负相关。各年龄组ASD儿童的IJA低水平、高水平频数以及RJA得分均无显著性差异(Z<4.816, P>0.05)。ASD组儿童高水平IJA的频数低于低水平IJA (Z=2.787, P<0.01)。结论 ASD儿童IJA、RJA均存在缺陷,尤其是高水平IJA缺陷明显。ASD儿童共同注意行为表现个体差异大。ASD儿童共同注意缺陷与疾病严重程度有关,而与年龄无确切关系。
Objective To compare the joint attention among children with autism spectrum disorders (ASD), developmental delay (DD) and typically development (TD) to explore the characteristic of joint attention in children with ASD.Methods From October, 2015 to February, 2016, 28 ASD children, 15 DD children and 25 TD children were administered in joint attention tasks. The initiating joint attention (IJA) and the responding to joint attention (RJA) were recorded and analyzed.Results The frequence of both low and high level of IJA and the score of RJA were significantly less in the children with ASD than with TD (Z>3.063, P<0.001). The frequence of high level of IJA and RJA were less in the children with ASD than with DD (Z>2.925, P<0.017), and no significant difference was found in the frequence of low level of IJA (Z=-2.118, P>0.017). There was no significant difference in the frequence of both IJA and RJA between children with DD and TD (Z<1.328, P>0.017). The frequence of low level (r=-0.552, P=0.002) and high level (r=-0.805, P<0.001) of IJA, and the score of RJA (r=-0.857, P<0.001) were negatively correlated with the score of Autism Diagnostic Observation Schedule (ADOS). No significant difference was found in the frequence of both IJA and RJA among ASD children with different ages (Z<4.816, P>0.05). The frequence was lower in the high level of IJA than in the low level of IJA in children with ASD (Z=2.787, P<0.01).Conclusion Children with ASD display deficits in IJA and RJA, especially in the high level of IJA. The features of joint attention are different in children with ASD, and correlate with the severity of autistic symptoms, instead of age.
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