Abstract: Objective To analyse the performance and the difference between autism spectruum disorder(ASD)and attention deficit hyperactivity disorder(ADHD)with the metaphor and sarcasm scenario test(MSST)and the crayon box test,then explore the feasibility of MSST for differential diagnosis of ASD and ADHD. Method A total of 120 children(40 ASD,40 ADHD and 40 typical children)were involved,the scores of this two tests among three groups were compared. Results Compared with typical children,both ASD and ADHD scored lower in metaphor subscale(P＜0.001 ),but the poor comprehension of sarcasm was only observed in ASD(P＜0.016 7).As for the comparison between children with ASD and ADHD,the deficit of comprehending sarcasm was showed in ASD(P＜0.016 7). Conclusions Both ASD and ADHD children show deficits in understanding the metaphor.But the ability to comprehend sarcastic situation is specifically inadequate in ASD.Thus MSST is a potential instrument to discriminate between ASD and ADHD.

Key words: autism spectrum disorder, attention deficit hyperactivity disorder, the metaphor and sarcasm scenario test

摘要： 目的 探讨高功能孤独症谱系障碍(autism spectruum disorder,ASD)儿童和注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童在隐喻和讽刺情景测试(metaphor and sarcasm scenario test,MSST)的表现特征,为二者的鉴别诊断提供依据。方法 选取ASD、ADHD和对照组儿童各40名(三组年龄、智力水平均衡可比),采用修订版MSST和蜡笔盒测试进行检测和分析比较。结果 ASD与ADHD儿童在MSST中的总分、隐喻分均低于对照组(P＜0.01);ADHD组与对照组的讽刺分无差异,但ASD组得分明显低于对照组(P<0.016 7)与ADHD组(P<0.016 7);蜡笔盒测试中,ASD组通过率(65.0%)低于ADHD组(87.5%)(P＜0.05)。结论 ASD与ADHD儿童的隐喻理解能力均较正常儿童差,但ASD儿童表现出特异性的讽刺理解能力缺陷。因此,MSST可为鉴别ASD和ADHD提供特异性辅助依据。

关键词: 孤独症谱系障碍, 注意缺陷多动障碍, 隐喻和讽刺情景测试