Abstract: Objective To investigate the outcomes and prognosis of autistic children by follow-up visiting children with positive autism caution index (CI) within 1 year for 3 years.Methods In the high-risk outpatient department,the follow-up examination,family intervention guidance,regular evaluation and 3-year follow-up visiting were conducted in the children with positive autism alert index according to the Autism Diagnosis and Rehabilitation Guide issued by the Ministry of Health in 2010.The Children Autism Rating Scale (CARS) and the Gesell Development Scale were tested in the children with autism (experimental group) and the random outpatient children at the same age (control group),and result of each group were analyzed.Results 30 autism spectrum disorders were diagnosed out of 35 high-risk patients,and 5 were diagnosed with others including 2 cases of mental retardation,1 case of congenital pigment incontinence,1 case of tuberous sclerosis,1 case of congenital blind child.The CARS score of the ASD children was lower than that of the control group (P<0.001).The Gesell development scale test showed that the children with ASD had a higher CARS score than the control group (P<0.001).The five energy levels of the two groups were both lower than normality,but each energy level of the control group was lower than that of the experimental group (P<0.001).Conclusion It is feasible to use infant early warning indicators of autism spectrum disorders to screen children with autism early,which is helpful to reduce the severity of autism and to improve the ability of autistic children.

Key words: autism, caution index, positive, infant, screening

摘要： 目的 通过对1岁以内孤独症警示指标阳性患儿进行随访3年,了解孤独症警示指标阳性患儿的结局及预后。方法 在高危儿门诊采用2010年卫生部颁布《儿童孤独症诊疗康复指南》中婴儿期孤独症警示指标对阳性患儿进行跟踪检查、家庭干预指导、定期评估及3年随访;并将3岁时确诊孤独症的儿童(实验组)与随机抽取的儿童孤独症门诊就诊的相同年龄段的儿童(对照组)用儿童孤独症评定量表(CARS)及Gesell发育量表进行评估,将各组结果进行对比分析。结果 警示指标阳性患儿35人中3年后确诊孤独症谱系障碍30人,5例其他,包括智力发育迟缓2例、先天性色素失禁症1例、结节性硬化1例,先天性盲童1例,所有患儿均进行早期干预;两组ASD儿童CARS评分:实验组低于对照组,证实对照组严重程度高于实验组,差异有统计学意义(P＜0.001);Gesell发育量表检测两组5个能区数值均低于正常,但对照组的儿童各能区平均水平均低于实验组,且各能区间差异有高度统计学意义(P＜0.001)。结论 利用婴儿孤独症早期阳性警示指标进行儿童孤独症的早期筛查具有可行性,有利于减轻孤独症的严重程度和提高孤独症儿童的各项能力。

关键词: 孤独症, 警示指标, 阳性, 婴儿, 筛查