Results of Gesell Developmental Scale of 2- to 3- year-old children with autism spectrum disorder or developmental language disorder

doi:10.11852/zgetbjzz2021-0706

Abstract

Abstract: Objective To compare the developmental characteristics of 2- to 3- year-old children with autism spectrum disorder(ASD) or developmental language disorder(DLD) by Gesell Developmental Scale(GDS),in order to provide evidence for early diagnosis and intervention. Method From March 2020 to March 2021,children with ASD(n=78) and DLD(n=80) were evaluated by GDS,their development characteristics were analyzed and compared retrospectively. Results 1) The average developmental quotient(DQ) of ASD children was lower than that of DLD children. Except for the gross motor,the DQs of adaptability,fine motor,language and personal-social in ASD children were significantly lower than those of DLD group(t=16.043,6.208,14.219,10.811,P<0.001). 2) The language development of ASD children was predominantly severely and moderately impaired(48.72%,33.33%),while the language development of DLD children was most mildly impaired(77.5%). Fifty percent of ASD children had a mild impairment in personal-social area and no one case was normal. However,68.75% of DLD children had a mild impairment in personal-social area,and 30% of personal-social DQ was at normal or borderline level. Conclusions Except for the gross motor energy area,the average DQs of other developmental areas in ASD children are lower than those in DLD children. Familiarity with the Gesell developmental characteristics of ASD children and DLD children is helpful for the early identification,rehabilitation and education plan development as well as the prognosis of children with ASD and DLD.

Key words: autism spectrum disorder, language disorder, Gesell Developmental Scale, children

摘要： 目的分析2~3岁儿童孤独症谱系障碍(ASD)与发育性语言障碍(DLD)的Gesell发育特征,为早期诊断和干预提供依据。方法回顾性分析2020年3月—2021年3月,明确诊断为ASD(n=78)、DLD(n=80)的2~3岁儿童,通过Gesell婴幼儿发育量表对每个儿童进行发育水平测评,并对两组儿童5个能区发育水平分布情况进行统计,分析ASD、DLD儿童的Gesell发育特征。结果 1)ASD组儿童平均发育商得分均低于DLD组儿童。除大运动能区外,ASD组儿童适应性、精细运动、语言、个人-社交能区间发育水平均低于DLD组,差异有统计学意义(t=16.043、6.208、14.219、10.811,P＜0.001)。2)语言、个人-社交发育比较:ASD组儿童的语言发育水平以重度、中度障碍为主(48.72%、33.33%),DLD组儿童的语言发育水平以轻度障碍为主(77.5%)。ASD组儿童50%的个人-社交分布在轻度障碍区域,无1例正常;DLD组儿童的个人-社交发育商68.75%分布在轻度障碍区域,30%处于正常或边缘水平。结论除大运动能区外,ASD儿童其余能区平均发育水平均低于DLD儿童。熟悉ASD、DLD儿童的Gesell发育特征,对ASD、DLD儿童的早期识别、康复及教育计划的制定和预后具有重要的意义。

关键词: 孤独症谱系障碍, 语言障碍, Gesell发育量表, 儿童

CLC Number:

R749.94

WU Man-hong, DENG Xue-mei, LIN Hua-zhao, YU Chu-lan, ZENG Liu-yuan, YANG Yun. Results of Gesell Developmental Scale of 2- to 3- year-old children with autism spectrum disorder or developmental language disorder[J]. Chinese Journal of Child Health Care, 2022, 30(8): 895-899.

吴满红, 邓雪梅, 林华照, 余楚岚, 曾柳苑, 阳芸. 孤独症谱系障碍与发育性语言障碍2~3岁儿童Gesell测评结果分析[J]. 中国儿童保健杂志, 2022, 30(8): 895-899.

References

[1] Randall M,Egberts KJ,Samtani A,et al.Diagnostic tests for autism spectrum disorder(ASD) in preschool children[J]. Cochrane Database Syst Rev, 2018,24,7(7):CD009044.
[2] Hyman SL,Levy SE,Myers SM,et al.Identification,evaluation,and management of children with autism spectrum disorder[J].Pediatrics,2020,145(1):e20193447.
[3] Laasonen M,Smolander S,Lahti-Nuuttila P,et al.Understanding developmental language disorder-the Helsinki longitudinal SLI study(HelSLI):A study protocol[J].BMC Psychol,2018,6(1):24.
[4] Agius MM,Vance M.A Comparison of PECS and iPad to teach requesting to pre-schoolers with autistic spectrum disorders[J].Augment Altern Comm,2016,32(1):58-68.
[5] 申夏惠,曹爱华,李莎莎,等.语言发育迟缓儿童的影响因素及综合干预疗效研究[J].中国儿童保健杂志,2018,26(12):1375-1379.
[6] 金星明,静进.发育与行为儿科学[M].北京:人民卫生出版社,2014:198-199.
[7] 苏怡,谢芊芊,苏林雁.孤独症儿童、发育迟缓儿童和语言障碍儿童早期语言表达的异同[J].中国临床心理学杂志,2020,28(3):508-512.
[8] 刘冬梅,邹时朴,龚俊,等.孤独症、全面发育迟缓及发育性语言延迟儿童早期语言发育特征[J].中国儿童保健杂志,2020,28(3):312-315.
[9] 黎文倩,刘晓,代英,等.孤独症谱系障碍儿童的诊断年龄及其影响因素[J].中国当代儿科杂志,2018,20(10):21-25.
[10] Klinger L,Dawson G,Renner P.Autistic disorder[M]//Mash EJ,Barkley RA.Child Psychopathology.2nd ed. New York:Guilford Press,2003:409-454.
[11] Landa R,Garrett-Mayer E.Development in infants with autism spectrum disorders:A prospective study[J].Child Psychol Psychiatry,2006,47(6):629-638.
[12] Dale PS,Price TS,Bishop DV,et al.Outcomes of early language delay:I. Predicting persistent and transient language difficulties at 3 and 4 years[J].Speech Lang Hear Res,2003,46(3):544-560.
[13] Rice ML,Hoffman L.Predicting vocabulary growth in children with and without specific language impairment:A longitudinal study from 2,6 to 21 years of age[J].Speech Lang Hear Res,2015,58(2):345-359.
[14] Leonard LB,Deevy P.Retrieval practice and word learning in children with specific language impairment and their typically developing peers[J].Speech Lang Hear Res,2020,63(10):3252-3262.
[15] 邹园园,张素卿,黄师菊,等.2~3岁儿童孤独症谱系障碍与发育性语言障碍的Gesell结果分析[J].中国儿童保健杂志,2015,23(3):298-300.
[16] 沈藕英,徐苗苗,吴桂红,等.6~12岁孤独症儿童社交适应性及心理理论评定调查分析[J].中国妇幼保健,2020,35(2):324-327.
[17] Mundy P,Sigman M,Kasari C,A longitudinal study of joint attention and language development in autistic children[J].Autism Dev Disord,1990,20:115-28.
[18] Duncan AW,Bishop SL.Understanding the gap between cognitive abilities and daily living skills in adolescents with autism spectrum disorders with average intelligence[J].Autism,2015,19(1):64-72.
[19] 周翔,陈强,陈红,等.Gesell发育量表对2岁内孤独症谱系障碍患儿的应用研究[J].中国儿童保健杂志,2016,24(12):1329-1331.
[20] Kapa LL,Erikson JA.The relationship between word learning and executive function in preschoolers with and without developmental language disorder[J].Speech Lang Hear Res,2020,63(7):2293-2307.
[21] Carson KL.Can an app a day keep illiteracy away? Piloting the efficacy of Reading Doctor Apps for preschoolers with developmental language disorder[J].Int J Speech Lang Pathol,2020,22(4):454-465.
[22] 陈强,彭仰华,徐文娟,等.不同功能孤独症儿童能力发育特征研究[J].临床儿科杂志,2014,32(4):326-329.
[23] 邱慧莹,徐开寿.孤独症谱系障碍儿童的运动技能障碍[J].中国实用儿科杂志,2019,34(9):645-648.
[24] Gima H,Kihara H,Watanabe H,et al.Early motor signs of autism spectrum disorder in spontaneous position and movement of the head[J].Exp Brain Res,2018,236(4):1139-1148.
[25] 李楠,梁颖,马健,等.孤独症儿童在婴儿期运动模式异常的研究进展[J].中国妇幼卫生杂志,2020,11(6):83-85.
[26] 蒙晓梅,江蕙芸,班彩霞.孤独症谱系障碍儿童智力结构及社会生活能力分析[J/OL].现代医学与健康研究电子杂志,2019,3(19):144-145.
[27] Iverson JM,Shic F,Wall CA,et al.Early motor abilities in infants at heightened versus low risk for ASD:A Baby Siblings Research Consortium(BSRC) study[J].AbnormPsychol,2019,128(1):69-80.
[28] Jones MW,Snowling MJ,Moll K.What automaticity deficit? Activation of lexical information by readers with dyslexia in a rapid automatized naming Stroop-switch task[J].Exp Psychol Learn Mem Cogn,2016,42(3):465-474.