Abstract: Objective To analyze the developmental characteristics and differences among autism spectrum disorder (ASD), developmental language disorder (DLD) and global developmental delay (GDD) by using Gesell Developmental Diagnostic Scale (GDDS), so as to provide scientific basis for early screening and differential diagnosis. Methods Clinical data of 178 children, involving 29 ASD children, 45 DLD children and 104 GDD children in the Department of Child Health care, Henan Children's Hospital from September 2021 to April 2022 were retrospectively analyzed. The developmental quotients (DQs) of the five dimensions of GDDS (gross motor, fine motor, language, adaptive behavior, personal-social behavior) of children in each group were analyzed and compared. The differences in the language development and nonverbal development levels (the average of gross motor, fine motor, adaptive behavior and personal-social behavior development) between the two groups were analyzed. Results 1) There were significant differences in the nonverbal development levels among ASD, DLD and GDD groups (H=―95.90, 38.25, ―57.65, P＜0.05), and also in the language functional area (H=―99.99, 30.89, ―69.11, P＜0.05). 2) There were significant differences in the DQs of language, personal-social behavior and gross motor development among ASD, DLD and GDD children (H=82.438, 51.156; 160.045, 65.098; 322.038, 210.908, P＜0.001). There were no significant differences among the DQs of fine motor, adaptive and gross motor in ASD and DLD groups (P>0.05). But there was a significant difference between the DQs of fine motor, adaptive and gross motor functional area in GDD groups (H=119.975, 63.621, P＜0.05). There was no significant difference between the DQs of language and personal-social dimension in ASD children(P＞0.05), but in the DLD group the difference was significant (H=-94.946, P＜0.001). Conclusions Children with ASD, DLD and GDD all have unbalanced development, with significant differences in GDDS dimensions in the different disease categories.The level of language development and nonverbal development of ASD children significantly lag behind GDD and DLD children. GDDS can be used to assess speech-related developmental disorders, and is helpful to facilitate the early identification and differential diagnosis of these disorders.

Key words: autism spectrum disorder, developmental language disorder, global development delay, Gesell Developmental Diagnosis Scale, children

摘要： 目的 采用Gesell发展诊断量表(GDDS)对18~42月孤独症谱系障碍(ASD)、发育性语言障碍(DLD)、全面发育迟缓(GDD)开展应用研究,分析这类儿童发育特点和差异性,为早期识别和鉴别诊断提供科学依据。方法 回顾性分析2021年9月—2022年4月于河南省儿童医院儿童保健科就诊的178例儿童病例资料,其中ASD29例,DLD45例,GDD104例。分析三组间非语言及语言发育水平差异,对儿童GDDS五大能区即大运动、精细动作、语言、适应性和个人-社交的DQ值进行组内比较分析。结果 1)ASD、DLD、GDD组间非语言发育水平两两比较差异均有统计学意义(H=-95.90、38.25、-57.65,P＜0.05),三组间语言能区DQ值两两比较差异均有统计学意义(H=-99.99、30.89、-69.11,P＜0.05);2)ASD、DLD、GDD组语言、个人-社交与大运动能区DQ值比较,差异有统计学意义(H=82.438、51.156;160.045、65.098;322.038、210.908,P＜0.001)。ASD、DLD组精细动作、适应性与大运动能区DQ值比较,差异无统计学意义(P＞0.05),而在GDD组差异有统计学意义(H=119.975、63.621,P＜0.05)。ASD组语言与个人-社交能区DQ值比较,差异无统计学意义(P＞0.05),而在DLD组差异有统计学意义(H=-94.946,P＜0.001)。结论 ASD、DLD、GDD儿童均存在发展不均衡,不同类疾病Gesell能区间差异不同;ASD儿童语言及非语言发育水平均显著落后于GDD、DLD儿童。GDDS用于评估语言相关的发育性疾病,有利于对此类疾病的早期识别和鉴别诊断。

关键词: 孤独症谱系障碍, 发育性语言障碍, 全面发育迟缓, Gesell发展诊断量表, 儿童