摘要
【目的】探索孤独症谱系障碍(ASD)儿童日常执行功能与其核心症状及注意缺陷多动(ADHD)症状的关联,以及心理理论等其他认知能力对关联的调节作用。【方法】招募6~12岁ASD儿童,并根据纳入排除标准确定了86名儿童。采用儿童韦氏智力测试(WISC-Ⅳ)、新异故事测试(SST)、执行功能行为评定量表(BRIEF)评估儿童的认知能力;注意缺陷多动障碍评定量表(SNAP-Ⅳ)、社交反应量表(SRS)、重复刻板行为检查表-修订版(RBS-R)分别评估儿童的注意缺陷多动症状、社交障碍及重复刻板行为的严重程度。统计方法使用多元线性回归,在控制新异故事分数、言语理解智商等因素的条件下,探索日常执行功能与注意缺陷多动症状、社交损害、重复刻板行为的关联。【结果】控制新异故事分数、言语理解指数(VCI)及其他因素后,ASD儿童的BRIEF总分及各指数与SNAP总分(b=0.619~0.741,b’=0.637~0.755)、SRS总分(b=0.928~1.200,b’=0.417~0.513)及RBS-R总分(b=0.326~0.525,b’=0.339~0.520)均存在明显的正向关联(P<0.05),并且与SNAP总分的关联更强(b’=0.637~0.755,P<0.01)。除了日常执行功能,新异故事分数(b=-2.218~-1.839)和年龄(b=3.181~4.037)也是影响ASD儿童社交功能的重要因素(P<0.01)。未发现新异故事分数、年龄对BRIEF分数与SNAP总分、SRS总分及RBS-R总分的关联存在调节效应(P>0.05)。【结论】学龄期ASD儿童的日常执行功能缺陷与ASD症状、ADHD症状显著相关,关联独立于其他领域的认知能力,如心理理论、言语理解智商。
【Objective】To explore the association between daily executive function and core symptoms,the symptoms of attention deficit hyperactivity disorder(ADHD)in children with autism spectrum disorder(ASD),and the moderating effect of theory of mind and other cognitive abilities on this association.【Methods】Children aged 6-12 years with ASD were recruited,and 86 children were identified according to the inclusion and exclusion criteria.Wechsler Intelligence Test for Children,Fourth Edition(WISC-Ⅳ),Strange Story Test(SST)and Behavior Rating Inventory of Executive Function(BRIEF)were used to evaluate children's cognitive ability.Swanson Nolan and Pelham-VersionⅣScale(SNAP-Ⅳ),Social Responsiveness Scale(SRS),and Repetitive Behavior Scale-Revise(RBS-R)were used to assess the severity of ADHD symptoms,social impairment,and repetitive stereotyped behavior.Multiple linear regression was used to explore the association between daily executive function and ADHD symptoms,social impairment,repetitive ste⁃reotyped behaviors.【Results】After controlling for the score of strange stories,verbal comprehension index(VCI)and oth⁃er factors,the full scale score and each index of BRIEF were positively correlated with full scale score of SNAP(b=0.619-0.741,b’=0.637-0.755),SRS(b=0.928-1.200,b’=0.417-0.513)and RBS-R(b=0.326-0.525,b’=0.339-0.520)in children with ASD(P<0.05),and the SNAP total score was more strongly correlated with the full scale BRIEF score and each index score(b’=0.637-0.755,P<0.01).In addition to daily executive function,strange stories score(b=-2.218--1.839)and age(b=3.181-4.037)were also the important factors affecting the social function of chil⁃dren with ASD(P<0.01).There were no moderating effects of strange stories score and age on the association between BRIEF score and full scale score of SNAP,SRS,and RBS-R(P>0.05).【Conclusion】The deficits of daily executive func⁃tion in school-aged ASD children are significantly associated with core symptoms and ADHD symptoms,and the associa⁃tio
作者
刘锦明
陈庆欣
陈琪
翟坤
吴玉岚
陈慧婷
张以恒
金宇
LIU Jin-ming;CHEN Qing-xin;CHEN Qi;ZHAI Kun;WU Yu-lan;CHEN Hui-ting;ZHANG Yi-heng;JIN Yu(School of Public Health,Sun Yat-sen University,Guangzhou 510080,China)
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2023年第5期776-783,共8页
Journal of Sun Yat-Sen University:Medical Sciences
基金
中国残疾人联合会听力语言残疾预防和康复专项(2022CDPFHS-13),广东省基础与应用基础研究基金(2020A1515010942,2023A1515012442),广东省中医药局面上项目(20211068),广州市民政科技基金课题(2022MZK02)。
关键词
孤独症谱系障碍
执行功能
注意缺陷-多动
孤独症核心症状
学龄期儿童
autism spectrum disorder
executive function
attention deficit disorder with hyperactivity
autistic symptoms
school-age children
