6~18岁智力障碍人群的孤独症谱系障碍样症状分析

Autism spectrum disorder-like symptoms in the population with intellectual disability aged 6 to 18 years

摘要:

目的 了解智力障碍（ID）人群的孤独症谱系障碍（ASD）样症状的发生情况。方法 选取2017年1~6月就读于上海市某特殊学校的6~18岁ASD人群和ID人群，以及同期在上海市某普通学校就读的同年龄段普通（TD）人群，由父母或其他监护人填写社交反应量表（SRS），分别对其进行ASD样症状评估。结果 共纳入69例ASD、74例ID和177例TD研究对象。ID组SRS量表检查阳性率（47.3%）显著高于TD组（1.7%）（P < 0.001），低于ASD组（87.0%）（P < 0.001）。ASD组、ID组和TD组SRS量表总分分别为114±26、80±24、38±19分，其中ID组SRS量表总分显著高于TD组得分（P < 0.05），以社交认知维度差异最为显著（Cohen's d值为2.00）。轻-中度ID亚组和重-极重度ID亚组的SRS总分及各维度得分差异无统计学意义（P > 0.05），且SRS得分与IQ之间无明显相关性（P > 0.05）。结论 6~18岁ID人群较普通人群存在更显著的ASD样症状，应对ID人群尽早进行ASD筛查并给予干预。

Abstract:

Objective To investigate the incidence of autism spectrum disorder (ASD)-like symptoms in the population with intellectual disability (ID). Methods The students with ASD or ID, aged 6-18 years, who studied in a special school in Shanghai from January to June, 2017, as well as the typically developing (TD) population of the same age, who studied in a general school in Shanghai during the same period, were enrolled. Social Responsiveness Scale (SRS) was completed by their parents or other guardians, and the ASD-like symptoms were evaluated. Results A total of 69 subjects with ASD, 74 subjects with ID and 177 TD subjects were enrolled. The ID group had a significantly higher SRS-positive rate than the TD group (47.3% vs 1.7%; P < 0.001) and a significantly lower SRS-positive rate than the ASD group (47.3% vs 87.0%; P < 0.001). The total score of SRS was 114±26 in the ASD group, 80±24 in the ID group and 38±19 in the TD group. The ID group had a significantly higher total score of SRS than the TD group (P < 0.05), and the score on the subscale of social cognition showed the most significant difference between the two groups (Cohen's d=2.00). There were no significant differences in the total score of SRS and the scores on each subscale of SRS between the mild-to-moderate ID and severe-to-extremely severe ID groups (P > 0.05), and there was no significant correlation between SRS score and IQ (P > 0.05). Conclusions The ID population aged 6-18 years has more ASD-like symptoms than the general population, and ASD screening and intervention should be performed for the ID population as early as possible.