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中国循证儿科杂志

中国循证儿科杂志 ›› 2021, Vol. 16 ›› Issue (4): 286-290.

• 论著 • 上一篇    下一篇

基于感觉讯息处理及自我调节功能量表对学龄前孤独症谱系障碍儿童自我调节能力的影响因素分析

胡梅新, 邓晶鑫, 李慧萍, 胡纯纯, 王怡, 张颖, 张凯峰, 徐琼, 徐秀   

  1. 复旦大学附属儿科医院儿童保健科 上海，201102
  • 收稿日期:2021-06-21 修回日期:2021-08-18 出版日期:2021-08-25 发布日期:2021-08-25
  • 通讯作者: 徐秀

Analysis of factors affecting self-regulation of preschool children with ASD based on sensory processing and self-regulation scale

HU Meixin, DENG Jingxin, LI Huiping, HU Chunchun, WANG Yi, ZHANG Ying, ZHANG Kaifeng, XU Qiong, XU Xiu   

  1. Department of Child Health Care, Children's Hospital of Fudan University, Shanghai 201102, China
  • Received:2021-06-21 Revised:2021-08-18 Online:2021-08-25 Published:2021-08-25
  • Contact: XU Xiu

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摘要： 背景：孤独症谱系障碍（ASD）患儿常存在对不同感觉刺激的处理困难，影响其参与正常日常生活所需的自我调节能力。 目的：探讨感觉讯息处理因素对学龄前ASD儿童自我调节能力的影响。 设计：病例对照研究。 方法：纳入首次诊断ASD且家长完成感觉讯息处理及自我调节功能量表（SPSRC）的学龄儿童。以SPSRC量表Z分值，将自我调节功能和感觉讯息处理能力及其不同版块区分为异常（Z＜-1）和正常。以自我调节功能及其版块为因变量，以性别、年龄和感觉讯息处理能力的6个版块为自变量，行单因素和多因素Logistic回归分析。 主要结局指标：影响ASD儿童自我调节功能的SPSRC内的感觉讯息处理能力的因素。 结果：155例ASD患儿的SPSRC量表数据进入本文分析，男126例，女29例，平均（48.1±10.2）月龄，自我调节功能维度整体异常112例（72.3%），正常43例；生理状况异常54例（34.8%），正常101例，情绪调节异常85例（54.8%），正常70例；适应能力异常72例（46.5%），正常83例。 单因素分析显示，自我调节功能异常患儿在听觉、视觉、触觉、味嗅觉、前庭平衡觉和本体觉异常发生率高于自我调节功能正常的患儿，差异均有统计学意义；多因素Logistic回归分析显示，听觉和触觉异常是导致自我调节功能整体异常（OR=0.319，95%CI：0.111~0.912；OR=0.236，95%CI：0.060~0.928）和情绪调节异常（OR=0.314，95%CI：0.130~0.759；OR=0.369，95%CI：0.145~0.937）的影响因素，听觉异常是导致生理状况（OR=0.382，95%CI：0.155~0.941）和适应能力（OR=0.393，95%CI：0.170~0.909）异常的影响因素。 结论：学龄前ASD儿童自我调节功能整体、情绪调节异常主要受听觉和触觉异常的影响，听觉异常也影响生理状况和适应能力的异常。

关键词: 孤独症谱系障碍, 生理状况, 情绪调节, 适应能力, 听觉, 视觉, 触觉, 味嗅觉, 前庭平衡觉, 本体觉

Abstract: Background:Children with ASD often encounter difficulties in processing different sensory stimuli, which affect their self-regulation ability to participate in activities of daily living. Objective: To explore the influence of sensory processing factors on the self-regulation abilities of preschool children with ASD. Design: Case-control study. Methods: Preschool children who were first diagnosed of ASD and whose parents completed SPSRC were included. The SPSRC z-score of -1 was used to divide the self-regulation abilities,the sensory processing abilities and their different scales into the group of abnormal (z<-1) and normal. Univariate and multivariate logistic regression analysis were performed to analysis the influence of gender, age and 6 scales of sensory processing abilities on self-regulation function and its scales. Main outcome measures: Sensory processing factors of APSRC scale affecting self-regulation of ASD children . Results: The SPSRC scale data of 155 children with ASD were included in this study, including 126 males and 29 females, with an average age of (48.1±10.2) months. The overall self-regulation dimension was abnormal in 112 cases (72.3%) and normal in 43 cases. Fifty-four cases (34.8%) had abnormal physiological conditions and 101 cases were normal, 85 cases (54.8%) had abnormal emotional regulation, and 70 cases were normal state, 72 cases (46.5%) had abnormal adaptability and 83 were normal. Univariate analysis showed that among children with abnormal self-regulation abilities, the incidence of abnormal auditory, visual, tactile, gustatory/olfactory, vestibular and proprioceptive sense was higher than that of normal children, and the differences were statistically significant. Multivariate logistic regression analysis showed that auditory and tactile abnormalities were the risk factors for overall abnormal self-regulation (OR=0.319, 95%CI: 0.111~0.912;OR=0.236, 95%CI: 0.060~0.928) and abnormal emotional regulation (OR=0.314, 95%CI: 0.130~0.759;OR=0.369, 95%CI: 0.145~0.937), and tactile abnormality was the risk factor for abnormal physiological conditions (OR=0.382, 95%CI: 0.155~0.941) and adaptability (OR=0.393, 95%CI:0.170~0.909). Conclusion: Abnormal auditory and tactile sensens were risk factors for abnormalities in self-regulation,physiological conditions and adaptability.

Key words: Autism spectrum disorder, Physiological condition, Emotional regulation, Adaptability, Auditory, Visual, Tactile, Gustatory/olfactory, Vestibular, Proprioceptive