神经心理发育量表在孤独症谱系障碍、全面发育迟缓中的早期鉴别意义

The Significance of Neuropsychological Development Scale in Early Identification of Autism Spectrum Disorder and Global Developmental Delay

摘要: 目的：探究孤独症谱系障碍(Autism Spectrum Disorder, ASD)和全面发育迟缓(Global Developmental Delay, GDD)儿童的神经心理发育情况，为早期鉴别和提前干预提供重要依据。方法：选取2020年1月至2024年1月在青岛大学附属医院儿童保健科门诊首次确诊的132例ASD儿童作为ASD组，同期门诊首次确诊的150例全面发育迟缓儿童作为GDD组。使用《0~6岁小儿神经心理发育量表》(2016版)对两组儿童的神经心理发育进行评估。比较两组的人口学特征以及量表指标。采用Logistic回归分析确定与ASD相关的因素，并通过受试者工作曲线确定预测因子的最佳截断值。采用SPSS26.0软件进行统计学分析。结果：ASD组儿童在大运动(P < 0.001)、精细运动分数(P < 0.001)及DQ分数(P = 0.001)高于GDD组，而在适应性分数要低于GDD组(P = 0.016)。单因素和多因素logistic回归显示大运动和精细运动是ASD的独立危险因素，大运动分数 ≥ 76.5时诊断ASD的灵敏度为93.3%，特异性为68.9%。结论：ASD与GDD在神经心理发育量表上具有显著差异性，大运动分数可以早期较准确的预测ASD。

Abstract: Objective: To investigate the neuropsychological development of children with Autism Spectrum Disorder (ASD) and Global Developmental Delay (GDD), providing an important basis for early identification and early intervention. Methods: 132 children with ASD who were first diagnosed in the pediatric health department of Qingdao University Affiliated Hospital from January 2020 to January 2024 were selected as the ASD group, and 150 children with comprehensive developmental delay who were first diagnosed in the outpatient department during the same period were selected as the GDD group. Evaluate the neuropsychological development of two groups of children using the 0~6-year-old Pediatric Neuropsychological Development Scale. Compare the demographic characteristics and scale indicators of two groups. Use logistic regression analysis to identify factors related to ASD, and determine the optimal cutoff value of the predictive factor through the subject’s work curve. Statistical analysis was conducted using SPSS 26.0 software. Results: Children in the ASD group had higher scores in gross motor (P < 0.001), fine motor (P < 0.001), and DQ (P = 0.001) than those in the GDD group, while their adaptive scores were lower than those in the GDD group (P = 0.016). Univariate and multivariate logistic regression showed that gross motor and fine motor were independent risk factors for ASD. The sensitivity and specificity for diagnosing ASD were 93.3% and 68.9%, respectively, when the gross motor score was ≥ 76.5. Conclusion: There is a significant difference between ASD and GDD on the neuropsychological development scale, and high motor scores can predict ASD early and accurately.