Early development score as a prognostic factor in nonverbal/minimally verbal children with autism spectrum disorder: A matched case-control study in Cyprus.

IF 2.5 Q1 EDUCATION, SPECIAL
Autism and Developmental Language Impairments Pub Date : 2024-10-01 eCollection Date: 2024-01-01 DOI:10.1177/23969415241286403
Margarita Kilili-Lesta, Konstantinos Giannakou, Louiza Voniati
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引用次数: 0

Abstract

Background and aims: Children with autism spectrum disorder (ASD) present with impairments in social interaction and stereotypic behaviors. About a third may exhibit delays in verbal expression beyond preschool age, potentially categorizing them as nonverbal/minimally verbal (NV/MV), a condition that can persist into adulthood and affect their quality of life. The risk and prognostic factors associated with this reduced verbal outcome remain uncertain. This study aims to identify such factors within children diagnosed with ASD in Cyprus.

Methods: In this case-control study, 56 children aged 3-12 years, with an ASD diagnosis, participated. Among them, cases were 22 children classified as ASD-NV/MV, and controls were 34 children classified as verbal (ASD-V), matched by age group and gender. Retrospective information on familial, perinatal, and developmental risk and prognostic factors were collected to calculate the familial risk score (FRS), perinatal risk score (PRS), and developmental risk score (DRS). Early development information was collected for the Early Development Score (EDS) and Early Gesture Score (EGS), to measure the children's skill level as toddlers across milestones. A low EDS and/or low EGS reflected general developmental delays and decreased frequency of early gestures and were considered in the DRS. A parent report questionnaire was utilized to determine the current overall linguistic level and status of participants, distinguishing cases from controls.

Results: Age group and gender-matched cases and controls were similar in socioeconomic status and demographic characteristics (p > .05). Among the various familial (e.g., sibling with ASD), perinatal (e.g., prematurity), and developmental (e.g., ASD regression) factors examined individually, as well as collectively as scores in a conditional logistic regression (CLR) model, only a high DRS (p = .03), due to low EDS (p = .04) was significantly associated with linguistic status. When considering all risk scores in a multivariate CLR model, children with a high DRS were more likely to belong to the cases than to the control group (p = .02). In a subsequent model with low EDS and low EGS, only the low EDS was significantly associated with the case group. Results showed that children with ASD and a low EDS, reflecting general delays in early development, were 4.5 times more likely to belong to the cases group than those with a high EDS (p = .02).

Conclusions: Early developmental delays in developmental milestones across various domains like gesture, motor, play, linguistic, cognition, and joint attention, in toddlerhood, were associated with later decreased verbal outcomes. Children in the sample with such early delays (low EDS), had a higher likelihood of persistent language delays (ASD-NV/MV) even at late school age. Future studies are needed to duplicate findings and explore possible contributing factors affecting linguistic outcome in ASD through prospective studies exploring within ASD differences.

Implications: These findings emphasized the importance of monitoring early development closely for children at risk for ASD, pre-diagnosis, to provide additional early support for those more likely to be ASD-NV/MV. Parents and specialists like pediatricians, educators, speech-language pathologists, among others, can track the EDS score of children at risk for ASD and refer to the appropriate specialists for early stimulation, intervention, and parent consultation promptly.

早期发育评分作为自闭症谱系障碍非言语型/微言语型儿童的预后因素:塞浦路斯的一项匹配病例对照研究。
背景和目的:患有自闭症谱系障碍(ASD)的儿童有社交互动障碍和刻板行为。约有三分之一的儿童在学龄前后可能会表现出言语表达迟缓,有可能被归类为非言语/轻度言语障碍(NV/MV),这种情况可能会持续到成年并影响他们的生活质量。与言语能力下降相关的风险和预后因素仍不确定。本研究旨在确定塞浦路斯确诊为 ASD 儿童的此类因素:在这项病例对照研究中,56 名年龄在 3-12 岁、被诊断为 ASD 的儿童参与了研究。其中,病例为 22 名被归类为 ASD-NV/MV 的儿童,对照为 34 名被归类为言语障碍(ASD-V)的儿童,年龄组和性别均匹配。研究人员收集了有关家族、围产期和发育风险及预后因素的回顾性信息,以计算家族风险评分(FRS)、围产期风险评分(PRS)和发育风险评分(DRS)。收集的早期发育信息包括早期发育评分(EDS)和早期手势评分(EGS),以衡量儿童在学步阶段的各里程碑技能水平。低 EDS 和/或低 EGS 反映了儿童的总体发育迟缓和早期手势频率的降低,因此在 DRS 中予以考虑。家长报告问卷用于确定参与者目前的整体语言水平和状况,并将病例与对照组区分开来:结果:年龄组和性别匹配的病例与对照组在社会经济地位和人口特征方面相似(P > .05)。在条件逻辑回归(CLR)模型中,对各种家族因素(如患有 ASD 的兄弟姐妹)、围产期因素(如早产)和发育因素(如 ASD 回归)进行了单独研究,并以分数的形式进行了集体研究,其中只有高 DRS(p = .03)和低 EDS(p = .04)与语言状况有显著关联。在多元逻辑回归模型中考虑所有风险评分时,DRS高的儿童属于病例组的可能性高于对照组(p = .02)。在随后的低 EDS 和低 EGS 模型中,只有低 EDS 与病例组显著相关。结果显示,患有 ASD 且 EDS 低的儿童属于病例组的可能性是 EDS 高的儿童的 4.5 倍(p = .02):结论:幼儿期在手势、运动、游戏、语言、认知和共同注意等不同领域的早期发育里程碑延迟与日后言语能力下降有关。样本中存在此类早期发育迟缓(低 EDS)的儿童,即使到了学龄后期,也更有可能出现持续性语言发育迟缓(ASD-NV/MV)。未来的研究需要重复研究结果,并通过探索 ASD 内部差异的前瞻性研究,探索影响 ASD 语言能力结果的可能因素:这些研究结果强调了对有 ASD 风险的儿童在诊断前密切监测其早期发展的重要性,以便为那些更有可能患有 ASD-NV/MV 的儿童提供额外的早期支持。家长和儿科医生、教育工作者、言语病理学家等专家可以跟踪 ASD 高危儿童的 EDS 评分,并及时转介给适当的专家进行早期刺激、干预和家长咨询。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Autism and Developmental Language Impairments
Autism and Developmental Language Impairments Psychology-Clinical Psychology
CiteScore
3.20
自引率
0.00%
发文量
20
审稿时长
12 weeks
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