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Journal of Zhejiang University SCIENCE B

ISSN 1673-1581(Print), 1862-1783(Online), Monthly

Early developmental levels of children with autism spectrum disorder with different adaptive behaviors: a retrospective analysis

Abstract: The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) (American Psychiatric Association, 2013) defines autism spectrum disorder (ASD) as a complex neurodevelopmental disorder that begins in early childhood and is accompanied by social communication deficits and repetitive stereotyped behaviors. According to the monitoring data released in 2021 in the United States, the prevalence of ASD in children was as high as 2.27%; that is, one in 44 children had autism (Maenneret al., 2021). China publicly reported this figure to be around 0.7% (Zhou et al., 2020). The current view is that children with ASD are generally impaired in their adaptation ability (McDonaldet al., 2016; Hodgeet al., 2021; Opertoet al., 2021). Adaptive behaviors comprise the conceptual, social, and practical skills that enable individuals to adapt to the environment, which play an important role in daily life (McDonald et al., 2019). Adaptive behavior was first described by Doll (1936). Subsequently, abnormalities in adaptive behavior were included in the criteria for intellectual disability for the first time (Heber, 1961). The American Association on Mental Retardation (AAMR) has refined and specified this term several times. Researchers hold different opinions on the structure of social adaptive capability. Greenspan and Granfield (1992) divided social adaptive capability into social understanding and social interaction. However, an increasing number of scholars considered that the concept of adaptive behaviors in children was constructed via multiple dimensions. The most representative one among them was the Vineland Adaptive Behavior Scales (VABS) proposed by Sparrow et al. (1984). This scale illustrates that adaptive behavior includes communication, daily living skills, socialization, and motor skills. Harrison and Oakland (2003) developed an Adaptive Behavior Assessment System (ABAS), by applying the theory of adaptive behavior proposed by AAMR and the American Association on Intellectual and Developmental Disabilities (AAIDD). This system shows that adaptive behavior has three adaptive composites, namely, conceptual composite (including communication, learning function, and self-management), social composite (including leisure and social skills), and practical composite (including community application, home living, health and safety, and self-care). As there are different requirements for the social adaptive capability of children from different cultural backgrounds and various regions, Chinese scholars have translated the Normal Development of Social Skills from Infant to Junior High School Children (S-M) scale compiled by Japanese scholars into Chinese, which is now widely used in China (Zhang et al., 1995). The impairment of adaptive function in children with ASD includes multiple dimensions, such as socialization, communication, and daily living skills (Kanne et al., 2011), and the degree of impairment can predict the prognosis and outcome in real life, including education acquisition and independent living ability (Farley et al., 2009). Therefore, adaptive behavioral capacity is considered to be a key intervention point that directly affects the individual and social outcomes of autistic children (Veenstra-VanderWeele et al., 2017; Blte et al., 2019).

Key words: Autism spectrum disorder (ASD); Child; Adaptive behavior; Early developmental level; Individualized intervention

Chinese Summary  <15> 不同适应行为能力的孤独症谱系障碍儿童早期发育水平研究:一项回顾性分析

宋超, 韩婷, 胡莉菲, 邵宁, 王泽鹏, 金燕, 陈婷婷, 竺智伟
浙江大学医学院附属儿童医院发育行为科, 国家儿童健康与疾病临床医学研究中心, 中国杭州市, 310052
摘要:孤独症谱系障碍(ASD)儿童的适应行为能力普遍受到损害,然而其与早期发展水平之间的关系尚不明确。深入开展二者间关系的研究,将有助于了解ASD儿童能力的发展规律,促进ASD儿童早期个体化干预的实施。本文回顾性选取了1656例在2019年1月至2022年3月期间在浙江大学医学院附属儿童医院发育行为科被诊断为ASD的儿童,汇总了《婴儿-初中学生社会生活能力量表》和《Gesell发育诊断量表》(GDS)的结果,并进行统计学分析。结果表明,年龄会影响ASD儿童的适应行为以及GDS中各能区的早期发展;同时,适应行为也会显著影响GDS各能区的发育商数,且呈正相关关系。综上所述,ASD儿童的适应行为和各方面能力相互影响,因此有必要对不同ASD个体能力进行全面评估,并采取个体化的综合干预模式。

关键词组:孤独症谱系障碍;儿童;适应行为;早期发育水平;个体化干预


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DOI:

10.1631/jzus.B2300310

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On-line Access:

2024-12-03

Received:

2023-05-08

Revision Accepted:

2023-09-27

Crosschecked:

2024-12-04

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