The diagnosis study of post-rehabilitation reevaluation of children with positive initial screening for autism spectrum disorders
Objective To explore the diagnosis and analysis of factors associated with post-rehabilitation reevaluation of children with positive initial screening for autism spectrum disorder(ASD).Methods A retrospective research analysis was used,97 cases children with positive initial screening for ASD were selected from August 2019 to August 2022 in the Department of Child Healthcare of Liaocheng People's Hospital,which were categorized into three age groups:≤24 months(12 cases),＞24-≤36 months(47 cases),and＞36-≤72 months(38 cases),and then,based on the diagnostic and statistical manual of mental disorders,fifth edition(DSM-5)of the United States,the children were divided into ASD group(73 cases)and non-ASD group(24 cases)according to the diagnostic criteria of the DSM-5.The Childhood Autism Rating Scale(CARS)or the Modified Childhood Autism Screening Scale-Revised/Further Revised(M-CHAT-R/F)scale and the Gesell Developmental Diagnostic Scale scores were collected at the time of the initial diagnosis of the children to analyze the diagnosis of the children with positive initial screening for ASD and the related factors after the reassessment of the diagnosis after the rehabilitation training.Results 75.3％children diagnosed as ASD after rehabilitation and the rate was 71.8％in male and 100％in female children respectively.In children with positive initial screening for ASD who were reevaluated after rehabilitation training,the compliance rate of ASD diagnosis increased sequentially with the age group(X2=10.032,P=0.002).Reevaluated after rehabilitation training,children in the ASD group had significantly lower scores on the Gesell scale in adaptive,gross motor,fine motor,language,and personal-social competence areas than those in the non-ASD group,and the differences were all statistically significant(t=-3.268,-1.970,-2.472,-3.205 and-3.570,respectively,P＜0.05).Reassessed after rehabilitation,the ASD diagnostic compliance rate was positively correlated with the degree of developmental lag in adaptive(r=0.325),gross-motor(r=0.229),fine-motor(r=0.241),language(r=0.286),and personal-social(r=0.356),ability areas(P＜0.05).The children in the ASD group ≤24 months had significantly lower M-CHAT-R/F scale scores were significantly lower than those of the non-ASD group(t=-4.950,P＜0.05),and the CARS scale and M-CHAT-R/F scale scores of the ASD group were significantly higher than those of the non-ASD group for children＞24-≤ 36 months of age(t=2.166 and 2.151,respectively,P＜0.05).The CARS scale scores of children in the ASD group(＞36-≤72 months)were significantly higher than those in the non-ASD group(t=2.695,P＜0.05).Higher CARS score was a risk factor for diagnosing as ASD for children older than 24 months.[OR=1.367,95％CI:1.133-1776,P＜0.05].Higher M-CHAT-R/F score was a risk factor for diagnosing as ASD for children between 24 to 36 months.(OR=1.623,95％CI:1.122-2.765,P＜0.05).Conclusion Reassessment of ASD diagnostic compliance after rehabilitation of children with initial positive ASD screening is high,and reassessment of ASD diagnostic compliance is related to the child's gender,age,developmental level,and score on either the initial screening CARS scale or the M-CHAT-R/F scale.
万方数据
维普
