Abstract:

Objective　To evaluate the value of symbolic play test (SPT) in screening children with autism. Methods　A total of 261 children with language problems were collected from Department of Pediatrics, Guangrao County People's Hospital from November 2021 to September 2022. Among them, 194 were diagnosed with autism and were included into the observation group, including 56 girls and 138 boys who were (41.70±13.70) months old; 67 children were diagnosed with language development delay and were included into the control group, including 20 girls and 47 boys who were (29.85±7.56) months old. The Gesell Developmental Scale, SPT, and Autism Behavior Checklist (ABC) were used to evaluate the 261 children. The Gesell child developmental levels (adaptability, gross motor, fine motor, language, and personal social interaction), symbolic play abilities, and scores of ABC were compared between the two groups. The value of SPT in screening children with autism was explored. χ² and t tests and Pearson correlation analysis were applied. Results　The scores of adaptability, gross motor, fine motor, language, and personal social interaction and SPT age, adaptive months, and personal social age in the observation group were lower than those in the control group [(50.41±15.46) vs. (78.87±13.40), (59.06±16.69) vs. (83.49±13.40), (56.38±17.79) vs. (82.67±15.70), (35.94±11.71) vs. (57.34±12.23), (42.01±13.61) vs. (67.69±14.98), (12.77±8.44) months vs. (19.06±7.04) months, (20.08±7.59) months vs. (23.08±6.13) months, and (16.89±6.77) months vs. (20.37±6.84) months], and the score ABC of was (90.94±13.83) in the observation group, and (26.48±10.67) in the control group, with statistical differences between the two groups (all P<0.001). The correlation analysis showed that the original SPT score was positively correlated with Gesell test scores of adaptability, gross motor, fine motor, language, and personal social interaction (r=0.405, 0.225, 0.308, 0.507, and 0.532; all P<0.001), and negatively with ABC (r=-0.386). In the observation group, the original SPT score was negatively correlated with ABC (r=-0.211, P<0.001); in the control group, the original SPT score was negatively correlated with ABC (r=-0.346, P<0.001). Conclusions　Compared with the children with simple language development delay, autism children have development delay of symbolic play ability. SPT plays a role in early identification of autism.

Key words:

Autism, Symbolic play test, Autism Behavior Checklist, Language development delay

摘要：

目的　了解象征性游戏测试（SPT）在儿童孤独症筛查中的作用价值。方法　采用回顾性横断面研究方法，收集2021年11月至2022年9月在广饶县人民医院儿科以语言问题就诊的患儿261例，确诊孤独症患儿194例为观察组［月龄（41.70±13.70）个月，女孩56例，男孩138例］，语言发育迟缓67例为对照组［月龄（29.85±7.56）个月，女孩20例，男孩47例］。均做Gesell发育量表、SPT及儿童孤独症行为量表（ABC），比较两组间Gesell儿童发育水平（适应性、大运动、精细运动、语言及个人社交能力5个能区）、象征性游戏能力和ABC评分，探讨SPT对儿童孤独症筛查的价值。采用χ²检验、t检验、Pearson相关性分析。结果　观察组患儿适应性评分为（50.41±15.46）分、大运动评分为（59.06±16.69）分、精细运动评分为（56.38±17.79）分、语言评分为（35.94±11.71）分、个人社交能力评分为（42.01±13.61）分、SPT测试发育月龄为（12.77±8.44）个月，适应性月龄为（20.08±7.59）个月，个人社交月龄为（16.89±6.77）个月，均显著低于对照组［（78.87±13.40）分、（83.49±13.40）分、（82.67±15.70）分、（57.34±12.23）分、（67.69±14.98）分、（19.06±7.04）个月、（23.08±6.13）个月、（20.37±6.84）个月］，ABC评分为（90.94±13.83）分，显著高于对照组（26.48±10.67）分，两组比较，差异均有统计学意义（均P<0.001）。相关性分析发现，SPT测试原始分与Gesell测试适应性、大运动、精细、语言、个人社交评分存在显著正相关性（r=0.405、0.225、0.308、0.507、0.532，均P<0.001），与ABC呈负相关（r=-0.386）。观察组SPT测试原始分与ABC呈负相关（r=-0.211，P<0.001），对照组SPT测试原始分与ABC呈负相关（r=-0.346，P<0.001）。结论　孤独症儿童的象征性游戏能力落后于语言发育迟缓儿童，象征性游戏测试可以为孤独症早期识别提供线索

关键词:

孤独症, 象征性游戏测试, 孤独症行为量表, 语言发育迟缓