基于潜类别增长模型孤独症患儿社会适应能力发展轨迹及影响因素OA

Objective To analyze the developmental trajectories of social adaptation abilities in children with autism spectrum disorder(ASD)using latent class growth model(LCGM),and investigate the influencing factors.Methods A total of 184 ASD children aged 3 to 6 years were selected as subjects who received treatment at Minda Hospital of Hubei Minzu University fromJanuary 2018 to September 2021.General information and clinical data of the children were collected upon admission,one year later,two years later,and three years later.The children's social adaptation was assessed using the social responsiveness scale second edition(SRS-2).LCGM was applied to characterize the developmental trajectory of social adaptation abilities,and univariate and multivariate Logistic regression analysis were used to explore the factors affecting the social adaptation ability of ASD children.Results Of the 184 ASD children,152 completed the follow-up assessments,the average SRS-2 scores at baseline,one year post-admission,two years post-admission,and three years post-admission were 85.37±4.62,82.23±3.93,79.04±2.32,and 75.33±3.23,respectively,indicating an overall downward trend.The results from the single-factor variance analysis showed significant differences among the SRS-2 scores across the four time points(F=214.092,P＜0.001).Through application of the LCGM,three distinctive developmental trajectories of social adaptation abilities in ASD children were discerned:low SRS-2 value-stable progress group accounting for 34.21％,moderate SRS-2 value-slow progress group accounting for 49.34％,and high SRS-2 value-stagnant group accounting for 16.45％.Single-factor analysis indicated that there were statistically significant differences among the three groups concerning whether they were the only child in the family,the social support rating scale(SSRS)scores,the autism rating scale(CARS)scores,the autism behavior checklist(ABC)scores,educational levels of guardians,and income levels(P＜0.05).The results from multivariate Logistic regression analysis,with the high SRS-2 value-stagnant group serving as the reference category,showed that major influencing factors contributing to membership in either the low SRS-2 value-stable progress group or the moderate SRS-2 value-slow progress group included being an only child,guardian's educational attainment,annual household income,and SSRS scores(P＜0.05).Conclusion Children with ASD have different developmental trajectories for their social adaptation abilities,where being an only child,guardian education level,household annual income,and SSRS scores are key factors influencing these trajectories.