The Investigation On Behavior Of Autism And Analysis Of Its Influencing Factors Among Preschool Children In Rural Areas Of Anhui Province

Objective With the development of social economy and the change of living environment and under the joint influence of environment and genes,the incidence of autism among preschoolers has shown a significant upward trend in recent decades.There is not only no healing cure for autism,but it is characterized by unknown etiology,frequent comorbidities,significant heterogeneity and heavy disease burden.While,early detection and intervention of autism behavior are of great significance for early diagnosis and treatment of autism.Following recent autism research in every Provinces and cities,our study are aim to investigate autism behavior and its related influencing factors and to further explore the association between left-behind status,screen time(ST)and autism behavior among preschool children in rural areas of Anhui Provinces.Methods 26 rural kindergartens were selected by convenience sampling for a cross-sectional survey from October 2019 to January 2020,and a structured questionnaire was used to investigate the basic information of children,children’s sleep,children’s eating behavior problems,autism behavior,the relationship of left-behind children with autism behavior and screen time(ST),etc.The statistical data were analyzed by SPSS 23.0 software.χ~2test was used to analyze the difference in the detection rate of factors related to autism behavior,multivariate Logistic regression analysis was used to explore the risk factors of autism behavior and to explore the relationship between left-behind status,ST and autism behavior in the sample areas preschool children.Results 1.Among 3636 preschool children from the sample area,420 children with autism behavior were screened based on the Clancy Autism Behavior Scale(CABS)with scores≥14,with a detection rate of 11.6%.2.Autism behavior were varied by children’s gender,age,body mass index(BMI),mother’s level of education,parenting attitude,family education way,mother’s mood during pregnancy,experiences,left-behind children left-behind status,screen time.3.Results of Logistic regression showed that the risk of autism behavior was influenced by studying factors except the mother’s education level and the mood during pregnancy.Among them,the gender,BMI,parental discipline attitude,family education style,children’s left-behind status and ST have significant effects on autism behavior.The risk of autism behavior in girls was 33%lower than that in boys(OR=0.67,95%CI:0.54-0.83);Children with BMI overweight had a 76%higher risk of autism behavior than those with BMI underweight and normal weight(OR=1.76,95%CI:1.29-2.41);Inconsistent parental attitudes were associated with a significantly increased risk of autistic behavior,with a 42%risk of occasional inconsistency(OR=1.42,95%CI:1.14-1.78)and a 108%risk of frequent inconsistency(adjusted OR=2.08,95%CI:1.37-3.15).The family parenting style of reprimanding and hitting was a risk factor for autism behavior,with a 65%increased risk compared with spontaneous parenting(OR=1.65,95%CI:1.01-2.69).Compared with non-left-behind children,the risk of autism behavior of left-behind children increased by 34%(OR=1.34,95%CI:1.07-1.61),while there was no significant difference in the risk of autism behavior between ever left-behind children and non-left-behind children(OR=1.05,95%CI:0.61-1.82).Compared with ST≤1 h/d,children with 1h/d<ST≤2 h/d and ST>2h/d had an increased risk of autism behavior of 42%(OR=1.42,95%CI:1.07-1.88)and81%(OR=1.81,95%CI:1.35-2.44),respectively.4.Compared with non-left-behind children,left-behind children had a overall 36%increased risk of developing autism behavior(adjusted OR=1.36,95%CI:1.10-1.69).When ST>2h/d was observed,the risk of autism behavior increased regardless of whether they were left-behind or not,98%increased for non-left-behind children(adjusted OR=1.98,95%CI:1.32-2.98),and 67%increased for left-behind children(adjusted OR=1.67,95%CI:1.09-2.55).Compared with non-left-behind children with ST≤1h/d,left-behind children with1h/d<ST≤2h/d had a 97%increased risk for autism behavior(adjusted OR=1.97,95%CI:1.32-2.94),while left-behind children with ST>2h/d had a 159%increased risk for autism behavior(adjusted OR=2.59,95%CI:1.71-3.92).Conclusion 1.Results show that the detection rate of autism behavior problems in the sample areas children is high,especially prominent among girls.The autism behavior were affected by the gender of children,age of children,BMI of children,education level of mothers,maternal mood during pregnancy,folic acid supplement of mothers during pregnancy,parental discipline attitude,family education style,left-behind status and daily ST.2.The correlation between left-behind status,ST and autism behavior of preschool children in rural areas of Anhui Province found that different left-behind status and exposure to different ST all increased the risk of autism behavior.There may have an addictive joint action between excessive daily ST and left-behind status among the sample areas children,the risk of autism behavior will be further increased when the two work together.The timely return of left-behind children’s parents and the timely release of left-behind children’s status may reduce the risk of autistic behaviors.