The Study On Tools Of Early Risk Warning And Assessment Of Children With Autism

Objectives: To understand and analyse the development and behavior in different age groups of 12~36 month old children,so as to explore the early warning tools of autism for different age children and provide evidence for early identification and early detection of autism.Methods: The cluster random sampling method was used to select 397 cases of 1~4 years old children with autism as the research object from the medical rehabilitation institutions in Wuhan, Zhuhai, Changsha, Xiamen and so on, while the same method was used to select 700 normal children in the same area as the control group. The Children's psychological behavior and related factors questionnaire survey was conducted on the children's guardians of the case group and the control group. EpiData3.1 was used to set up a database and SPSS22.0 used to statistical analysis. The statistical methods of response rate,Cronbach's ? coefficient, discrimination analysis,response rate,factor analysis, stepwise regression, Stepwise discrimination were applied to analyse each abnormal sign. The sign should be eliminated which meet the three or more of the rejection criteria standards. After excluding, cluster analysis was used to get the autism risk early warning tools. The autism risk early warning tools for 12,18,24,30,36 months of children were selected by testing the tools and comprehensive analysis.Results:(1) Basic situation of research target: A total number of 397 children with autism and 700 normal children were in the study. The sex ratio was 6.35:1, and the average age of the case group was 39.47±12 months. In the control group, the sex ratio was 5.67:1, and the average age of the case group was 40.25±13.82 months. There was no significant difference in the age distribution of children with different sex(?2=0.560,P=0.967), while there was no significant difference in the age distribution between the case group and the control group(?2=0.241,P=0.993).(2) Abnormal signs of children with autism: Analysis results showed that all of 44 abnormal signs had appeared in 12 months, while with the increase of age, the emergence rate of each indicator showed a significant upward trend. The incidence rate of the indicator that showed "no interest or no hearing" in the case group of all age groups was the highest: 19.8%?43.1%?64.7%?70.3% and 73.0%. At the age of 18 and 12 months, there were 13 and 35 abnormal signs in the case group, which were more than 10%. At the age of 24,30 and 36 months, there were 14,19 and 20 abnormal signs in the case group, which were more than 30%., while there were 5,8 and 11 abnormal signs in the case group, which were more than 50%.(3) Early risk warning and assessment tools for autism of children with different age:(1)At the age of 12 months, the warning indicators are 11 such as "ittle crying, happy or grievances and other emotional responses", "can't accept simple instructions"( Cronbach's ? is 0.789, Spearman coefficient is 0.474, AUC is 0.706, the sensitivity is less than 0.500(P<0.05)).(2)At the age of 18 months, the warning indicators are 10 such as "activities have no purpose", "repeat an action"(Cronbach's ? is 0.842, Spearman coefficient is 0.601, AUC is 0.852, the sensitivity is 0.747(P<0.05)).(3)At the age of 24 months, the warning indicators are 6 such as "lack of communication with the surrounding environment", "refuse to imitate other people's actions, expressions, or sounds"(Cronbach's ? is 0.806, Spearman coefficient is 0.765, AUC is 0.878, the sensitivity is 0.743(P<0.05)).(4)At the age of 30 months, the warning indicators are 4 such as "refuse to imitate other people's actions, expressions, or sounds", "no response to other people's facial expressions.".(Cronbach's ? is 0.841, Spearman coefficient is 0.784, AUC is 0.827, the sensitivity is 0.759(P<0.05)).(5)At the age of 36 months, the warning indicators are 4 such as "lack of communication with the surrounding environment", "like the front punch and toe walking".(Cronbach's ? is 0.828, Spearman coefficient is 0.798, AUC is 0.910, the sensitivity is 0.860(P<0.05)). Conclusions: In the early stage of autistic children, abnormal signs appear. With the increase of the age, the rate of occurrence is obviously increasing. The early risk warning and assessment tool for 12 months children contains 11 indicators, and the sensitivity is less than 0.500. The early risk warning and assessment tool for 18 months children contains 10 indicators, and the sensitivity is better. The early risk warning and assessment tools for 24~36 months children contain 4~6 indicators, and the sensitivity is better.