A Multi-center Study On The Relationship Between Developmental Regression And Disease Severity And Risk Facrors In Children With Autism Spectrum Disorders

Part1 RELATIONSHIP BETWEEN DEVELOPMENTAL REGRESSION AND DISEASE SEVERITY IN CHILDREN WITH AUTISM SPECTRUM DISORDERSObjective: To investigate the incidence of developmental regression in children with Autism Spectrum Disorder(ASD)and to explore its relationship with disease severity.Methods: Informations of ASD children were collected in 13 hospitals from 13 cities across the country,and all aspects of information were collected by self-made interview questionnaire.Children were divided into regressive group and non-regressive group according to the result of interview questionnaire.The Autism Behavior Checklist(ABC),Social Responsiveness Scale(SRS),Childhood Autism Rating Scale(CARS),Children Neuropsychological and Behavioral Scale-Revision 2016(CNBS-R2016)were used to evaluate the core symptoms and developmental status of children in the two groups.Results: Among the 1448 ASD children eventually included,43.85%(635/1448)showed regressive behavior and the average regressive age was(25.27±9.75)months.94.54%(589/623)of the children’s specific regressive skills were concentrated in language,social-communication and motor,among which the regression of language was the most significant with 85.87%(532/623).The total scores of ABC and the sub-score of sensation,communication,somatic movement,self-care(Z=-6.228,-4.861,-4.813,-5.544,-4.611,P=0.000),SRS total score and each sub-score(Z/t=-5.543,-3.266,-3.600,-5.423,-5.317,-4.360,P=0.000,0.001,0.000,0.000,0.000,0.000),CARS total score(Z=-4.518,P=0.000)and CNBS-R2016 warning behavior(Z=-3.781,P=0.000)of children in the regressive group were all higher than those in the non-regressive group.The full scale developmental quotient(DQ)of CNBS-R2016 and the five domains DQ(Z/t=-6.116,-2.452,-4.829,-5.520,-7.331,-6.000,P=0.000,0.014,0.000,0.000,0.000,0.000)were lower than that of children in the non-regressive group and the proportion of children with intelligent developmental disorder was higher than that of the non-regressive group(χ2=26.333,P=0.000).Conclusions: The incidence of regression was higher in ASD children.Children with regressive ASD had more severe core symptoms and a lower DQ.Clinicians and parents should be strengthened to recognize this type of children.Part2 RISKS FACTORS OF DEVELOPMENTAL REGRESSION IN CHILDREN WITH AUTISM SPECTRUM DISORDERSObjective: To investigate the risk factors for developmental regression in children with ASD.Methods: A total of 1448 children with ASD were included,and the Children were divided into regressive group and non-regressive group according to the result of interview questionnaire.Univariate analysis and multivariate Logistic regression analysis were used to compare the growth environments of the two groups of children and analyze the potential risk factors for the occurrence of developmental regression.Results: Compared with the non-regressive group,the regressive group had statistically significant differences in residence,single child,maternal educational level,maternal mood before pregnancy,pathological jaundice and severe picky eating after birth(P<0.05).The multivariate Logistic analysis showed that the independent risk factors for regressive behavior included the mother’s low educational level(OR=1.167,95%CI:1.026-1.328,P=0.019)and the children’s severe picky eating after birth(OR=1.257,95%CI:1.002-1.577,P=0.048).Conclusion: The risk factors of developmental regression in children with ASD are multifaceted,and the developmental status of children should be actively monitored to detect the regressive manifestations in time.More attention should be paid to the children whose mothers have low education level and are serious picky eaters.