【摘要】 目的 了解如东县0～6岁儿童孤独症谱系障碍(autism spectrum disorder, ASD)流行病学特征，为ASD早期筛查、诊断与干预提供科学依据。方法 2022年6月—2025年6月，选择如东县14个乡镇儿保门诊接受ASD初筛的0～6岁儿童为研究对象，通过ASD筛查三级转诊服务体系，采用0～6岁儿童心理行为发育预警征象筛查表、ASD“五不”行为标志、丹佛发育筛查量表(DDST)进行初筛，格赛尔发育诊断量表(Gesell)、儿童孤独症谱系筛查量表(M-chat)、孤独症行为量表(ABC)进行复筛，儿童孤独症评定量表CARS)、国际孤独症诊断观察量表(ADOS-2)进行诊断，分析如东县儿童ASD患病情况及影响因素。结果 接受ASD初筛服务0～6岁儿童19 135人，初筛阳性925人，初筛阳性率4.83%;有效转诊复筛789人，复筛率为85.29%。复筛阳性743人，接受诊断662人，确诊115例，0～6岁儿童ASD患病率为6.01‰。男童患病率为8.70‰,女童为3.20‰,差异有统计学意义(χ~2=24.21,P<0.01)。多因素logistic回归分析显示，男童(OR=2.83,95%CI:1.28～4.74)、非父母养育(OR=2.18,95%CI:1.18～5.01)、亲子互动时间<3 h/d(OR=1.64,95%CI:1.37～2.98)、屏幕暴露时间≥1 h/d(OR=1.96,95%CI:1.58～5.44)的儿童ASD发生风险更高。结论 如东县儿童ASD患病率低于全国水平，应重点干预男童、非父母养育、亲子互动时间少与屏幕暴露时间多的儿童。更多还原

【Abstract】 Objective To understand the epidemiological characteristics of autism spectrum disorder(ASD) among children aged 0-6 years in Rudong County, so as to provide a scientific basis for early screening, diagnosis and intervention of ASD. Methods From June 2022 to June 2025,children aged 0-6 years who underwent initial ASD screening at child health clinics in 14 townships of Rudong County were selected as study subjects.Through a threelevel referral service system for ASD screening, the initial screening was conducted by using the Psychological and Behavioral Development Warning Signs Screening Chart for Children Aged 0-6 Years, the “Five Not’s” behavioral markers of ASD,and the Denver Developmental Screening Test(DDST).The secondlevel screening(rescreening) was performed by using the Gesell Developmental Diagnosis Scale(Gesell),the Modified Checklist for Autism in Toddlers(MCHAT),and the Autism Behavior Checklist(ABC).Diagnosis was made by using the Childhood Autism Rating Scale(CARS) and the Autism Diagnostic Observation Schedule2(ADOS2).The prevalence and influencing factors of ASD among children in Rudong County were analyzed. Results Among the 19 135 children aged 0-6 years who received initial ASD screening, 925 tested positive, yielding an initial screening positivity rate of 4.83%.A total of 789 children were effectively referred for rescreening, with a rescreening rate of 85.29%.Among those rescreened, 743 were positive; 662 underwent diagnostic assessment, and 115 were confirmed with ASD.The overall prevalence of ASD among children aged 0-6 years was 6.01‰.The prevalence was 8.70 ‰in boys and 3.20‰ in girls, with a statistically significant difference(χ~2=24.21,P<0.01).Multivariate logistic regression analysis showed that boys(OR=2.83,95%CI:1.28-4.74),children not raised by their parents(OR=2.18,95%CI:1.18-5.01),those with parentchild interaction time <3 h/d(OR=1.64,95%CI:1.37-2.98),and those with screen exposure time ≥ 1 h/d(OR=1.96,95%CI:1.58-5.44) were at a higher risk of developing ASD. Conclusions The prevalence of ASD among children in Rudong County is lower than the national average.Priorityintervention should be given to boys, children not raised by their parents, those with less parent-child interaction time, andthose with more screen exposure time.更多还原