| 其他摘要 | Autism spectrum disorder（ASD）is defined by persistent deficits in social communication and social interaction across multiple contexts, restricted, repetitive patterns of behavior, interests, or activities. ASD has a prevalence of up to 1% to 2% worldwide. Action imitation deficits is one of the core impairments in children with ASD, which directly affects the development of language function and the level of social communication in them. The identification and the effective intervention of action imitation deficits will contribute to the overall improvement of multifaceted capacity in children with ASD. However, at present, there is still a lack of objective evaluation tools for action imitation deficits, that can reduces the sensitivity of recognition of ASD. In addition, most of the existing intervention methods for action imitation deficits are limited to the improvement of the symptoms, and the more etiology-targeted intervention programs still need to be explored. In order to clarify the objective evaluation metrics that can be used for auxiliary identification of action imitation deficits, this study intended to explore the objective identification characteristics of action imitation deficits in children with ASD, and analyze their association with the imitation score as well as the severity of ASD symptoms. Moreover, according to the pathogenesis of action imitation deficits, the current study explored the effect of intervention technology combining action imitation training with aerobic exercise on action imitation deficits in children with ASD. The sensitivity of the objective evaluation metrics of the intervention effect was further tested through the intervention study. In the first study, fifty-two ASD children and thirty matched typical development children （TD）were enrolled in this study. The level of children's action imitation was evaluated using the meaningless-gesture imitation paradigm. When the children watched the action pictures to be imitated, their eye movements were recorded by eye tracker interfaced with the computer followed by scoring the performance of imitations task. Differences in eye movement metrics and action imitation performance were compared between the two groups. The Children Autism Rating Scale （CARS）was administered to all ASD children. For the ASD group, the correlation analysis of eye movement metrics, action imitation scores and the CARS was conducted. Finally, the ridge regression model was used to explore the predictive effect of eye movement metrics on action imitation. Results of the first study found that, time to first fixation, time of action observation, and proportion of region of interest (ROI) were significantly correlated with action imitation scores in children with ASD and varied significantly between children with ASD and TD. Children with ASD had a longer time to first fixation than children with TD. Time to first fixation is a good eye movement metrics for evaluating abnormal imitation tendency in children with ASD. ASD children took significantly longer time of action observation in the imitation task than the TD children. The proportion of ROI in the ASD children was significantly less than that of the TD group. Time of action observation and the proportion of ROI contributed to the action imitation scores of children with ASD, which were sensitive metrics reflecting the overall action imitation level of children with ASD. The second study used a randomized controlled trial in which “between-subject factor” was “group” and “within-subject factor” is “time”. Thirty-three ASD children were assigned to either experimental group (n = 18) or control group (n = 15). The experimental group was required to take an additional 12-week mini-basketball training program (five sessions per week, and forty minutes per session), while the control group was instructed to maintain their daily trainings. The level of action imitation and the eye movement metrics were assessed twice with a meaningless-gesture task before and after the experiment. Differences in the trend of imitation level and of the eye movement metrics over time between the two groups were analyzed using generalized estimation equations. The results of study 2 showed that, there were different trends in the imitation level of the two groups of the intervention experiments over time. Imitation scores and the time to first fixation improved significantly in the training group, while no significant difference was observed before and after that in the control group. The current study concluded that, time to first fixation, time of action observation, and the proportion of ROI are good objective identification metrics of imitation deficits in children with ASD. Eye movement measurement is expected to be an objective and effective means to assist in the identification of action imitation deficits in children with ASD. In addition, the mini-basketball training program improved the action imitation performance and imitation tendency of children with ASD. The research findings provide new implications for identifying and ameliorating action imitation deficits in children with ASD. |
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