目的：探讨早期康复治疗对孤独症谱系障碍患儿康复疗效的影响。

方法：本研究纳入2个样本。样本1纳入持续接受康复治疗6个月的76例孤独症谱系障碍（autism spectrum disorder，ASD）患儿，样本2纳入持续接受康复治疗≥2年的108例ASD患儿。按照开始康复治疗时的年龄，分为早期康复组（≤3岁）与非早期康复组（＞3岁～≤5岁）。所有患儿均接受以社会功能为主线的综合干预模式结合针灸疗法的康复治疗。样本1于康复治疗前和康复治疗6个月后进行心理教育评估量表第3版（Psychoeducational Profile-Third Edition，PEP-3）和儿童孤独症评定量表（Childhood Autism Rating Scale，CARS）评估。样本2于6岁（正常入学）或7岁（延迟1年入学）时评估入读普通学校或特殊学校的比例。

结果：样本1和样本2中，早期康复组与非早期康复组治疗前的CARS 总评分差异均无统计学意义（P ＞ 0.05）。样本1中，早期康复组PEP-3 模仿项目较非早期康复组明显进步（P ＝ 0.022），其余项目包括认知、语言表达、语言理解、小肌肉、大肌肉、情感表达、社交互动、非语言行为特征和语言行为特征的差异均无统计学意义（P ＞ 0.05）；早期康复组的CARS总评分也较非早期康复组显著进步（P ＜ 0.05）。样本2中，早期康复组入读普通学校的比例显著高于非早期康复组（41.67% vs 20.83%，P ＜ 0.05）。

结论：早期康复治疗能够显著提高ASD患儿的康复疗效，并且降低致残率，值得临床推广应用，也期望获得相应的政策支持。

Objective: To explore the effect of early rehabilitation intervention in children with autism spectrum disorder (ASD) .

Methods: Two samples were included in this study. Sample 1 included 76 children with ASD who received continuous rehabilitation for 6 months, and sample 2 included 108 children with ASD who received continuous rehabilitation for more than 2 years. According to the age at the beginning of rehabilitation intervention, they were divided into early rehabilitation intervention group (≤3 years of age) and non-early rehabilitation intervention group (more than 3 years and up to 5 years of age). All the children received comprehensive intervention mode with social function as the principal line combined with acupuncture therapy. The patients in sample 1 were assessed with Psychoeducational Profile-Third Edition (PEP-3) and Childhood Autism Rating Scale (CARS) before and 6 months after rehabilitation intervention, and the proportion of patients enrolled in general or special schools in sample 2 were assessed when they were 6 years old (normal enrollment) or 7 years old (delayed enrollment for one year).

Results: In sample 1 and sample 2, there was no significant difference in the baseline total score of CARS between the early rehabilitation intervention group and the non-early rehabilitation intervention group (P > 0.05). In sample 1, imitation in PEP-3 in early rehabilitation intervention group was significantly improved compared with that in the non-early rehabilitation intervention group (P = 0.022). There were no significant differences in other items including cognition, language expression, language understanding, small muscle, big muscle, emotional expression, social interaction, nonverbal behavior characteristics and language behavior characteristics (P > 0.05); the overall score of CARS in the early rehabilitation intervention group was significantly higher than that in the non-early rehabilitation intervention group (P < 0.05). In sample 2, the proportion of patients enrolled in general schools in the early rehabilitation intervention group was significantly higher than that in the non-early rehabilitation intervention group (41.67% vs 20.83%, P < 0.05).

Conclusion: Early rehabilitation intervention can significantly improve the outcomes of children with ASD, and reduce the disability rate, which is worthy of clinical application and policy support.