Évaluation du changement de comportement après adénotonsilectomie pour l'apnée obstructive du sommeil chez les enfants avec un diagnostic de trouble du spectre de l'autisme

Aperçu: G.M.

L'apnée obstructive du sommeil (AOS) peut affecter le fonctionnement cognitif quotidien chez les enfants. Les objectifs de l'étude étaient double. Le premier objectif était de détecter, en utilisant la checklist du comportement de l'enfant (CBCL), si l'adénotonsilectomie (AT) pour le traitement de l'OSA a amélioré le comportement des enfants avec un diagnostic de trouble du spectre de l'autisme (TSA). Le deuxième objectif était d'identifier les caractéristiques d'amélioration comportementale suite au traitement de l'OSA chez ces enfants avec un diagnostic de TSA.

Les problèmes comportementaux ont été considérablement améliorés suite à l'AT chez les enfants avec un diagnostic de TSA et une AOS. Le dépistage précoce et le traitement des enfants avec AOS sont essentiels pour prévenir les problèmes de comportement et pour soutenir le développement mental. 

Res Dev Disabil. 2017 May 14;65:127-139. doi: 10.1016/j.ridd.2017.04.012.

Evaluation of behavioral change after adenotonsillectomy for obstructive sleep apnea in children with autism spectrum disorder

Murata E¹, Mohri I², Kato-Nishimura K³, Iimura J⁴, Ogawa M⁵, Tachibana M⁶, Ohno Y⁷, Taniike M⁶.

Author information

1

Department of Child Development, United Graduate School of Child Development, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 5650871, Japan.

2

Department of Child Development, United Graduate School of Child Development, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 5650871, Japan; Department of Pediatrics, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 5650871, Japan. Electronic address: ikuko@kokoro.med.osaka-u.ac.jp.

3

Department of Child Development, United Graduate School of Child Development, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 5650871, Japan; Ota Memorial Sleep Center, 1-50 Nisshincho, Kawasaki, Kawasaki-ku, Kanagawa, 2100024, Japan.

4

Department of Otorhinolaryngology, Ota General Hospital, 1-50 Nisshincho, Kawasaki, Kawasaki-ku, Kanagawa, 2100024, Japan.

5

Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 5650871, Japan.

6

Department of Child Development, United Graduate School of Child Development, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 5650871, Japan; Department of Pediatrics, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 5650871, Japan.

7

Department of Mathematical Health Science, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 5650871, Japan.

Abstract

BACKGROUND AND OBJECTIVE:

Obstructive sleep apnea (OSA) may affect daily cognitive functioning in children. The aims of our study were two-fold. The first aim was to detect, using the Child Behavior Checklist (CBCL), whether adenotonsillectomy (AT) for the treatment of OSA improved the behavior of children with autism spectrum disorder (ASD). The second aim was to identify characteristics for behavioral improvement following the treatment of OSA in these children with ASD.

METHODS:

The behaviors of ASD children aged 5-14 years diagnosed as having OSA (n=30) were evaluated using CBCL before and after AT. CBCL evaluation of ASD children without OSA at two time points with the same interval served as a control (n=24). We statistically examined the two groups. In addition, we conducted a paired t-test to assess changes in CBCL Tscores between the improved group and unchanged/deteriorated group to identify characteristics that may affect behavioral changes following OSA treatment.

RESULTS:

After AT, T-scores of the CBCL scales were significantly improved in the OSA group, but no change was observed in the control. A paired t-test revealed that the improved group had significantly higher scores on the CBCL pre-AT than the unchanged/deteriorated group in ASD children with OSA after OSA treatment.

CONCLUSIONS:

Behavioral problems were significantly improved following AT in ASD children with OSA. Early detection and treatment of children with OSA is essential to prevent behavioral problems and to support mental development.

Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

PMID:28514706

DOI:10.1016/j.ridd.2017.04.012