Effects of stage recovery training on children with autism spectrum disorder
-
摘要:
目的 探讨阶段恢复训练对孤独症谱系障碍儿童的影响, 为科学合理制定康复恢复训练计划提供参考。 方法 筛选泸州市儿童医院59名孤独症谱系障碍儿童为研究对象, 并随机分为对照组、干预Ⅰ组、干预Ⅱ组进行T1-T4 4个阶段恢复训练, 干预Ⅰ组和干预Ⅱ组分别侧重运动类及补交类训练。训练前后, 利用自闭症行为量表(ABC)筛查患儿的感觉、语言、动作、交往以及生活自理能力。 结果 3组儿童(ABC)总体评分在T1和T2阶段差异均无统计学意义(P值均>0.05), 在T3和T4阶段差异均有统计学意义(F值分别为3.98, 5.09, P值均 < 0.05), 且表现为干预Ⅰ组、Ⅱ组低于对照组。分维度来看, 3组儿童除语言评分差异无统计学意义外(P值均>0.05), 感觉、交往、动作、生活自理评分差异均有统计学意义(P值均 < 0.05)。相较于对照组, 干预Ⅰ组和Ⅱ组儿童总体评分在T3和T4阶段差异均有统计学意义(P值均 < 0.05)。相较于T1阶段, 对照组儿童总体评分在T2、T3和T4阶段的差异均无统计学意义(P值均>0.05), 而干预Ⅰ组和Ⅱ组总体评分在T2~T4阶段的差异均有统计学意义(P值均 < 0.05)。 结论 阶段恢复训练有助于缓解孤独症谱系障碍儿童的总体症状, 侧重体力运动的阶段恢复训练能够有效缓解患儿躯体功能, 侧重社交互动的阶段恢复训练更有利于提高患儿社交能力。 Abstract:Objective To explore the impact of stage recovery training on children with autism spectrum disorder, and to provide reference for the scientific and rational rehabilitation and recovery training plans. Methods A total of 59 children with autism spectrum disorder in Luzhou were recruited and randomly divided into control group, intervention group Ⅰ and intervention group Ⅱ for 4 stages of T1-T4 recovery training.Before and after the training, Autism Behavior Checklist (ABC) was used to assess child's sensation, language, motor, communication and self-care ability. Results There was no significant difference in the overall score of the ABC among the three groups in T1 and T2 stages (P>0.05), but there was significant difference in T3 and T4 stages (F=3.98, 5.09, P < 0.05), which showed the intervention group Ⅰ and Ⅱ were lower than the control group.In terms of dimensions, in addition to the insignificant difference in language scores (P>0.05), there were significant differences in feeling, communication, movement, and self-care scores (P < 0.05).Overall score of the ABC in intervention group Ⅰ and group Ⅱ was lower than the control group (P < 0.05).Compared with the control group, the overall scores of children in intervention Ⅰ and intervention Ⅱ were significant in both T3 and T4 stages (P < 0.05).Compared with T1 stage, there were no significant differences in the overall scores of children in the control group in T2 stage, T3 stage and T4 stage (P>0.05), while significant difference was observed in the intervention group Ⅰ and group Ⅱ in T2-T4 stage (P < 0.05). Conclusion Stage recovery training might help to alleviate the overall symptoms of children with autism spectrum disorder in sensation, communication, motor development and self-care behaviors.The stage recovery training focusing on physical exercise can effectively alleviate the physical function of the child, while those focusing on social interaction is more conducive to improving child's social ability. -
Key words:
- Autistic disorder /
- Health promotion /
- Intervention studies /
- Child
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 孤独症谱系障碍儿童阶段恢复训练干预方案内容与说明
Table 1. The content and description of the phased recovery training intervention program on children with autism spectrum disorder
组别 阶段训练 内容 说明 干预Ⅰ组 前期 单人运动训练,包括跑、跳、爬 预先设定轨迹路障,每项测试循环3次 中期 双人运动训练,包括接力蛙跳+兔跳、接力推轮胎跑、两人三足 每项测试循环2次,同一周期内人员固定 后期 小组运动训练,包括老鹰捉小鸡、合力运球 每项测试1次,5人为一组且同一周期内人员固定 干预Ⅱ组 前期 单人搭积木 单人测试循环3次 中期 双人合力搭积木 双人测试循环2次,同一周期内人员固定 后期 小组合力搭积木 小组测试1次,5人为一组且同一周期内人员固定 表 2 不同组别儿童阶段恢复训练前后自闭症行为评分比较(x±s)
Table 2. Comparison of overall scoring results before and after children stage recovery training in different groups(x±s)
组别 感觉 语言 T1 T2 T3 T4 t1值 t2值 t3值 T1 T2 T3 T4 t1值 t2值 t3值 对照组 12.02±0.55 11.54±0.99 10.12±1.30 9.87±1.63 1.85 5.87** 5.45** 5.87±0.28 5.64±1.10 5.46±2.19 5.30±2.41 0.88 0.81 1.02 干预Ⅰ组 12.45±0.76 10.81±1.74 8.51±2.81 7.45±3.59 3.86** 6.05** 6.09** 5.56±0.46 4.33±1.98 3.09±3.80 2.64±4.57 2.71* 2.89** 2.84** 干预Ⅱ组 12.84±0.97 10.29±2.09 8.22±3.03 6.93±3.82 2.75** 5.61** 6.07** 5.43±0.62 4.55±2.36 3.33±4.22 2.95±4.40 1.61 2.20* 2.50* F值 5.35 2.71 3.20 4.68 4.35 2.64 2.64 2.64 P值 < 0.01 0.08 < 0.05 0.01 0.02 0.08 0.08 0.08 组别 动作 交往 T1 T2 T3 T4 t1值 t2值 t3值 T1 T2 T3 T4 t1值 t2值 t3值 对照组 13.78±0.75 13.44±1.17 13.36±1.47 13.11±1.73 1.07 1.11 1.55 17.23±1.05 16.55±2.69 15.81±4.23 15.62±4.50 1.03 1.42 1.52 干预Ⅰ组 13.25±0.82 12.37±1.76 11.48±2.81 10.63±3.65 2.03 2.70* 3.13** 16.94±1.10 13.56±3.94 11.04±5.93 10.35±6.39 3.70** 4.37** 4.55** 干预Ⅱ组 13.16±0.91 12.22±2.14 11.37±3.46 10.13±3.57 1.81 2.24* 3.68** 16.69±1.12 13.21±4.72 10.60±6.70 9.56±6.45 3.21** 4.01** 4.87** F值 3.15 2.81 3.25 5.02 1.19 4.30 4.90 6.09 P值 0.05 0.07 < 0.05 < 0.01 0.31 0.02 0.01 < 0.01 组别 生活自理 总分 T1 T2 T3 T4 t1值 t2值 t3值 T1 T2 T3 T4 t1值 t2值 t3值 对照组 13.03±1.23 12.58±1.69 12.10±1.51 11.86±2.46 0.94 2.08 1.85 61.93±3.86 59.75±7.64 56.85±10.70 55.78±12.73 1.11 1.95 2.02 干预Ⅰ组 13.48±1.31 11.45±2.31 9.23±3.75 8.48±4.33 3.42** 4.78** 4.94** 61.68±4.45 52.52±11.73 43.35±18.90 39.55±21.53 3.27** 4.22** 4.50** 干预Ⅱ组 13.66±1.34 11.29±2.53 8.91±4.18 8.17±4.34 3.70** 4.84** 5.41** 61.78±4.96 51.56±13.84 42.43±21.59 37.74±22.58 3.11** 3.91** 4.65** F值 1.22 1.95 5.22 5.51 0.02 2.97 3.98 5.09 P值 0.30 0.15 < 0.01 < 0.01 0.99 0.06 0.02 < 0.01 注: t1值是T2与T1阶段比较的结果,t2值是T3与T1阶段比较的结果,t3值是T4与T1阶段比较的结果;*P < 0.05,**P < 0.01。 -
[1] 陈昕慧. 3~6岁自闭谱系障碍儿童社会情绪能力及其影响因素研究[D]. 上海: 华东师范大学, 2019.CHEN X H. Study on social and emotional ability and its influencing factors in children aged 3-6 with autism spectrum disorder[D]. Shanghai: East China Normal University, 2019. (in Chinese) [2] 徐慧, 王滔. 自闭症谱系障碍个体的社会动机缺陷[J]. 心理科学进展, 2022, 30(5): 1050-1061. https://www.cnki.com.cn/Article/CJFDTOTAL-XLXD202205009.htmXU H, WANG T. Social motivation deficits in individuals with autism spectrum disorders[J]. Adv Psychol Sci, 2022, 30(5): 1050-1061. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XLXD202205009.htm [3] 孙美琦. 自闭症谱系障碍儿童共同注意干预的个案研究[D]. 大连: 辽宁师范大学, 2021.SUN M Q. A case study of joint attention intervention in children with autism spectrum disorder[D]. Dalian: Liaoning Normal University, 2021. (in Chinese) [4] 季煜钦, 高润, 叶强. 运动干预对自闭症谱系障碍儿童生活认知能力影响的Meta分析[J]. 南京体育学院学报, 2021, 20(9): 47-55. https://www.cnki.com.cn/Article/CJFDTOTAL-NTXZ202109008.htmJI Y Q, GAO R, YE Q. A Meta analysis of the effect of exercise intervention on life cognitive ability of children with autism spectrum disorder[J]. J Nanjing Sports Inst, 2021, 20(9): 47-55. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-NTXZ202109008.htm [5] 赵凡, 马姗姗, 刘电芝. 分阶综合运动大社交干预对自闭症谱系障碍儿童的症状改善[C]//中国心理学会. 第二十三届全国心理学学术会议摘要集(上). 北京, 2021: 37-39.ZHAO F, MA S S, LIU D Z. Effects of stepped integrated sport-group social intervention on children with autism spectrum disorder[C]//Chinese Psychological Society. Abstracts of the 23rd National Psychological Academic Conference (Part 1). Beijing, 2021: 37-39. (in Chinese) [6] 陈丽华. 观察早期干预对孤独症谱系障碍儿童日常行为及自闭症状的影响[J]. 世界睡眠医学杂志, 2022, 9(2): 282-284. https://www.cnki.com.cn/Article/CJFDTOTAL-SMZZ202202033.htmCHEN L H. Observing the effects of early intervention on daily behavior and autism symptoms in children with autism spectrum disorders[J]. World J Sleep Med, 2022, 9(2): 282-284. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SMZZ202202033.htm [7] CAREY M, SHEEHAN D, HEALY S, et al. The effects of a 16-week school-based exercise program on anxiety in children with autism spectrum disorder[J]. Int J Environ Res Public Health, 2022, 19(9): 5471-5471. doi: 10.3390/ijerph19095471 [8] 郑艳. 体育游戏对自闭症儿童社会交往能力的影响[D]. 北京: 首都体育学院, 2022.ZHENG Y. The effect of sports games on the social interaction ability of children with autism[D]. Beijing: Capital University of Physical Education and Sports, 2022. (in Chinese) [9] 杨友, 金星明. 美国精神障碍诊断和统计手册第五版对儿童孤独症谱系障碍诊治的影响[J]. 中国儿童保健杂志, 2015, 23(12): 1278-1280, 1283. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201512014.htmYANG Y, JIN X M. The impact of the fifth edition of the American Manual of Mental Disorder Diagnosis and Statistics on the diagnosis and treatment of autism spectrum disorders in children[J]. Chin J Child Health Care, 2015, 23(12): 1278-1280, 1283. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201512014.htm [10] 宋永宁, 俞晨曦, 夏榕. 自闭谱系障碍: 一种主动性的社会认知控制缺陷[J]. 心理科学, 2021, 44(3): 745-753. https://www.cnki.com.cn/Article/CJFDTOTAL-XLKX202103031.htmSONG Y N, YU C X, XIA R. Autism spectrum disorder: a social cognitive control deficit of initiative[J]. J Psychol Sci, 2021, 44(3): 745-753. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XLKX202103031.htm [11] 许婷. 互动媒介艺术帮助干预自闭症儿童的探索研究[J]. 河北师范大学学报(教育科学版), 2021, 23(1): 135-140. https://www.cnki.com.cn/Article/CJFDTOTAL-HSJY202101020.htmXU T. An exploratory study on interactive media art helping to intervene in children with autism[J]. J Hebei Norm Univ (Educ Sci), 2021, 23(1): 135-140. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-HSJY202101020.htm [12] 吕莹, 张晶宇, 张书凯, 等. 孤独症与正常儿童父母泛自闭症表型特征分析[J]. 中国学校卫生, 2015, 36(10): 1524-1527. http://www.cjsh.org.cn/article/id/zgxxws201510024LYU Y, ZHANG J Y, ZHANG S K, et al. Phenotypic analysis of autism and parents of normal children[J]. Chin J Sch Health, 2015, 36(10): 1524-1527. (in Chinese) http://www.cjsh.org.cn/article/id/zgxxws201510024 [13] 石筱菁. 自闭症儿童多元一体化教育干预的实践与探索[J]. 上海教育科研, 2020, 39(12): 80-84. https://www.cnki.com.cn/Article/CJFDTOTAL-SJYY202012017.htmSHI X J. The practice and exploration of diversified integrated education interventions for children with autism[J]. J Shanghai Educ Res, 2020, 39(12): 80-84. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SJYY202012017.htm [14] 徐云, 徐晨欣, 朱旻芮. 家长执行式干预在自闭症儿童家庭中的应用[J]. 中国临床心理学杂志, 2019, 27(3): 634-637, 612. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201903043.htmXU Y, XU C X, ZHU M R. The application of parental executive intervention in the family of children with autism[J]. Chin J Clin Psychol, 2019, 27(3): 634-637, 612. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201903043.htm [15] 赵凡, 卢凤, 谭成慧, 等. 分阶综合运动训练对自闭症谱系障碍儿童的干预效果: 多动症共病与非共病的比较[J]. 中国临床心理学杂志, 2021, 29(4): 869-875. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY202104042.htmZHAO F, LU F, TAN C H, et al. Effects of graded comprehensive exercise intervention on children with autism spectrum disorder: comparison of ADHD comorbidities and non-comorbidities[J]. Chin J Clin Psychol, 2021, 29(4): 869-875. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY202104042.htm -

计量
- 文章访问数: 323
- HTML全文浏览量: 146
- PDF下载量: 22
- 被引次数: 0