学龄前期孤独症谱系障碍儿童交叉式团体与个体沙盘干预的疗效比较

王艳霞, 卢国斌, 葛品, 欧萍, 刘桂华, 钱沁芳, 李国凯, 黄艳, 谢燕钦, 王章琼, 余秋娟

中国当代儿科杂志 ›› 2019, Vol. 21 ›› Issue (4) : 342-347.

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中国当代儿科杂志 ›› 2019, Vol. 21 ›› Issue (4) : 342-347. DOI: 10.7499/j.issn.1008-8830.2019.04.008
论著·临床研究

学龄前期孤独症谱系障碍儿童交叉式团体与个体沙盘干预的疗效比较

  • 王艳霞, 卢国斌, 葛品, 欧萍, 刘桂华, 钱沁芳, 李国凯, 黄艳, 谢燕钦, 王章琼, 余秋娟
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Clinical efficacy of interactive group sandplay versus individual sandplay in the treatment of preschool children with autism spectrum disorder

  • WANG Yan-Xia, LU Guo-Bin, GE Pin, OU Ping, LIU Gui-Hua, QIAN Qin-Fang, LI Guo-Kai, HUANG Yan, XIE YanQin, WANG Zhang-Qiong, YU Qiu-Juan
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摘要

目的 探讨学龄前期孤独症谱系障碍(ASD)儿童交叉式团体与个体沙盘干预的疗效。方法 将80例4~6岁ASD儿童随机分成试验组和对照组,每组40例。试验组患儿与正常儿童以1:3配比交叉式加入团体沙盘,对照组患儿采用一对一个体沙盘干预。以异常行为评定量表(ABC)和孤独症治疗评估量表(ATEC)评估治疗3个月后的整体疗效。结果 实际入选试验组33例,对照组28例。试验组干预3个月后ABC量表情绪不稳、社交退缩、刻板行为因子得分及总分较干预前下降;对照组干预后刻板行为、言语失当得分及总分较干预前下降(P < 0.05)。试验组社交退缩和总分的干预前后差值大于对照组(P < 0.05)。试验组干预3个月后ATEC量表社交、感知觉、行为及总分较干预前下降,对照组语言、社交、行为及总分较干预前下降(P < 0.05)。试验组语言、社交、感知觉和总分的干预前后差值大于对照组(P < 0.01)。干预后试验组目光交流和沙具刻板排列的改善优于对照组(P < 0.05)。结论 个体沙盘和交叉式团体沙盘干预均可改善学龄前ASD患儿的症状。交叉式团体沙盘对ASD患儿的干预效能优于个体沙盘,以社交、情绪及刻板行为改善为著。

Abstract

Objective To study the clinical efficacy of interactive group sandplay versus individual sandplay in the treatment of preschool children with autism spectrum disorder (ASD). Methods A total of 80 ASD children, aged 4-6 years, were enrolled and randomly divided into experimental and control groups, with 40 children in each group. The children in the experimental group joined group sandplay with normal children at a ratio of 1:3, and those in the control group were treated with individual sandplay. The Aberrant Behavior Checklist (ABC) and Autism Treatment Evaluation Checklist (ATEC) were used to evaluate the treatment outcome after three months of intervention. Results There were 33 children in the experimental group and 28 in the control group. After three months of intervention, the experimental group had significant reductions in the scores of irritability, social withdrawal, and stereotypic behavior and the total score of the ABC scale (P < 0.05), and the control group had significant reductions in the scores of behavior and inappropriate speech and the total score of the ABC scale (P < 0.05). Compared with the control group, the experimental group had significantly greater improvements in the score of social withdrawal and the total score of the ABC scale after three months of intervention (P < 0.05). After three months of intervention, the experimental group had significant reductions in the scores of sociability, sensory and cognitive awareness, and physical/health behavior and the total score of the ATEC scale (P < 0.05), and the control group had significant reductions in the scores of speech, sociability, and physical/health behavior and the total score of the ATEC scale (P < 0.05). Compared with the control group, the experimental group had significantly greater improvements in the scores of speech, sociability, and sensory and cognitive awareness and the total score of the ATEC scale after intervention (P < 0.01). Compared with the control group, the experimental group also had significantly greater improvements in eye contact and sand stereotyped arrangement (P < 0.05). Conclusions Both interactive group sandplay and individual sandplay are effective in the treatment of ASD in preschool children. Interactive group sandplay is better than individual sandplay in the treatment of ASD, with significant improvements in sociability, emotion and stereotypic behavior.

关键词

孤独症谱系障碍 / 沙盘游戏治疗 / 团体沙盘 / 儿童

Key words

Autism spectrum disorder / Sandplay therapy / Group sandplay / Child

引用本文

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王艳霞, 卢国斌, 葛品, 欧萍, 刘桂华, 钱沁芳, 李国凯, 黄艳, 谢燕钦, 王章琼, 余秋娟. 学龄前期孤独症谱系障碍儿童交叉式团体与个体沙盘干预的疗效比较[J]. 中国当代儿科杂志. 2019, 21(4): 342-347 https://doi.org/10.7499/j.issn.1008-8830.2019.04.008
WANG Yan-Xia, LU Guo-Bin, GE Pin, OU Ping, LIU Gui-Hua, QIAN Qin-Fang, LI Guo-Kai, HUANG Yan, XIE YanQin, WANG Zhang-Qiong, YU Qiu-Juan. Clinical efficacy of interactive group sandplay versus individual sandplay in the treatment of preschool children with autism spectrum disorder[J]. Chinese Journal of Contemporary Pediatrics. 2019, 21(4): 342-347 https://doi.org/10.7499/j.issn.1008-8830.2019.04.008

参考文献

[1] Lord C, Elsabbagh M, Baird G, et al. Autism spectrum disorder[J]. Lancet, 2018, 392(10146):508-520.
[2] 李洪华, 单玲, 杜琳, 等. 儿童孤独症谱系障碍的治疗研究进展[J]. 中国当代儿科杂志, 2015, 17(8):886-892.
[3] Saiano M, Pellegrino L, Casadio M, et al. Natural interfaces and virtual environments for the acquisition of street crossing and path following skills in adults with autism spectrum disorders:a feasibility study[J]. J Neuroeng Rehabil, 2015, 12:17.
[4] Sacrey LA, Bennett JA, Zwaigenbaum L. Early infant development and intervention for autism spectrum disorder[J]. J Child Neurol, 2015, 30(14):1921-1929.
[5] 葛品, 刘桂华, 李国凯, 等. 箱庭疗法对学龄前注意缺陷多动障碍共患睡眠障碍患儿的疗效[J]. 中华实用儿科临床杂志, 2017, 32(24):1882-1886.
[6] 陈志玮, 陈叶. 沙盘游戏在孤独症谱系障碍儿童心理治疗中的应用[J]. 中国妇幼卫生杂志, 2018, 35(2):27-30.
[7] 王敏佳,刘建新,罗庆华,等. 沙盘游戏联合音乐疗法对自闭症患儿康复干预研究[J]. 中国地方病防治杂志,2017, 32(2):232-233.
[8] Germain B, Eppinger MA, Mostofsky SH, et al. Recent advances in understanding and managing autism spectrum disorders[J]. J Child Neurol, 2015, 30(14):1887-1920.
[9] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders[M]. 5th ed. Virginia:American Psychiatric Publishing, 2013:55-59.
[10] Valicenti-McDermott M, Lawson K, Hottinger K, et al. Parental stress in families of children with autism and other developmental disabilities[J]. J Child Neurol, 2015, 30(13):1728-1735.
[11] 马俊红, 郭延庆, 贾美香, 等. 异常行为量表中文版在儿童孤独症群体中的信效度[J]. 中国心理卫生杂志, 2011, 25(1):14-19.
[12] 卢建平, 杨志伟, 舒明耀, 等. 儿童孤独症量表评定的信度、效度分析[J]. 中国现代医学杂志, 2004, 14(13):119-121.
[13] 刘超, 卢斌, 张瑜, 等. 机构结构化教育联合家庭康复训练治疗儿童孤独症的疗效观察[J]. 中国当代儿科杂志, 2015, 17(12):1277-1281.
[14] Mussey JL, Travers BG, Klinger LG, et al. Decision-making skills in ASD:performance on the Iowa Gambling Task[J]. Autism Res, 2015, 8(1):105-114.
[15] Plitt M, Barnes KA, Wallace GL, et al. Resting-state functional connectivity predicts longitudinal change in autistic traits and adaptive functioning in autism[J]. Proc Natl Acad Sci USA, 2015, 112(48):E6699-E6706.
[16] Kaboski JR, Diehl JJ, Beriont J, et al. Brief report:a pilot summer robotics camp to reduce social anxiety and improve social/vocational skills in adolescents with ASD[J]. J Autism Dev Disord, 2015, 45(12):3862-3869.
[17] Ledbetter-Cho K, Lang R, Davenport K, et al. Effects of script training on the peer-to-peer communication of children with autism spectrum disorder[J]. J Appl Behav Anal, 2015, 48(4):785-799.
[18] MacDonald J, Ahearn WH. Teaching observational learning to children with autism[J]. J Appl Behav Anal, 2015, 48(4):800-816.
[19] Biscaldi M, Rauh R, Müller C, et al. Identification of neuromotor deficits common to autism spectrum disorder and attention deficit/hyperactivity disorder, and imitation deficits specific to autism spectrum disorder[J]. Eur Child Adolesc Psychiatry, 2015, 24(12):1497-1507.
[20] Kim K, Rosenthal MZ, Gwaltney M, et al. A virtual joy-stick study of emotional responses and social motivation in children with autism spectrum disorder[J]. J Autism Dev Disord, 2015, 45(12):3891-3899.
[21] Koehne S, Hatri A, Cacioppo JT, et al. Perceived interpersonal synchrony increases empathy:insights from autism spectrum disorder[J]. Cognition, 2016, 146:8-15.
[22] Sharer E, Crocetti D, Muschelli J, et al. Neural correlates of visuomotor learning in autism[J]. J Child Neurol, 2015, 30(14):1877-1886.
[23] Yi L, Quinn PC, Fan Y, et al. Children with autism spectrum disorder scan own-race faces differently from other-race faces[J]. J Exp Child Psychol, 2016, 141:177-186.
[24] Han B, Tijus C, Le Barillier F, et al. Morphing technique reveals intact perception of object motion and disturbed perception of emotional expressions by low-functioning adolescents with autism spectrum disorder[J]. Res Dev Disabil, 2015, 47:393-404.
[25] Wang S, Jiang M, Duchesne XM, et al. Atypical visual saliency in autism spectrum disorder quantified through model-based eye tracking[J]. Neuron, 2015, 88(3):604-616.

基金

福建省自然科学基金资助项目(2016J01490);福建省卫生计生青年科研课题(2016-1-15);中国疾病预防控制中心妇幼保健中心儿童早期发展适宜技术研究项目(2017FYE007)。


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