
Curative effect of progressively integrated sandplay therapy on core symptoms and sleep management in preschool children with mild-to-moderate autism spectrum disorder
LIU Gui-Hua, HUANG Long-Sheng, QIAN Qin-Fang, WANG Yan-Xia, GE Pin
Chinese Journal of Contemporary Pediatrics ›› 2019, Vol. 21 ›› Issue (8) : 743-748.
Curative effect of progressively integrated sandplay therapy on core symptoms and sleep management in preschool children with mild-to-moderate autism spectrum disorder
Objective To explore the curative effect of progressively integrated sandplay therapy on core symptoms and sleep management in preschool children with mild-to-moderate autism spectrum disorder (ASD). Methods A total of 50 mild-to-moderate ASD preschool children were randomly divided into an experimental group (n=25) and a control group (n=25). The control group was treated with structured teaching and auditory integration training (AIT). Based on these, the experimental group was treated with progressively integrated sandplay therapy. The Autism Behavior Checklist (ABC), Children Autism Rating Scale (CARS), Social Responsiveness Scale (SRS), Children's Sleep Habit Questionnaire (CSHQ) and emotion recognition tools were used to evaluate the overall curative effect before treatment and 3 months after treatment. Results The experimental group had significantly lower scores of feeling, social interaction, somatic motor, language factor, total ABC and total CARS than the control group (P < 0.05). The experimental group had also significantly lower scores of social cognition, social communication, social motivation, autistic behavior factor and total SRS than the control group (P < 0.05). The experimental group had a significantly higher accurate rate of recognition of the upper facial expression and lower facial expression than the control group (P < 0.05). The experimental group had significantly lower scores of bedtime resistance, sleep onset, sleep duration, night waking, daytime sleepiness, and total CSHQ than the control group (P < 0.05). The experimental group had significantly reduced themes of wounding and significantly increased themes of healing after sandplay therapy (P < 0.05). Conclusions Progressively integrated sandplay therapy can effectively improve the core symptoms and sleep quality of preschool children with mild-to-moderate ASD, which can be used as an early rehabilitation measure.
Autism spectrum disorder / Sandplay therapy / Integration / Social interaction / Emotion recognition / Preschool child
[1] Posar A, Visconti P. Omega-3 supplementation in autism spectrum disorders:a still open question?[J]. J Pediatr Neurosci, 2016, 11(3):225-227.
[2] Baio J, Wiggins L, Christensen DL, et al. Prevalence of autism spectrum disorder among children aged 8 years -autism and developmental disabilities monitoring network, 11 sites, United States, 2014[J]. MMWR Surveill Summ, 2018, 67(6):1-23.
[3] 吕复莉, 谢晓凤, 张玲, 等. 引导式教育联合融合教育的护理方法对孤独症患儿社交能力的影响[J]. 中华护理杂志, 2014, 49(10):1194-1198.
[4] 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.
[5] 美国精神医学学会. 精神障碍诊断与统计手册(第五版)[M]. 张道龙, 刘春宇, 童慧琦, 等, 译. 北京:北京大学出版社, 2015:46-55.
[6] 杨玉凤. 儿童发育行为心理评定量表[M]. 北京:人民卫生出版社, 2016:203-207.
[7] Gau SS, Liu LT, Wu YY, et a1. Psychometric properties of the Chinese version of the Social Responsiveness Scale[J]. Res Autism Spect Dis, 2013, 7(2):349-360.
[8] 陈秋如. 社交反应量表的修订和应用初步研究[D]. 广州:中山大学, 2009.
[9] Cen CQ, Liang YY, Chen QR, et al. Investigating the validation of the Chinese Mandarin version of the Social Responsiveness Scale in a Mainland China child population[J]. BMC Psychiatry, 2017, 17(1):51.
[10] 郭嘉, 静进, 邹小兵, 等. 阿斯伯格综合征儿童对人物基本面部表情的识别特点[J]. 中国心理卫生杂志, 2011, 25(1):47-52.
[11] 李生慧, 金星明, 沈晓明, 等. 儿童睡眠习惯问卷中文版制定及测量性能考核[J]. 中华儿科杂志, 2007, 45(3):176-180.
[12] 蔡宝鸿. 初始沙盘及其临床诊断意义研究-行为问题儿童初始沙盘诊断特征的分析与探索[D]. 广州:华南师范大学, 2005.
[13] Tchaconas A, Adesman A. Autism spectrum disorders:a pediatric overview and update[J]. Curr Opin Pediatr, 2013, 25(1):130-144.
[14] Hsiao YJ, Higgins K, Pierce T, et al. Parental stress, family quality of life, and family-teacher partnerships:families of children with autism spectrum disorder[J]. Res Dev Disabil, 2017, 70:152-162.
[15] Vernetti A, Senju A, Charman T, et al. Simulating interaction:using gaze-contingent eye-tracking to measure the reward value of social signals in toddlers with and without autism[J]. Dev Cogn Neurosci, 2018, 29:21-29.
[16] 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.
[17] 孙建超. 团体整合性沙盘游戏治疗技术对职高学生自我同一性的干预研究[J]. 中小学心理健康教育, 2019, 3:19-21.
[18] Quinn S, Donnelly S, Kidd E. The relationship between symbolic play and language acquisition:a meta-analytic review[J]. Dev Rev, 2018, 49:121-135.
[19] Won DC, Feldman HM, Huffman LC. Sleep problem detection and documentation in children with autism spectrum disorder and attention-deficit/hyperactivity disorder by developmental-behavioral pediatricians:a DBPNet study[J]. J Dev Behav Pediatr, 2019, 40(1):20-31.
[20] Sanberg SA, Kuhn BR, Kennedy AE. Outcomes of a behavioral intervention for sleep disturbances in children with autism spectrum disorder[J]. J Autism Dev Disord, 2018, 48(12):4250-4277.