摘要
目的:探讨特殊教育结合感觉统合训练治疗孤独症谱系障碍(ASD)患儿的临床疗效。方法:选取南京医科大学附属儿童医院康复医学科收治的ASD患儿100例,按照随机数字表法分为特感组和单特组,每组各50例,单特组给予特殊教育干预,按照特殊教育课程对患儿进行干预,主要包括正负强化、系统脱敏、消退法、暂时隔离、惩罚法等,其中对负强化者应选择适当厌恶、警告等刺激并尽量减少不良行为诱因,对正强化者应选择有效强化物并逐渐脱离强化程序,教育后指导患儿家属按给予的居家干预作业进行同步配合治疗。每次约40 min,每周6次,3个月为1个疗程。特感组在给予特殊教育干预基础上进行感觉统合训练,依据ASD患儿病情、社会能力、发育等情况制定个性化感觉统合训练方案,内容包括触觉、前庭、本体等感觉训练,每次约2 h,每周3次,3个月为1个疗程。分别于治疗前和治疗3、6个月后,采用儿童自闭症评定量表(CARS)评估患儿的自闭程度,儿童自闭症行为量表(ABC)评估患儿的行为状态,自闭症治疗评定量表(ATEC)评估患儿的治疗疗效。结果:2组治疗前CARS、ABC、ATEC评分比较,差异无统计学意义(P>0.05);治疗3、6个月后,2组CARS、ABC、ATEC评分较治疗前明显降低;特感组治疗3、6个月后,CARS、ABC、ATEC评分降低程度明显大于单特组,差异有统计学意义(P<0.05)。治疗6个月后,特感组有效率(84.00%)明显高于单特组(64.00%),差异有统计学意义(P<0.05)。结论:特殊教育结合感觉统合训练可有效改善ASD患儿自闭程度、行为状态,提高患儿的治疗效果,值得临床推广。
Objective: To investigate the clinical effect of special education combined with sensory integration training on children with autism spectrum disorder(ASD). Methods: A total of 100 ASD children in the department of rehabilitation medicine, Children’s Hospital affiliated Nanjing Medical University were randomly assigned to the special sensation group and the single special group by random number table method, with 50 cases in each group. The single special group was given special education intervention,the children should be intervened according to the special education curriculum, including the positive and negative reinforcement, systematic desensitization, extinction, temporary isolation and retribution. We would choose appropriate disgust, warning and other stimuli to minimize the incentives for bad behavior in children with negative reinforcement. For the children with positive reinforcement,we would choose effective reinforcement and gradually depart from the reinforcement process, after education, family members of the children should be guided to intervene at home according to the given intervention operations, which were synchronized with treatment, 40 minutes each time, 6 times a week, 3 months as a course of treatment. The special sensation group was given sensory integration training on the basis of the special education intervention, the personalized sensory integration training program was developed according to the condition, social ability and development of ASD children, which was included the training of tactile, vestibular and proprioceptive sensory, 2 hours each time, 3 times a week, 3 months as a course of treatment. Before the treatment and after 3, 6 months treatment, the children’s autism was assessed by children’s autism rating scale(CARS), the children’s behavior was assessed by children’s autism behavior scale(ABC), the children’s therapeutic efficacy was assessed by autism treatment evaluation checklist(ATEC). Results: There was no significant difference in the CARS score, ABC score and ATEC score between the two groups before the treatment(P>0.05);after 3 and 6 months of treatment, the CARS score, ABC score and ATEC score in the two groups were significantly lower than those before the treatment;after 3 and 6 months of treatment, the degree of decrease of CARS score, ABC score and ATEC score in the special sensation group were significantly more than those in the single special group(P<0.05). After 6 months of treatment, the effective rate in the special sensation group(84.00%) was significantly higher than that in the single special group(64.00%), and the difference was significant(P<0.05). Conclusion: Special education combined with sensory integration training can effectively improve ASD children’s autistic degree and behavior state, and improve the therapeutic effect on children, which is worthy of further clinical promotion.
作者
单亚
朱敏
SHAN Ya;ZHU Min(Children's Hospital of Nanjing Medical University,Nanjing,Jiangsu 210008,China)
出处
《康复学报》
CSCD
2019年第6期55-58,69,共5页
Rehabilitation Medicine
基金
国家自然科学青年基金项目(81401864)
