从言语病理学角度看孤独症谱系障碍儿童的沟通障碍

doi:10.11852/zgetbjzz2024-0114

摘要/Abstract

摘要： 孤独症谱系障碍(ASD)儿童在沟通、语言与社交方面均存在不同程度的困难,本文从言语病理学的角度分析ASD儿童的基本沟通能力、语言发展特点以及社交语用方面的表现特征并介绍相应的评估工具,同时提出基于国际功能、残疾和健康分类(ICF)的干预策略,强调采用医疗、家庭、学校三位一体的综合干预模式,以期全面提升该群体的沟通、语言和社交能力,有效提升其生活质量。

关键词: 孤独症谱系障碍, 社交沟通障碍, 国际功能、残疾和健康分类, 综合干预模式

Abstract: Children with autism spectrum disorder (ASD) face varying degrees of difficulties in communication, language, and social interactions.This article analyzes the basic communication abilities, language development characteristics, and social pragmatic features of ASD children from the perspective of speech pathology, introduces corresponding assessment tools and proposes intervention strategies based on the International Classification of Functioning, Disability, and Health (ICF).Meanwhile, this article emphasizes the adoption of a comprehensive intervention model that involves medical, family, and school components to enhance the communication, language, and social skills of this group comprehensively, with the aim of effectively improving their overall quality of life.

Key words: autism spectrum disorder, social pragmatic disorders, International Classification of Functioning, Disability, and Health, comprehensive intervention approach

中图分类号:

R749.94

杨峰. 从言语病理学角度看孤独症谱系障碍儿童的沟通障碍[J]. 中国儿童保健杂志, 2024, 32(3): 233-236.

YANG Feng. Communication disorders in children with autism spectrum disorder from speech language pathology perspective[J]. Chinese Journal of Child Health Care, 2024, 32(3): 233-236.

参考文献

[1] 中华医学会儿科学分会发育行为学组,中国医师协会儿科分会儿童保健专业委员会,儿童孤独症诊断与防治技术和标准研究项目专家组.孤独症谱系障碍儿童早期识别筛查和早期干预专家共识[J].中华儿科杂志,2017,55(12):890-897.
The Subspecialty Group of Developmental and Behavioral Pediatrics, the Society of Pediatrics, Chinese Medical Association, The Subspecialty Group of Primary Health Care, the Society of Pediatrics, Chinese Medical Doctor Association, Project Expert Group of Diagnosis, Prevention and Therapy Techniques and Standards of Childhood Autism Spectrum Disorders.Consensus on early identification screening and early intervention for autism spectrum disorder[J].Chin J Pediatr, 2017,55(12):890-897.(in Chinese)
[2] Zhou H,Xu X, Yan W, et al.Prevalence of autism spectrum disorder in China: A nationwide multi-center population-based Study among children aged 6 to 12 years[J].Neurosci Bull, 2020, 36 (9): 961-971.
[3] 卜凡帅,徐胜.自闭症谱系障碍诊断标准:演变、影响与展望[J].中国特殊教育, 2015,22(2):40-45
Bu FS, Xu S. Diagnostic criteria for autism spectrum disorder: Evolution, impact and prospect [J]. Chinese Special Education, 2015,22 (2):40-45. (in Chinese)
[4] 李晓燕,周兢.自闭症儿童语言发展研究综述[J].中国特殊教育, 2006,13(12):60-66, 59.
Li XY, Zhou J. A survey on language development of children with autism[J]. Chinese Special Education, 2006,13 (12):60-66, 59. (in Chinese)
[5] Wetherby AM, Prutting CA.Profiles of communicative and cognitive-social abilities in autistic children[J].J Speech Hear Res, 1984, 27(3): 364-377.
[6] 杜青,何宏祥.孤独症谱系障碍儿童语言和社交沟通障碍相关问题[J].中国实用儿科杂志, 2019, 34(8): 632-637.
Du Q, He HX.Issues related to language and social communication disorders in children with autism spectrum disorders[J].Chin J Pract Pediatr, 2019, 34 (8): 632-637.(in Chinese)
[7] Losh M, Carrs L.Narrative skills of children with communication impairments[J].Int J Lang Commun Disord,2003,38:287-313.
[8] Pietsch K, Lyon T, Dhillon VK.Speech language pathology rehabilitation[J].Medical Clinics, 2018, 102(6): 1121-1134.
[9] Mathisen BA, Threats T.Speech-language pathology and spiritual care[M]//Carey LB, Mathisen BA.Spiritual care for allied health practice: A person-centred approach. London: Jessica Kingsley Publishers,2018: 22-54.
[10] Lunenburg FC.Communication: The process, barriers, and improving effectiveness[J].Schooling, 2010, 1(1): 1-11.
[11] Hage SVR, Sawasaki LY, Hyter Y, et al.Social communication and pragmatic skills of children with autism Spectrum disorder and developmental language disorder[C]//CoDAS.Sociedade Brasileira de Fonoaudiologia, 2021,34: e20210075.
[12] Vanderstraeten R.Autopoiesis and socialization: On Luhmann's reconceptualization of communication and socialization[J].British J Sociol, 2000, 51(3): 581-598.
[13] Boucher J, Bigham S, Mayes A, et al.Recognition and language in low functioning autism[J].J Autism Dev Disord, 2008, 38: 1259-1269.
[14] Nazeer A, Ghaziuddin M.Autism spectrum disorders:Clinical features and diagnosis[J].Pediatric Clinics, 2012, 59(1): 19-25.
[15] Seung HK.Linguistic characteristics of individuals with high functioning autism and Asperger syndrome[J].Clin Linguist Phon, 2007, 21(4): 247-259.
[16] Fuchs C, Hofkirchner W, Schafranek M, et al.Theoretical foundations of the web: Cognition, communication, and co-operation.Towards an understanding of Web 1.0, 2.0, 3.0[J].Future Internet, 2010, 2(1): 41-59.
[17] Colombi C, Liebal K, Tomasello M, et al.Examining correlates of cooperation in autism: Imitation, joint attention, and understanding intentions[J].Autism, 2009, 13(2): 143-163.
[18] 胡琪珍.基于沟通矩阵评估的无口语孤独症学生个案研究[J]. 现代特殊教育, 2023,32(7):73-75.
Hu QZ. A case study of non-verbal autism students based on Communication Matrix assessment [J]. Modern Special Education, 2023,32 (7): 73-75. (in Chinese)
[19] Zalsman G, Misgav S, Sommerfeld E, et al.Children's Depression Inventor (CDI) and the Children's Depression Rating Scale-Revised (CDRS-R): Reliability of the Hebrew version[J].Int J Adolesc Med Health, 2005,17(3):255-257.
[20] Rispoli MJ.Verbal behavior milestones assessment and placement program VB-MAPP[M]//Encyclopedia of Special Education. John Wiley & Sons Inc, 2013.
[21] Seibert JM, Hogan AE, Mundy PC.Assessing interactional competencies: The Early Social-Communication Scales[J].Infant Ment Health J, 1982, 3(4): 244-258.
[22] Liu XL, de Villiers J, Ning C, et al.Research to establish the validity, reliability, and clinical utility of a comprehensive language assessment of Mandarin[J].J Speech Lang Hear Res, 2017, 60(3): 592-606.
[23] 徐亚琴,张秀萍,池霞,等.江苏城区1~6岁儿童语言发育常模研究[J].临床儿科杂志, 2019, 37 (10): 756-760,768.
Xu YQ, Zhang XP, Chi X, et al.A study on language development norms of children aged 1-6 in Jiangsu city[J].Journal of Clinical Pediatrics, 2019, 37(10): 756-760,768.(in Chinese)
[24] Wong V, Lee PWH, Lieh-Mak F, et al.Language screening in preschool Chinese children[J].Int J Lang Commun Disord, 1992, 27(3): 247-264.
[25] Liska J.Sign arbitrariness as an index of semiogenesis[J].Studies in Language Origins, 1995, 3: 161.
[26] Hickman M E.The development of narrative skills: Pragmatic and metapragmatic aspects of discourse cohesion[D].Chicago: The University of Chicago, 1982.
[27] Dillon E, Holingue C, Herman D, et al.Psychometrics of the Pragmatic Rating Scale for School-age Children with a range of linguistic and social communication skills[J].J Speech Lang Hear Res, 2021, 64(9): 3477-3488.
[28] Hong TA, Peixin PS, Rui KY, et al.Assessment of the effectiveness of a Chinese literacy assessment tool for school learners in Singapore[J].Asia Pac J Dev Differ, 2018, 5(1): 25-41.
[29] Baixauli I, Rosello B, Berenguer C, et al.Reading and writing skills in adolescents with autism spectrum disorder without intellectual disability[J].Front Psychol, 2021, 12: 646849.doi: 10.3389/fpsyg.2021.646849.
[30] Stucki G, Cieza A, Ewert T, et al.Application of the International Classification of Functioning, Disability and Health (ICF) in clinical practice[J].Disabil Rehabil, 2002, 24(5): 281-282.
[31] 黄文桥.融合教育背景下自闭症谱系障碍儿童识字能力的干预研究[D]. 重庆:西南大学, 2020.
Huang WQ. An intervention study on the literacy ability of children with autism spectrum disorder in the context of integrated education [D]. Chongqing: Southwest University, 2020.(in Chinese)