目的 探究多成分、多策略的综合性心灵解读(ToM)干预的有效性,为孤独症谱系障碍(ASD)儿童ToM能力干预提供新的临床思路及实证依据。方法 选取2022年7月—2023年6月期间,在重庆市第九人民医院儿童孤独症康复治疗中心进行康复训练的80名ASD儿童,所有儿童均符合DSM-5的ASD诊断标准。采用随机数字法将被试分为实验组(40名)和对照组(40名),两组均接受常规训练,实验组在常规训练的基础上接受为期6个月的ToM干预,对照组未接受ToM干预。干预前后采用ToM任务量表评估儿童ToM能力。结果 组内比较:干预前后,实验组区分信念(t=6.56)和错误信念任务(意外内容任务:t=6.56;意外地点任务:t=6.95)得分均有显著提高(P<0.05),而对照组的分数虽有一定的提高,但差异无统计学意义(P>0.05);组间比较:干预前,实验组和对照组ToM各项任务得分差异无统计学意义(P>0.05);干预后,实验组区分信念(t=5.37)和错误信念任务(意外内容任务:t=4.98;意外地点任务:t=4.87)得分高于对照组,差异有统计学意义(P<0.05)。结论 从ToM的多成分出发,采取多种策略开展的综合性干预模式,能够显著改善ASD儿童的ToM能力。
Abstract
Objective To explore the effectiveness of a multi-component, multi-strategy comprehensive theory of mind (ToM) intervention, in order to provide new clinical ideas and empirical evidence for ToM ability intervention in children with autism spectrum disorder (ASD). Methods From July 2022 to June 2023, 80 children with ASD who underwent rehabilitation training in Children's Autism Rehabilitation Treatment Center of Chongqing Ninth People's Hospital were selected into this study. All children met the diagnostic criteria for ASD in the diagnostic and statistical manual of mental disorders, 5th edition (DSM-5). The participants were divided into experimental group (n=40) and control group (n=40) by a random number method. Children in the control group were given traditional rehabilitation for 6 months, while children in the experimental group received ToM intervention additionally. ToM task scale was used to evaluate the ToM ability of children in the two groups before and after the intervention. Results Intra-group comparison showed that before and after the intervention, the experimental group had a significant improvement in the score of the task of distinguishing belief (t=6.56) and false belief (unexpected content task: t=6.56; unexpected location task: t=6.95) (P<0.05). The control group also showed some improvement, but these changes were not statistically significant (P>0.05). Inter-group comparison showed that before intervention, there was no significant difference in scores of ToM tasks between the experimental group and the control group (P>0.05). However, post-intervention, the experimental group scored higher than the control group in belief discrimination (t=5.37) and false belief tasks (unexpected content task: t=4.98, unexpected location task: t=4.87) with statistical significance (P<0.05). Conclusion An integrated intervention model employing multiple strategies grounded in the multifaceted nature of ToM effectively enhances ToM abilities in children with ASD, highlighting the efficacy of a comprehensive approach in addressing this complex cognitive domain.
关键词
心灵解读 /
孤独症谱系障碍 /
错误信念 /
ToM任务量表
Key words
theory of mind /
autism spectrum disorder /
false belief /
ToM Task Scale
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基金
重庆市自然科学基金面上项目(cstc2021jcyj-msxmX0045);重庆英才·创新领军人才项目(技术创新与应用发展)(CQYC20200303136)
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