目的 研究孤独症谱系障碍(ASD)儿童家长压力及相关影响因素,为缓解育儿压力及提升干预疗效提供依据。方法 选取复旦大学附属儿科医院儿保科首次诊断为ASD患儿家长为研究对象,并将同期诊断的精神发育迟缓/言语障碍和正常儿童家长作为对照组,分析不同组家长育儿压力的差异。采用家长育儿压力简表(PSI-SF)对家长压力值进行评定,一般育儿信息问卷调查相关育儿压力因素,0~6岁发育筛查测试(DST)评估ASD儿童发育商。结果 多数入组的ASD儿童伴随发育迟缓,存在智力及社会适应发育落后的几率高于运动发育。ASD组儿童家长在压力总分、亲子互动失调及困难儿童分量表得分显著高于精神发育迟缓/言语障碍儿童组家长及正常儿童家长(总分:100.67±15.08 vs 93.19±13.85 vs 82.61±17.68,F=43.85,P<0.05)。孤独症家长在育儿愁苦分量表压力值高于正常儿童家长(33.34±7.07 vs 29.77±7.47,P<0.05),与精神发育迟缓/言语障碍儿童组家长的差异不显著。增加父亲带养时间以及家庭经济收入,父母拥有更高的文化程度能帮助缓解家长育儿压力。结论 1)多数ASD儿童伴随发育迟缓,其家长承受着更高的育儿压力。2)增加父亲带养时间、引导父亲更多参与家庭干预,政府、社会对ASD儿童及家长投入更多的资金与教育支持,将对缓解患儿家长育儿压力以及提升干预疗效具有重要的作用。
Abstract
Objective To explore parental stress and related factors of children with autism spectrum disorder(ASD),and provide the basis for reducing parental stress and promoting the results of intervention. Methods Parents of ASD children who were first diagnosed in the Department of Child Health Care,Children's Hospital of Fudan University were included in the research as experimental group,parents of children who were first diagnosed as intellectual disability/language disorder and of typical children as control groups.Interview included parental stress index/short form (PSI/SF),self-made general parenting information questionnaire,Developmental Screening Test (DST) was performed for developmental quotient (DQ) of ASD children. Results Most included ASD children were comorbid with developmental delay-a higher proportion of intellectual disability and poor social adaptability than motor abnormality.Parents of ASD children scored higher than control groups in the total score of parenting stress,PCDI domain and DC domain (total score:100.67±15.08 vs 93.19±13.85 vs 82.61±17.68,F=43.85,P<0.05).They also scored higher in PD domain than parents of typical children(33.34±7.07 vs 29.77±7.47,P<0.05),with no statistical difference comparing with parents of children with intellectual disability/language disorder.Increasing nursing time of father and family income,parents with higher education level could help to relieve stress. Conclusions 1) A large number of ASD children are comorbid with developmental delay.Parents of ASD children experience higher stress.2) To increase nursing time of father,father should be guide to participate in the family intervention of ASD children.It is also important for the government and society to invest more funds and education resources for the ASD families for relieving stress and improving the effect of intervention.
关键词
孤独症谱系障碍 /
育儿压力 /
儿童
Key words
autism spectrum disorder /
parental stress /
children
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基金
国家自然科学基金项目(81371270);卫生行业科研专项项目(201302002)
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