目的 基于全人发展视角,研究幼小衔接课对学龄前脑性瘫痪(CP)儿童智能发育的影响,为促进CP患儿全面康复提供新方法。方法 选取在湘雅博爱康复医院2019年2—7月就诊的79例学龄前CP儿童采用数字表法随机分组,分为对照组(39例)和干预组(40例),对照组予以常规康复治疗,干预组行常规康复治疗结合幼小衔接课。采用Gesell发育诊断量表(GDDS)、韦氏幼儿智力量表(WPPSI)分别评估患儿治疗前后5个能区的发育龄(DA)和总智商(FIQ)。结果 治疗4月后,干预组总有效率(92.5%)显著高于对照组(66.7%),差异有统计学意义(χ2=13.403,P<0.01);两组患儿大运动和精细动作DA比较,差异无统计学意义(t=0.283、0.414,P>0.05),干预组在适应性、语言和个人社交DA以及WPPSI FIQ值显著优于对照组,差异有统计学意义(t=2.280、2.005、2.020、2.010,P<0.05)。结论 幼小衔接课能有效促进学龄前CP儿童适应性、语言以及个人社交能力的发育,提高其智力发育水平。
Abstract
Objective To study the impact of kindergarten curriculum on the intellectual development of preschool cerebral palsy (CP) children based on the perspective of holistic development,in order to provide a new method for facilitating the rehabilitation of CP children. Methods A total of 79 preschool CP children in Xiangya Boai Rehabilitation Hospital from February to July 2019 were divided into control group (n=39) and intervention group (n=40) by digital table method. The control group received routine rehabilitation treatment,while the education group was given kindergarten curriculum additionally. The Gesell Developmental Diagnostic Scale (GDDS),Webster Infant Intelligence Scale (WPPSI) were adopted to evaluate developmental age (DA) of the five energy zones and full intelligence quotient (FIQ) before and after treatment. Results After four-month treatment,the total effective rate of intervention group (92.5%) was significantly higher than that of control group(66.7%)(χ2=13.403,P<0.01). The difference in DA of gross and fine motor between the two groups was not significant (t=0.283,0.414,P>0.05). The adaptability/language/personal social DA and WPPSI FIQ scores were significantly better than the control group (t=2.280,2.005,2.020,2.010,P<0.05). Conclusion Kindergarten curriculum can effectively promote the development of adaptability/language/personal social ability of preschool-age CP children and improve their intellectual development level.
关键词
全人发展 /
幼小衔接课 /
脑瘫 /
智能发育 /
学龄前儿童
Key words
whole-person development /
kindergarten curriculum /
cerebral palsy /
intelligence development /
preschool children
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参考文献
[1] Reid SM,Meehan EM,Arnup SJ,et al.Intellectual disability in cerebral palsy:apopulation-based retrospective study[J].Dev Med Child Neurol,2018,60(7):687-694.
[2] 唐久来,秦炯,邹丽萍,等.中国脑性瘫痪康复指南:第一部分[J].中国康复医学杂志,2015,30(7):749-754.
[3] 王婷,李晓捷,朱琼,等.脑性瘫痪并发智力障碍特点及其治疗进展[J].中国儿童保健杂志,2020,28(7):756-758,762.
[4] 万惠颖.学前特殊儿童教育补偿研究[D].吉林:东北师范大学,2014.
[5] 陈秀洁,姜志梅,史惟,等.中国脑性瘫痪康复指南:第三部分[J].中国康复医学杂志,2015,30(9):972-978.
[6] 陈秀洁,姜志梅,史惟,等.中国脑性瘫痪康复指南:第四部分[J].中国康复医学杂志,2015,30(10):1082-1090.
[7] Fluss J,Lidzba K.Cognitive and academic profiles in children with cerebral palsy:a narrative review[J].Ann Phys Rehabil Med,2020,62(3):283-289.
[8] Myrhaug HT,Odgaard-Jensen J,Østensjø S,et al.Effects of a conductive education course in young children with cerebral palsy:A randomized controlled trial[J].Dev Neurorehabil,2018,21(8):481-489.
[9] 舒川.全人发展视野下学龄前残疾儿童运动康复课程理论与实践[J].体育科学,2018,38(2):32-81.
[10] 杨锦媚,粟愿学,汪湘军,等.引导式教育半日制流程课对脑瘫儿童智力发育的影响[J].护士进修杂志,2018,33(18):1642-1645.
[11] 关宏岩,赵星,屈莎,等.学龄前儿童(3~6岁)运动指南[J].中国儿童保健杂志,2020,28(6):714-720.
[12] 张广宇,刘国庆,朱登纳,等.2020年Current Neurology and Neuroscience Reports《2019年证据交通信号灯状况:儿童脑性瘫痪防治干预措施的系统评价》中国专家解读[J].中国当代儿科杂志,2020,35(6):439-445.
[13] 韩雪婷,李洁,金妍,等.“童期教育”结合医学康复干预对学龄前脑瘫儿童疗效的影响[J].中国妇幼健康研究,2018,29(8):954-957.
[14] 杜翔,陈嘉,姜琨,等.粗大运动功能分级系统Ⅰ-Ⅲ级的学龄前期脑性瘫痪儿童接受普通学前教育的研究[J].中国康复医学杂志,2017,32(12):1366-1369.
[15] Kolb B,Mychasiuk R,Gibb R.Brain development,experience,and behavior[J].Pediatr Blood Cancer,2014,61(10):1720-1723.
[16] Lebeer J.It is a long road to inclusive education for children with cerebral palsy[J].Dev Med Child Neurol,2018,60(4):336-337.
基金
湖南省残疾人康复科研资助项目(2020XK028)