目的 探讨基于结构化教学法(TEACCH)的小组训练对学龄前孤独谱系障碍(ASD)儿童的训练效果,为TEACCH本土化训练模式提供参考。方法 将武汉市精神卫生中心2018年1月— 2021年10月的60例ASD儿童进行康复训练,随机分为TEACCH组和对照组各30例,分别比较两组在训练前、训练后、训练后6个月随访和1年随访时评估康复效果各项得分的变化,采用PEP-3进行康复效果的评估。结果 TEACCH组和对照组在训练前基线得分差异均无统计学意义(P>0.05)。在所有评估项目中时间主效应均显著(P<0.001),TEACCH组在语言表达、语言理解、小肌肉、社交互动、问题行为、个人自理和适应行为得分均高于对照组,差异具有统计学意义(F=4.159、10.447、4.556、4.666、12.922、4.199、8.484,P<0.05),组间和时间交互效应在情感表达、问题行为、个人自理差异具有统计学意义(F=3.919、5.071、9.689,P<0.05)。TEACCH组的语言表达、问题行为、个人自理在训练后、6个月随访和1年随访前后测差值均高于对照组,差异有统计学意义(P<0.05),情感表达、社交互动仅在训练后和6个月随访时前后测差值高于对照组,差异有统计学意义(P<0.05),语言理解、小肌肉、适应行为仅在训练后和1年随访时前后测差值高于对照组,差异有统计学意义(P<0.05)。结论 基于TEACCH的小组训练,对于学龄前ASD儿童语言、小肌肉、情感、社交、行为方面均有促进作用。
Abstract
Objective To explore the effect of treatment and education of autistic and communication handicapped children (TEACCH) group training in preschool children with autism spectrum disorder (ASD), in order to provide reference for localization of the training mode of TEACCH. Methods Totally 60 preschool children with ASD in Children's Rehabilitation Department of Wuhan Mental Health Center from January 2018 to October 2021 were enrolled in this study, and were randomly assigned to the TEACCH group (n=30) and the control group (n=30).The Chinese version of Psycho-Educational Profile, 3rd ed(PEP-3) was used to assess treatment effects at baseline, posttest, 6-month follow-up and 1-year follow-up after training. Results No significant difference was found between the two groups at baseline (P>0.05). Time effect was significant for all indicators (P＜0.001). The scores of expressive language, receptive language, fine motor, social reciprocity, problem behavior, personal self-care and adaptive behavior in the TEACCH group were significantly improved than those of the control group (F=4.159, 10.447, 4.556, 4.666, 12.922, 4.199, 8.484, P<0.05). The interaction effects between time and group were significant in affective expression, problem behavior and personal self-care scores (F=3.919, 5.071, 9.689, P<0.05). The change scores of expressive language, problem behavior and personal self-care in the TEACCH group were significantly higher than those of the control group at posttest, 6-month follow-up and 1-year follow-up (P<0.05). The change scores of emotional expression and social interaction in the TEACCH group were significantly higher than those of the control group only at posttest and 6-month follow-up (P<0.05). The change scores of receptive language, fine motor and adaptive behavior in the TEACCH group were significantly higher than those of the control group only at posttest and 1-year follow-up (P<0.05). Conclusion Group training based on TEACCH can promote the language, fine motor, emotion, social interaction and behavior of preschool ASD children.
关键词
孤独谱系障碍 /
结构化教学法 /
学龄前儿童
Key words
autism spectrum disorder /
treatment and education of autistic and communication handicapped children /
preschool children
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基金
武汉市卫生计生科研项目(WX17Q29,WX18Q19);武汉市第四批公共卫生重点学科项目(儿童青少年精神卫生)
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