自然发展行为干预在孤独症谱系障碍儿童中的应用进展

朱晴晴; 康贝贝; 曹建国; 刘燕; 张玉涵

doi:10.11852/zgetbjzz2024-1012

PDF(746 KB)

中国儿童保健杂志 ›› 2026, Vol. 34 ›› Issue (3) : 338-343. DOI: 10.11852/zgetbjzz2024-1012

综述

自然发展行为干预在孤独症谱系障碍儿童中的应用进展

朱晴晴¹, 康贝贝², 曹建国³, 刘燕¹, 张玉涵¹

作者信息 +

Application progress of naturalistic developmental behavioral interventions in children with autism spectrum disorder

ZHU Qingqing¹, KANG Beibei², CAO Jianguo³, LIU Yan¹, ZHANG Yuhan¹

Author information +

文章历史 +

摘要

自然发展行为干预是一系列结合应用行为分析和发展心理学理论、在自然环境中实施的孤独症早期干预方法的总称。自然发展行为干预包括关键反应训练、早期丹佛模式、共同注意假想游戏参与和调节、自然情境教学、交互模仿训练、让家长成为儿童沟通训练的老师等,这些方法的目标领域和有效性各有侧重,但又具有共同的核心要素和特征。近年来,自然发展行为干预在国际范围内受到青睐,实证研究不断扩大,为推动自然发展行为干预在我国的本土化研究和实践,现对自然发展行为干预的理论基础、核心组成、优势、应用现状进行论述。

Abstract

Naturalistic developmental behavioral interventions(NDBI) is a series of early intervention methods for autism spectrum disorder that combine applied behavioral analysis and developmental psychology theory and are implemented in natural settings. NDBI includes pivotal response training, Early Denver Model, Joint Attention, Symbolic Play, Engagement and Regulation, Milieu Teaching, Reciprocal Imitation Training, Improving Parents as Communication Teachers, etc. These methods have different focus on the target field and effect, eristics, but have common core elements and characteristics. In recent years, NDBI has received extensive attention in the international scope, and the empirical research continues to expand. To promote the localization research and practice of NDBI in China, the theoretical basis, advantages and application status of NDBI are discussed here.

导出引用

朱晴晴, 康贝贝, 曹建国, 刘燕, 张玉涵. 自然发展行为干预在孤独症谱系障碍儿童中的应用进展[J]. 中国儿童保健杂志. 2026, 34(3): 338-343 https://doi.org/10.11852/zgetbjzz2024-1012

ZHU Qingqing, KANG Beibei, CAO Jianguo, LIU Yan, ZHANG Yuhan. Application progress of naturalistic developmental behavioral interventions in children with autism spectrum disorder[J]. Chinese Journal of Child Health Care. 2026, 34(3): 338-343 https://doi.org/10.11852/zgetbjzz2024-1012

中图分类号： R749.94

参考文献

[1] American Psychiatric Association. Diagnostic and statistical manual of mental disorder[M]. 5th ed. Arlington: American Psychiatric Publishing, 2013.
[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] Shaw KA, Williams S, Patrick ME, et al. Prevalence and early identification of autism spectrum disorder among children aged 4 and 8 years—Autism and Developmental Disabilities Monitoring Network, 16 Sites,United States, 2022[J]. MMWR. Surveillance Summaries, 2025, 74(2):1-22.
[4] 肖石花,李晶.自然发展行为干预在孤独症早期干预中的应用[J].心理科学进展,2023,31(12): 2350-2367.
Xiao SH, Li J. Implementation ofnaturalistic developmental behavioral interventions: An early intervention program for children with autism spectrum disorder[J]. Advances in Psychological Science, 2023,31 (12): 2350-2367.(in Chinese)
[5] Schreibman L, Dawson G, Stahmer AC, et al. Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder[J]. J Autism Dev Disord, 2015, 45(8):2411-2428.
[6] Frost KM, Brian J, Gengoux GW, et al. Identifying and measuring the common elements of naturalistic developmental behavioral interventions for autism spectrum disorder: Development of the NDBI-Fi[J]. Autism, 2020, 24(8):2285-2297.
[7] D′Agostino SR, Dueñas AD, Bravo A, et al. Toward deeper understanding and wide-scale implementation of naturalistic developmental behavioral interventions[J]. Autism, 2023, 27(1):253-258.
[8] Kasari C, Shire S, Shih W, et al. Spoken language outcomes in limited language preschoolers with autism and global developmental delay: RCT of early intervention approaches[J]. Autism Res, 2023, 16(6):1236-1246.
[9] Gladfelter A, Goffman L. Semantic richness and word learning in children with autism spectrum disorder[J]. Dev Sci, 2018, 21(2):10.
[10] 杨晓真,桑杲.丰富环境在孤独症谱系障碍患儿中的作用及应用研究进展[J].中国临床新医学,2024,17(2): 233-237.
Yang XZ, Sang G. Research progress on the role and application of environmental enrichment in children with autism spectrum disorder[J]. Chinese Journal of New Clinical Medicine, 2024,17(2): 233-237.(in Chinese)
[11] Ferrara R, Damato F, Iovino L, et al. ESDM intervention in severe preschool autism: An Italian Case report, psychological and social medicine reflections[J]. Ital J Pediatr, 2024, 50(1):60.
[12] 魏寿洪,张文京.自然情境教学在自闭症儿童沟通教学中的应用[J].现代特殊教育,2007,32(10):28-29.
[13] 王敏,吴冬连,葛新斌.关键反应训练对孤独症儿童的干预有效性——基于国外2001-2021年随机对照试验证据的Meta分析[J].中国特殊教育,2023,30(1): 69-81.
Wang M, Wu DL, Ge XB. Intervention effectiveness of pivotal response training for children with autism :A Meta-analysis based on evidence from foreign randomized controlled trials from 2001-2021[J]. Chinese Journal of Special Education, 2023,30(1): 69-81.(in Chinese)
[14] 叶宁晓.关键反应训练对促进学前自闭症儿童口语沟通能力的有效性研究[D].上海:华东师范大学,2021.
Ye NX. The effects of pivotal response treatment on verbal communication skills of preschool children with autism spectrum disorder[D]. Shanghai: East China Normal University, 2021.(in Chinese)
[15] 尼罗帕,艾力帕提·太来提,等.关键反应训练对孤独症谱系障碍患儿治疗效果的系统综述[J].四川精神卫生,2024,37(1): 86-90.
Niluopa, Ailipati T, Wang MN, et al. Effeet of pivotal response training for children with autism spectrum disorder :A systematic review[J]. Sichuan Mental Health, 2024,37(1): 86-90.(in Chinese)
[16] Wang L, Li S, Wang C. Using pivotal response treatment to improve language functions of autistic children in special schools: A randomized controlled Trial[J].J Autism Dev Disord, 2024, 54(6):2081-2093.
[17] 王石换,邹小兵,邹园园,等.早期介入丹佛模式对孤独症谱系障碍婴幼儿的疗效分析[J].中国儿童保健杂志,2021,29(12): 1300-1303.
Wang SH, Zou XB, Zou YY, et al. Effect of early start denver model on toddlers with autism spectrum disorder[J]. Chin J Child Health Care, 2021,29 (12): 1300-1303.(in Chinese)
[18] 刘宇默,苗春越,单玲,等.早期介入丹佛模式治疗孤独症谱系障碍研究进展[J].吉林大学学报(医学版),2024,50(1): 273-279.
Liu YM, Miao CY, Shan L, et al. Research progress in early start denver model for treatment of autism spectrum disorder[J]. Journal of Jilin University (Medicine Edition), 2024,50(1): 273-279.(in Chinese)
[19] Dawson G, Rogers S, Munson J, et al. Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model[J]. Pediatrics, 2010, 125(1):17-23.
[20] Rooks-Ellis DL, Scheibel G, Mason C, et al. Feasible adaptation of ESDM for statewide implementation: A look at potential effects, implementation conditions, and cost[J]. J Early Interv, 2024, 46(2):255-275.
[21] Kasari C, Gulsrud AC, Shire SY, et al. The JASPER model for children with autism: Promoting joint attention, symbolic play, engagement, and regulation[M]. New York: Guilford Publications, 2021.
[22] Kasari C, Freeman S, Paparella T. Joint attention and symbolic play in young children with autism: A randomized controlled intervention study[J]. J Child Psychol Psychiatry, 2006, 47(6):611-620.
[23] Waddington H, Reynolds JE, Macaskill E, et al. The effects of JASPER intervention for children with autism spectrum disorder: A systematic review[J]. Autism, 2021, 25(8):2370-2385.
[24] 张焱,庞焙丹,曾慧琴.自然情境教学法干预特殊需要幼儿口语沟通行为的个案研究[J].中国特殊教育,2022,29(1): 47-54.
Zhang Y, Pang BD, Zeng HQ. Acase study on Milieu Teaching for oral communication behavior of children with special needs[J]. Chinese Journal of Special Education, 2022,29(1): 47-54.(in Chinese)
[25] 刘佃振.自然情境教学对自闭症儿童初级言语行为的干预研究[D].济南:济南大学,2023.
Liu DZ. The intervention study on Milieu Teaching of primary verbal behavior of children with autism[D]. Jinan: University of Jinan, 2023.(in Chinese)
[26] 魏寿洪.自然情境教学法对自闭症儿童主动语言的绩效研究[J].现代特殊教育,2015,24(4): 46-51.
Wei SH. Theeffects of the spontaneous language using Milieu Teaching for the children with autism[J]. A Journal Of Modern Special Education, 2015,24(4): 46-51.(in Chinese)
[27] 石彩英.家长执行改良式情境教学对孤独症儿童主动语言提升的成效研究[D].重庆:重庆师范大学,2023.
Shi CY. A study on the effectiveness of parent implemented Enhanced Milieu Teaching on the spontaneous language improvement of children with autism[D]. Chongqing: Chongqing Normal University, 2023.(in Chinese)
[28] 王存友.基于PII的交互模仿训练对自闭症儿童模仿能力的干预研究[D].济南:济南大学,2023.
Wang CY. Interventionstudy of PII-based reciprocal imitation training on the imitation ability of children with autism[D]. Jinan: University of Jinan, 2023.(in Chinese)
[29] Ingersoll B. The social role of imitation in autism: Implications for the treatment of imitation deficits[J]. Infant Young Child, 2008, 21(2):107-119.
[30] Töret G, Özmen ER. Karşılıklı takliteğitimi′nin otizm spektrum bozukluğu olan çocukların sosyal iletişim becerileri üzerinde etkililiğinin belirlenmesi[J]. EĞİTİM VE BİLİM, 2019, 44(199):279-296.
[31] Ishizuka Y, Yamamoto J. The effect of contingent imitation intervention on children with autism spectrum disorder and co-occurring intellectual disabilities[J]. Res Autism Spect Dis, 2021, 85:101783.
[32] Cidav Z, Mandell D, Ingersoll B, et al. Programmatic costs of project impact for children with autism: A time-driven activity based costing study[J]. Adm Policy Ment Health, 2023, 50(3):402-416.
[33] 吴丹萍,任芳,沈理笑,等.孤独症谱系障碍ImPACT干预方案的改编及适应性调查[J].上海交通大学学报(医学版),2022,42(9): 1239-1246.
Wu DP, Ren F, Shen LX, et al. Adaptation and adaptability investigation of Improving Parents as Communication Teachers (ImPACT) program for autism spectrum disorder[J].Journal of Shanghai Jiaotong University (Medical Science), 2022,42(9): 1239-1246.(in Chinese)
[34] Ingersoll B, Wainer A. Initial efficacy of Project ImPACT: A parent-mediated social communication intervention for young children with ASD[J]. J Autism Dev Disord, 2013, 43(12):2943-2952.
[35] Sengupta K, Mahadik S, Kapoor G. Glocalizing project ImPACT: Feasibility, acceptability and preliminary outcomes of a parent-mediated social communication intervention for autism adapted to the Indian context[J]. Res Autism Spect Dis, 2020, 76:101585.
[36] 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 F. Communication disorders in children with autism spectrum disorder from speech language pathology perspective[J]. Chin J Child Health Care, 2024,32(3): 233-236.(in Chinese)