目的 评估基于虚拟现实(VR)技术的康复训练对孤独症谱系障碍(ASD)儿童的治疗效果,以期为ASD儿童的数字化治疗提供理论依据。方法 本研究选取 2023年12月—2024年4月期间就诊于上海市儿童医院儿童保健医学部的60名ASD儿童,随机分为干预组和对照组。对照组接受康复团队指导的早期家庭干预;干预组在对照组的干预训练基础上接受VR康复训练,每周1次,每次1h。治疗前后使用孤独症行为量表(ABC)、儿童孤独症评定量表(CARS)、长处与困难问卷(SDQ)以及社交反应量表(SRS)来评估疗效。结果 干预前干预组和对照组ABC、CARS、SDQ和SRS评分差异均无统计学意义(P>0.05),干预组干预后ABC感觉、交往、运动因子得分和总分及CARS总分均低于对照组,差异有统计学意义(t=2.253、2.113、2.162、3.364、2.742,P<0.05)。SDQ显示干预组干预后多动注意缺陷、同伴交往问题、亲社会行为、困难总分得分低于对照组,差异有统计学意义(t=2.084、3.623、2.591、3.074,P<0.05)。SRS结果表明,干预后干预组在社交认知、社交沟通和孤独症行为方式得分及总分优于对照组(t=2.012、2.546、2.126、3.507,P<0.05)。结论 基于VR技术的康复训练对ASD儿童核心症状和社会功能具有积极改善作用,显示出良好的临床应用潜力,但其长期效果和普适性仍需进一步研究验证。
Abstract
Objective To evaluate the therapeutic efficacy of virtual reality (VR)-based rehabilitation training for children with autism spectrum disorder (ASD), in order to provide a theoretical foundation for digital interventions in ASD treatment. Methods From December 2023 to April 2024, a total of 60 children diagnosed with ASD at the Department of Child Health Medicine, Shanghai Children′s Hospital were randomly assigned to either an intervention group or a control group.The control group received early family intervention guided by a rehabilitation team, while the intervention group underwent VR-based rehabilitation training once a week for one hour per session additionally.Therapeutic outcomes were assessed before and after the intervention using the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), Strengths and Difficulties Questionnaire (SDQ), and Social Responsiveness Scale (SRS). Results Before the intervention, there were no statistically significant differences in ABC, CARS, SDQ, and SRS scores between the intervention and control groups (P>0.05).After the intervention, the intervention group showed significantly lower scores in the sensory, social, and motor factors of the ABC, as well as in the total ABC and CARS scores, compared to the control group (t=2.253, 2.113, 2.162, 3.364, 2.742, P < 0.05).The SDQ revealed that the intervention group had significantly lower scores in hyperactivity/inattention, peer relationship problems, prosocial behavior, and total difficulties compared to the control group (t=2.084, 3.623, 2.591, 3.074, P < 0.05).The SRS results indicated that the intervention group outperformed the control group in social cognition, social communication, autistic mannerisms, and total scores after the intervention (t =2.012, 2.546, 2.126, 3.507, P<0.05). Conclusions VR-based rehabilitation training demonstrates positive effects on improving core symptoms and social functioning in children with ASD, highlighting its potential for clinical application.However, further research is needed to validate its long-term efficacy and generalizability.
关键词
虚拟现实 /
康复训练 /
学龄前期 /
孤独症谱系障碍 /
治疗效果
Key words
virtual reality /
rehabilitation /
preschool /
autism spectrum disorder /
therapeutic efficacy
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基金
上海交通大学/医学院-儿童医院临床研究培育专项重点项目(2021YLYZ02);上海交通大学医学院-儿童医院临床研究培育专项面上项目(2022YLYM09);上海市康复医学会“康复科技创新行动计划”专项(2024JGKT13);上海市卫生健康委员会卫生行业临床研究青年项目(20234Y0071); 深圳市深爱公益基金会专项研究基金(SA202300107)
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