干预因素对孤独症谱系障碍患儿社交行为影响的观察性研究

来源期刊：广州医药 | 1159-1165 发布时间：2024-11-05 收稿时间：2025/11/13 18:44:18 阅读量：99

作者：: 黄庆,

成艳玲,

凡伟,

吴文华,

郭碧华,

温慧玲,

关键词：: 孤独症谱系障碍上学情况干预时长社交; autism spectrum disorder school attendance intervention duration social

DOI：: 10.20223/j.cnki.1000-8535.2024.10.010

收稿时间：: 2023-11-13
修订日期：
接收日期：
引用总数：: 1

目的探索干预因素对4~12岁孤独症谱系障碍（ASD）患儿社交反应的影响,为开展ASD患儿的早期干预提供参考。方法选取于2020年1月—2023年3月在清远市妇幼保健院儿童神经与发育中心康复干预的ASD患儿,采用社交反应量表（SRS）对患儿进行社交行为评估,采用自编一般情况问卷对家长进行问卷调查,调查内容包括患儿的基本情况（性别、共患病情况、干预时长、上学情况等）。结果 202例ASD患儿中,男性患儿162例（80.2%）,女性40例（19.8%）,性别对社交反应的影响比较差异无统计学意义（t=2.969,P>0.05）。共患病方面,无共患病的ASD患儿与共患智力发育障碍及注意缺陷多动障碍的患儿相比,其SRS得分差异有统计学意义（F=6.920,P<0.05）。在上学情况方面,普通学校就读的患儿与特殊学校及未上学的患儿相比,其SRS得分差异有统计学意义（F=3.823,P<0.05）,但在特殊学校就读的患儿与未上学的患儿相比,差异无统计学意义（P>0.05）。在干预时长方面,干预≥1年与干预<1年及未干预的患儿比较,其SRS得分更低,差异有统计学意义（F=4.477,P<0.05）,但干预<1年与未干预患儿相比,两者差异无统计学意义（P>0.05）。结论 ASD患儿中,是否患有其他无共患病、上学情况、干预时长会影响其社交反应;存在共患疾病的ASD患儿社交反应表现更差;相较于就读特殊教育机构和未上学的患儿,就读于普通学校的ASD患儿社交障碍程度更轻;干预时间越长,其社交障碍程度也越轻。

Objective To explore the impact of intervention factors on social response in children with autism spectrum disorder（ASD）aged 4—12,and to provide reference for early intervention in children with ASD. Methods Children with ASD who underwent rehabilitation intervention at the Children's Neurology and Development Center of Qingyuan Maternal and Child Health Hospital from January 2020 to March 2023 were selected．The social behavior of the children was evaluated using the Social Response Scale（SRS）,and the parents were surveyed using a self-made general situation questionnaire．The survey content included the basic information of the children（gender,comorbidity,intervention duration,and school attendance,etc．）. Results Among the 202 cases of ASD,162 were male（80.2%）and 40 were female（19.8%）．There was no statistically significant difference in the impact of gender on social response（t=2.969,P>0.05）．In terms of comorbidities,there was a statistically significant difference in SRS scores between ASD children without comorbidities and those with comorbidities such as intellectual development disorder and attention deficit hyperactivity disorder（F=6.920,P<0.05）．In terms of school attendance,there was a statistically significant difference in SRS scores between children enrolled in regular schools and those who attended special schools and those who did not attend school（F=3.823,P<0.05）,but there was no statistically significant difference between children enrolled in special schools and those who did not attend school（P>0.05）．In terms of intervention duration,compared with children with intervention≥1 year and those with intervention<1 year and no intervention,the SRS score was lower and the difference was statistically significant（F=4.477,P<0.05）．However,compared with children with intervention<1 year and those without intervention,the difference was not statistically significant（P>0.05）. Conclusions No comorbidities,attending regular schools,and intervention duration≥1 year are positive factors that affect social response．Children with ASD who have comorbidities have poorer social response performance;compared to children who attend special education institutions and those who do not attend school,children with ASD who attend regular schools have lower levels of social impairment;the longer the intervention time,the lighter the degree of social impairment．

1、 FRANZ L,GOODWIN C D,RIEDER A,et al.Early intervention for very young children with or at high likelihood for autism spectrum disorder:An overview of reviews[J].Dev Med Child Neurol,2022,64(9):1063-1076.

2、唐彩云,闻芳,于兰,等.孤独症综合干预年龄及时间对治疗效果的影响[J].中国妇幼健康研究,2018,29(3):258-261.

3、郭德华,徐素琼,刘劲.孤独症儿童融合教育发展现状与立法建议[J].教育观察,2022(9):107-112.

4、 NAHMIAS A S,KASE C,MANDELL D S.Comparing cognitive outcomes among children with autism spectrum disorders receiving community-based early intervention in one of three placements[J].Autism,2014,18(3):311-320.

5、 DUE?AS A D,PLAVNICK J B,BAK M Y S.Effects of joint video modeling on unscripted play behavior of children with autism spectrum disorder[J].J Autism Dev Disord,2019,49(1):236-247.

6、左娟娟,贺荟中.美国孤独症儿童学前融合教育安置研究综述及启示[J].中国特殊教育,2023(4):51-58.

7、 VIVANTI G,DISSANAYAKE C,DUNCAN E,ct al.Outcomes of children receiving Group-Early Start Denver Model in an inclusive versus autism-specific setting:A pilot randomized controlled trial[J].Autism,2019,23(5):1165-1175.

8、 MCGEE G G,MORRIER M J,DALY T.An incidental teaching approach to early intervention for toddlers with autism[J].J Assoc pers Sev Handicap,1999,24(3):133-146.

9、 MAENNER M J,SHAW K A,BAKIAN A V,et al.Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network,11 Sites,United States,2018[J] .MMWR Surveill Summ,2021(70):1-16.

10、 BARTAK L,RUTTER M.Differences between mentally retarded and normally intelligent autistic children[J].J Autism Child Schizophr,1976,6(2):109-120.

11、 BOLTON P F,CARCANI-RATHWELL I,HUTTON J,et al.Epilepsy in autism:Features and correlates[J].Br J Psychiatry,2011,198(4):289-294.

12、 TURK J,BAX M,WILLIAMS C,et a1.Autism spectrum disorderin children with and without epilepsy:iImpact on social functioning and communication[J].Aeta Paediatr,2009,98(4):675-681.

13、白钦钦. 孤独症谱系障碍共患癫痫的危险因素、临床特点及药物治疗[D].贵阳:贵州医科大学,2023.

14、 THOMAS S,HOVINGA M E,RAI D,et al.Brief Report:Prevalence of Co-occurring Epilepsy and Autism Spectrum Disorder:The U. S.National Survey of Children's Health 2011-2012[J].J Autism Dev Disord,2017,47(1):224-229.

15、 SINZIG J,MORSCH D,LEHMKUHL G.Do hyperactivity,impulsivity and inattention have an impact on the ability of facial affect recognition in children with autism and ADHD?[J].Eur Child Adolesc Psychiatry,2008,17(2):63-72.

16、 YERYS B E,WALLACE G L,SOKOLOFF J L,et al.Attention deficit/hyperactivity disorder symptoms moderate cognition and behavior in children with autism spectrum disorders[J].Autism Res,2009,2(6):322-333.

17、 SPENDER K,CHEN Y R,WILKES-GILLAN S,et al.The friendships of children and youth with attention-deficit hyperactivity disorder:A systematic review[J].PLoS One,2023,18(8):e0289539.

18、 ROS R,GRAZIANO P A.Social functioning in children with or at risk for attention deficit/hyperactivity disorder:A meta-analytic review[J].J Clin Child Adolesc Psychol,2018,47(2):213-235.

19、 GADOW K D,DEVINCENT C J,POMEROY J.ADHD symptom subtypes in children with pervasive developmental disorder[J].J Autism Dev Disord,2006,36(2):271-283.

20、 AMR M,RADDAD D,EL-MEHESH F,et al.Comorbid psychiatric disorders in Arab children with autism spectrum disorders[J].Research in Autism Spectrum Disorders,2012(6):240-248.

21、 HERNANDEZ L M.Sex-differential neuroanatomy in autism:A shift toward male-characteristic brain structure[J].Am J Psychiatry,2023,180(1):8-10.

22、钟慧. 孤独症患者脑功能连接的性别差异及发展轨迹研究[D].南京:南京师范大学,2021.

23、孙竹瑶. 孤独症谱系障碍儿童干预效果的影响因素分析[D].衡阳:南华大学,2022.

24、龚俊,邹时朴,刘冬梅,等.社交反应量表的信效度分析[J].中国医学创新,2019,16(1):19-23.

25、教育部,国家发展改革委,民政部,等.国务院办公厅关于转发教育部等部门“十四五”特殊教育发展提升行动计划的通知[EB/OL].(2022-01-26)[2022-05-29] .www.gov.cn/zhengce/contenM2022 - 01/25/content _ 5670341.htm.2022.

26、 BAXTER A J,BRUGHA T S,ERSKINE H E,et al.The epidemiology and global burden of autism spectrum disorders[J].Psychol Med,2015,45(3):601-613.

27、 MAENNER M J,WARREN Z,WILLIAMS A R,et al.Prevalenc e and characteristics of autism spectrum disorder among children aged 8 years-autism and developmental disabilities monitoring network,11 Sites,United States,2020[J].MMWR Surveill Summ,2023,72(2):1-14.

28、吴文华,温慧玲,郭碧华,等.家庭睡眠习惯调查在孤独症患儿睡眠评估中的信效度研究[J].广州医药,2022,53(3):70-73,78.

1、汪旭,夏庆.运动干预孤独症儿童刻板行为的研究进展[J].心理月刊,2025,20(13):224-226+230.DOI:10.19738/j.cnki.psy.2025.13.066.