认知和感觉统合训练对学习困难儿童的干预作用

Interventional effect of cognition and sensory integration training on children with learning difficulty

目的:观察认知、行为干预和感觉统合训练对学习困难儿童的影响。方法:实验于2000-01/2005-02在淄博市第五医院儿童心理门诊完成。纳入对象标准:①年龄6～12岁。②病程1～6年。③符合中国精神障碍分类与诊断标准—特定学校技能发育障碍的诊断标准。④自愿参加,符合纳入标准患儿41例。进行疗程为20周的认知训练、行为干预、感觉统合训练。儿童为研究人群。运用数字划消测验、听觉广度及记忆测验,于治疗后10周、20周对患儿进行测评,评估患儿的认知能力使用联合型瑞文测验量表、儿童感觉统合量表,评估智力水平及感觉统合能力。结果:纳入符合标准的患儿41例,剔除资料不全者9例,最后有32例进入结果分析,男27例,女5例。①治疗前后儿童注意力的比较:视觉注意力、数字划削测验,错误率明显降低,听觉注意广度和记忆显著提高,与治疗前相比,差异具有显著性意义(治疗后10周:数字划消10.95±9.40,顺背9.42±1.20,倒背4.24±0.98,P均<0.05)和非常显著性意义(治疗后20周:数字划消3.96±4.80,顺背10.37±1.29,倒背5.15±1.21,P均<0.001)。②治疗前后智力水平及感觉统合能力比较:治疗前瑞文测验平均智商86.23±9.14。治疗后20周,瑞文测验平均智商91.12±8.60,与治疗前相比评分明显提高,差异具有显著性(t=2.20,P<0.05)。儿童感觉统合量表4项得分均有显著提高,接近或达到正常水平。与治疗前相比,差异具有显著性意义(治疗后10周P均<0.05)和非常显著性意义(治疗后20周P均<0.001)。③学习成绩明显提高,与治疗前相比总有效率为88%。结论:综合性康复训练可使学习困难儿童的注意力、集中程度、智力水平及感觉统合能力和学习成绩都有明显改善。

AIM： To observe the effects of cognitive and behavioral interventions and sensory integration on children with learning difficulty.METHODS： The study was carried out in the pediatric psychology clinic of Zibo Fifth People＇s Hospital between January 2000 and February 2005,Inclusion criteria： ① at 6 to 12 years of age; ② disease course of 1 to 6 years; ③ met the diagnostic standards of developmental disorder for special school skills in the third edition of the Chinese Classification and diagnostic criteria of Mental Disorders （CCMD-3）; ④ voluntarily took part in the study; And 41 children were in accordance with the inclusion criteria and involved in the study, they received the cognitive training, behavioral intervention and sensory integration training for 20 weeks. The children with learning difficulty were assessed with digital cancellation test, auditory attention extent test and memory test 10 and 20 weeks after treatment;The cognitive ability of the children was evaluated with combined Raven＇s test （CRT） and children sensory integration scale; Their intellectual level and ability of sensory integration were also evaluated.RESULT＇S： Forty children met the inclusion criteria, and 9 with incomplete data were excluded, finally 32 cases （27 boys and 5 girls） were involved in the analysis of results. ① Comparison of children＇s attention before and after treatment： The error rates of visual attention and digital cancellation test were obviously decreased; auditory attention span and memory were significantly improved; Compared with before treatment,there were significant differences [ 10 weeks ,after treatment：digital cancellation （10.95±9.40）, forward recitation （9.42±1.20）, backward recitation（4.24±0.98）, P 〈 0.05] and very significant differences [20 weeks after treatment： digital cancellation （3.96±4.80）, forward recitation （10.37±1.29）,backward recitation （5.15±1.21）, P 〈 0.001]. ② Comparison of intellectual level and ability of sensory integration： As compared with before treatment the average intelligence quotient was significantly improved 20 weeks after treatment （86.23±9.14, 91.12±8.60, t=2.20, P 〈 0.05）; The scores of 4 items in the children sensory integration scale were significantly improved, and close to or reached the normal levels; As compared with before treatment,there were significant differences （10 weeks after treatment, P 〈 0.05） or very significant differences （20 weeks after treatment, P 〈 0.001）.③ Compared with before treatment, their learning results were obviously improved,the total effective rate was 88%.CONCLUSION： Comprehensive rehabilitation training can obviously improve the concentrative degree of attention, intellectual level, ability of sensory integration and learning results in children with learning difficulty.