自闭症儿童训练个案分析

Individual case analysis of autism children training

目的:为自闭症患儿的系统康复训练提供一种可资借鉴的模式。方法:选择2004-09/2005-03上海市华泾地段医院门诊收治的1名7岁自闭症患儿,监护人知情同意。主要按照行为分析训练法的基本原则进行康复训练,包括注意力、模仿能力、接受型语言能力、表达型语言能力及认知能力的训练。1次/d,每周训练5d,3个月为1个疗程。在训练过程中结合患儿的具体表现,在阶段目标明确、相对稳定的训练程序中,兼顾患儿心理特点,注重具体训练方法的灵活性,并指导、监督家长进行家庭康复训练。治疗前后均采用儿童自闭症评定量表(共15个项目4级评分,总分大于30分可以诊断为自闭症,30～36分为轻～中度,大于36分为重度)及自闭症儿童行为量表(共57个项目4级评分,53分疑诊,67分确诊)进行评估。结果:①儿童自闭症评定量表评分:治疗后评分明显低于治疗前(37,27)。②自闭症儿童行为量表:治疗后评分明显低于治疗前(66,36)。③该例患儿在语言和交流方面都取得了明显进步。④语言表达及理解能力:治疗后语言理解达3岁水平,表达能力达5岁水平,明显优于治疗前相当于1岁孩童发育水平。结论:科学系统且具有灵活性的语言和行为矫治训练可以对自闭症患儿产生积极的影响。

AIM： A suitable model which can be used for reference is provided for the system rehabilitation training of autism children patient. METHODS： A 7 years old autism children patient who treated in out-patient clinic of Shanghai Huajing District Hospital was selected after the agreement of its guardian. The basic principle of behavior analysis training method was mainly accorded to perform rehabilitation training, including attention, borrow ability, the acceptance ability of language, expression ability of language and cognition training, once a day, 5 days in one week and 3 months were a course. The detailed behavior of the children patient incorporated during the procedure of training. The mental character of children patient was attended during the procedure with definite stage target and relatively stable training. Flexibility of the detailed training method was paid attention and the parents were instructed and monitored to perform home rehabilitation training. Before and after treatment, and the chil- dren autism score scale （totally 15 terms with 4 grade score, over 30 points of the total mark could be diagnosed autism, 30-36 points for light-medium, over 36 points for sever） and autism children behavior scale （totally 57 terms with 4 grade score, 53 points for doubtful diagnosis, 67 of final diaguosis） was used to evaluate. RESULTS： ① The score of children autism scale： The score after treatment was significantly lower than that before treatment （37, 27）. ② Autism children behavior scale： The score after treatment was significantly lower than that before treatment （66, 36）. ③ This children patient gained significant progress on the aspect of language and communication. ④ The language expression and faculty of understanding： After treatment the language understanding reached the level of 3 years old children and the expression ability reached the level of 5 years old children, and it was significantly better than the developmental level of 1 years old children before treatment. CONCLUSION： Scientific system with flexible language and rectificatory behavior training can bring active effect on autism children patient.