孤独症儿童临床症状及母亲心理状况的应用行为分析干预效果

The effectiveness analysis of applied behavior analysis intervention on clinic symptoms of children with autism and psychological condition of their mothers

目的:探讨孤独症儿童母亲在专业人员指导下对患儿进行应用行为分析(ABA)干预对患儿临床症状和母亲心理状况的改善效果。方法:76名孤独症儿童母亲在专业人员指导下对患儿进行70dABA干预,在学期开始和结束时对患儿母亲进行医院焦虑抑郁量表(HADS)测试,并对患儿进行孤独症行为评定量表测量。结果:孤独症儿童的感觉、交往、运动、言语、自理能力均得到明显改善,但患儿母亲的焦虑、抑郁状况未能明显改善。孤独症女童交往能力和自理能力的改善效果优于男童;较大年龄患儿自理能力改善效果优于较小年龄患儿;父亲高中或中专、大学以上文化程度的患儿言语能力改善效果优于父亲初中及以下文化程度的患儿,家庭收入>5000元/月的患儿言语能力和交往能力改善效果优于家庭收入3000—5000元/月的患儿。结论:增加患儿家庭的经济救助、加强患儿家长的康复培训也许有助于患儿临床症状的改善;需要探索有效干预孤独症儿童母亲心理状况的方法,帮助她们以健康良好的心理状况面对生活。

Objective：To analyze the effect of treating autistic children with applied behavior analysis（ABA） by their mothers under instruction of therapist on clinic symptoms of children with autism and psychological condition of mothers.Method：Seventy-six mothers treated their autistic children with ABA under instruction of therapist for 70d.At the beginning and the end of semester,the improvement of children＇ s clinical symptoms and mothers＇ psychological condition were evaluated with autism behavior checklist（ABC） and hospital anxiety and depression scale（HADS） respectively,and the predictors were analyzed.Result：Autistic children＇ s sense ability,social ability,movement ability,speech ability,and self-care ability improved significantly,but their mothers＇ anxiety and depression did not improve.Meanwhle,girls got more improvement in social ability and self-care ability than boys.Elder children got more improvement in self-care ability than younger ones.The children whose fathers had received equivalent or highly senior high school education got more improvement in speech ability than those children father had received equivalent or lowly junior high school education,and the children with family income above 5000RMB per month got more improvement in speech and social ability than those children with family income between 3000 to 5000 RMB per month.Conclusion：It is necessary to explore an effective way to help mothers with autistic children to live with good mental health.Improving family＇s economic condition and more training to autistic children＇s mothers maybe helpful for children to improve more symptoms.