运用沙箱游戏区分自闭症谱系障碍儿童功能的可行性探索

Explore the Possibility of Using Sand Play to Distinguish the Function Level of Children with Autistic Spectrum Disorder

本研究力图探索通过沙箱游戏过程观察和作品分析来区分自闭症谱系障碍(ASD)儿童功能水平的可能性。通过对152名已被诊断为ASD的3.2—14.5岁儿童的沙箱游戏过程观察及作品分析,提炼出"体验与适应"、"识认与选择"和"策略与操作"三个具有内在一致性和较高辨别力的等级性功能指标。研究表明:第一等级功能指标适用于对所有ASD儿童的功能评估,第二等级功能指标是区分ASD儿童功能水平的分水岭,第三等级功能指标是甄别中、高功能ASD儿童有力工具。

Sand play reflects player＇s mind and emotion. However, it is rarely used to distinguish the functional level of children with autistic spectrum disorder （ASD）. This study aims to explore the interplay. The subjects were 152 children diagnosed by hospital as having ASD, 121 boys, 31 girls, ranging from 3 years and 2 months old to 14 years and 5 months old, with a mean age of 8 years and 8 months. Based on IQ scores, parent questionnaires, and play observations, tbe subjects were grouped into four function levels： low, middle-low, middle-high, and high. During the study, children were told to play freely in the sandbox with toys and create something. Still and video cameras were used to record the play processes and products and then recordings were analyzed both quantitatively and qualitatively. Three hierarchical function indexes, ＂Experience and Adaption＂, ＂Recognition and Selection＂, and ＂Strategy and Operation＂ with three variables in each index, were used to quantitatively analyze the process and products of children＇s sand play. Function indexes are found to be consistent in all three levels. The range of correlation coefficients of the three variables, ＂attention＂, ＂action＂, and ＂adaptation＂, of the first function index is. 399 to. 536. The range of correlation coefficients of the three variables, ＂choosing plastic toys＂, ＂using plastic toys＂, and ＂arranging plastic toys＂, of the second index is . 440 to . 647. The range of correlation coefficients of the three variables, ＂layout of products＂, ＂harmony of products＂, and ＂theme of products＂, of the third index is . 515 to. 672. This data indicate that the three levels of function indexes appear to work well for distinguishing the function level of children with ASD. The first level of function index can be used to evaluate all the children with ASD. When consciously or unconsciously experiencing and adapting to the external world, low function children scored significantly lower than high function children on all three variables. The second level of function index, ＂identification and selection＂, is a determining factor for distinguishing between the low - , middle -, and high -function children with ASD. The inability to recognize plastic toys prevents low function children from selecting and displaying with them.. Different scores on all three variables in the high function group are observed while group differences in the middle-low and middle-high children are very significant. The＂ Strategy and operation＂ function index of the third level is a powerful tool for distinguishing the middle - and high - function children as only the high - function children can enter this level with all three variables related to strategy choice, component operation, and other higher thinking activities. In summary, this study suggests that sand play might be used to distinguish the function level of children with ASD.