影响孤独症谱系障碍儿童短期转归因素的初步探讨

Preliminary study on influencing factors of short-term outcome in children with autism spectrum disorder

【目的】探讨孤独症谱系障碍(autism spectrum disorder,ASD)儿童干预过程中转归的影响因素,为更好地建立综合干预模式提供依据。【方法】收集ASD患儿发育水平(DQ)、沟通能力、行为问题及转归等相关信息,并进行6个月短期追踪,在干预前后进行0、3、6个月共3次评估。【结果】干预6个月与干预0个月相比,PEP-3的沟通和行为变化显著(F=43.61,12.26,P均<0.01)。干预时间越长,患儿的沟通和行为能力的良好转归就越显著(β=3.885 2、5.163 9,P均<0.01)。初始DQ、康复训练持续性和干预训练强度对沟通转归起正性作用(β=0.265 5、0.905 9、0.028 4,P均<0.05);初始DQ、配合家庭训练对行为的转归起正性作用(β=0.227 8、3.889 2,P均<0.01)。【结论】6个月短期干预后,患儿沟通能力和行为特征均有明显改善。初始发育水平、训练持续性和持久性、训练强度、配合家庭训练与否均对其转归有着极为重要的影响。

[Objective] To find out the influencing factors of the short-term intervention outcome for the children with autism spectrum disorder （ASD） ,and provide a basis for establishing a comprehensive intervention model. [Methods] The children with ASD were recruited and their information were collected, including DQ level, communication, aberrant behavior and outcome. All ASD patients were followed up for 6 months and they were administered assessments in 0,3 and 6 months after intervention, respectively. [Results] After intervention 6 months, PEP-3 communication and behavior changed significantly（F=43.61,12.26, all P〈0.01）. The longer of intervention duration, the better of patients＇ outcome in communication and behavioral abilities（β= 3. 885 2,5. 163 9, all P〈0.01）. Initial DQ and training intensity had positive effects on communication outcome（β= 0. 265 5,0. 905 9,0. 028 4, all P（0.05）, inversely, uncontinuous training played a negative role（β=-0. 876 2,P〈0.01）. Initial DQ and family training had positive effects on behavior outcome （β= 0. 227 8, 3. 889 2,all P〈0.01）. [Conclusion] There are significant improvements after short-term intervention for six months. Initial DQ, continuous training, training intensity and family training play extremely important roles to intervention outcomes.