孤独症谱系障碍儿童执行功能干预研究

Study of executive function intervention on children with autism spectrum disorder

目的观察执行功能干预对孤独症谱系障碍(ASD)儿童的影响。方法将12例ASD儿童随机分为实验组和对照组,每组6例,两组均接受常规的培智、康复等训练。实验组患儿同时采用执行功能训练系统进行执行功能训练,内容包括抑制控制能力、工作记忆、认知灵活性等,其中抑制控制能力采用Stroop、Go/No-Go范式,工作记忆采用N-back范式,认知灵活性采用平板上的威斯康星卡片,一对一训练,30 min/d,每周训练5次,共12周。观察两组患儿干预前后抑制控制能力、认知灵活性、工作记忆和注意力的变化。结果干预后,实验组患儿抑制控制能力、认知灵活性、注意力明显改善(P<0.05),但工作记忆变化无统计学意义(P>0.05)。对照组患儿干预前后上述指标无改善(P>0.05)。实验组干预后形成性评价评分明显提高(P<0.05)。结论执行功能干预可改善ASD儿童的抑制控制能力、认知灵活性和注意力,但对于工作记忆的改善效果甚微。

Objective To observe the effect of executive function intervention on children with autism spectrum disorder（ ASD） . Methods Twelve ASD children were randomly divided into experimental group and control group,with 6 cases in each group.The two groups received the routine training such as special education,rehabilitation and so on.The children in the experimental group were given executive function intervention based on the executive function training system.The intervention involved inhibitory control ability training, working memory training and cognitive flexibility training,in which Stroop paradigm and Go/No-Go paradigm were applied to inhibitory control ability training,N-back paradigm was applied to working memory training,and Wisconsin card in tablet was applied to cognitive flexibility training.The trainings conducted in a one-to-one manner 30 minutes per day,five times every week for 12 weeks.The changes in inhibitory control ability,working memory,cognitive flexibility and attention of the children in two groups before and after intervention were observed.Results After intervention,inhibitory control ability,cognitive flexibility and attention of the children improved significantly in the experimental group（P〈0.05）,but working memory showed no statistically significant changes（P〉0.05）.The indexes mentioned above showed no improvement after intervention in contrast with those before intervention in the control group（P〉0.05）.The formative assessment score increased significantly in the experimental group after intervention（P〈0.05）.Conclusion Executive function intervention might improve inhibitory control ability, cognitive flexibility and attention of ASD children, but it has little effect on the improvement of working memory.