象征性游戏测试在儿童语言发育异常临床评估中的应用价值

Application of symbolic play test on clinical evaluation for children with abnormal language development

目的通过象征性游戏测试判断语言发育异常儿童的早期概念形成,以及用最简单方式处理符号,表达自我经验和想象的能力,探索其在儿童语言发育评估中的价值,并为促进儿童的语言发育和语言治疗目标的制定提供依据。方法 2010年8月-2011年1月在上海儿童医学中心发育行为儿科因语言问题就诊的263例儿童,男206例(78.3%),女57例(21.7%)。对所有儿童进行象征性游戏、Gesell婴幼儿发育量表、婴幼儿语言发育筛查量表及ABC儿童孤独症量表测试。结果 263例儿童的象征性游戏测试的发育年龄明显落后于平均生理年龄,且4个年龄段的象征性游戏测试的发育年龄均显著落后于其平均生理年龄,随年龄增长,两者差距有增大的趋势。象征性游戏测试的原始分与Gesell婴幼儿发育量表的4个能区的发育商(DQ)、婴幼儿语言发育筛查量表总分存在显著正相关性(P<0.001),与ABC儿童孤独症量表总分存在显著负相关性(P<0.001)。结论象征性游戏测试结果可以提示语言发育异常儿童的早期概念形成,以及用最简单方式处理符号,表达自我经验和想象的能力,有助于鉴别不同原因的语言发育异常,并为促进儿童的语言发育和语言治疗目标的制定提供依据。

Objective To explore value of symbolic play test for assessment of children＇s language development,and to promote children＇s language development and provide proof for the formulation of language therapy treatment goals. Methods A total of 263 children were divided into four groups.All children were evaluated by symbolic play test（SPT）,Gesell developmental scale,the infant screening scale of language development,and autism behavior checklist（ABC）. Results The development age in symbolic play test was all less than chronological age in four groups.Along with age increasing,the gap between development age and chronological age became grow.Partial correlation analysis showed that positive correlations existed between symbolic play test raw score and developmental quotients in four areas of Gesell developmental scale and the infant screening scale of language development,negative correlations existed between the symbolic play test raw score and the total score of ABC. Conclusions Symbolic play test results can prompt concept formation for children with abnormal early language development,use easiest way to deal with symbols,express the life experience and ability to imagine,help identify different causes of abnormal language development,promote children＇s language development and provide proof for the formulation of language therapy treatment goals.