沙盘游戏治疗技术对儿童孤独症交流能力及想象力的影响

Effect of Sandplay Therapy on communication ability and imagination of children with autism

目的探讨沙盘游戏治疗技术对儿童孤独症交流能力及想象力的影响。方法收集2011年1月至2017年1月陕西省第四人民医院儿保科收治的儿童孤独症49例,分为对照组24例与观察组25例,前者接受常规综合干预,后者在此基础上加沙盘游戏治疗技术。比较两组治疗前后发展状况、特征性症状改善情况及儿童孤独症评定量表(CARS)评分。结果治疗后,观察组在不爱讲话、缺乏主动语言、不理解指令、主动回避眼光接触、缺乏想象性游戏、缺乏模仿性动作、完全依赖他人照顾方面得到显著改善,与对照组比较差异有统计学意义(χ~2=4.608~24.747,均P<0.05),在词汇量少、混用、不与外人交往、注意力涣散方面,与对照组比较无统计学意义(χ~2值分别为2.452、3.432、1.647,均P>0.05)。治疗后,观察组在人际关系、语言交流、非语言交流等13项中的评分及CARS总评分方面均明显低于对照组,差异有统计学意义(χ~2=4.281~19.437,均P<0.05),而在情感反应、总体印象及智力水平评分与对照组比较无统计学意义(χ~2值分别为1.984、1.768、0.853,均P>0.05)。结论沙盘游戏治疗技术对儿童孤独症是一种良好的心理治疗技术,可有效改善其交流能力及想象力。

Objective To explore the effect of Sandplay Therapy on communication ability and imagination of children with autism. Methods Forty nine children with autistic in Fourth People＇s Hospital of Shaanxi Province were collected from January 2011 to January 2017, and they were divided into control group with 24 cases and observation group with 25 cases. The former received routine comprehensive intervention, and the latter added Sandplay Therapy techniques. The development status, characteristic symptoms improvement and Children Autism Rating Scale （CARS） scores before and after treatment between two groups were compared. Results After treatment, great improvement in speech, active language, instruction understanding, active avoidance of eye contact, imaginative games, imitative action and complete dependence on other people＇s care were found in the observation group, and the differences from those of the control group were statistically significant （Ze value ranged 4.608-24.747, all P〈 0.05）. There was no significant difference between two groups in vocabulary lacking, mixing, no communication with outsiders, and divergence of attention （χ^2 value was 2.452, 3.432 and 1.647, respectively, all P〉0.053. The scores of 13 items including interpersonal relationship, language communication, nonverbal communication and total score of CARS of the observation group were lower than those of the control group, and the differences were statistically significant （Z2 value ranged 4.281-19.437, all P〈0.05）, but the scores of emotional response, overall impression and mental level were not statistically different from those of the control group （χ^2 value was 1. 984, 1. 768 and 0.853, respectively, all P 〉0.05）. Conclusion Sandplay Therapy is a good psychological therapy for children with autistic, which can effectively improve their communication ability and imagination.