可视音乐干预联合调序疗法对精神发育迟缓儿童适应行为能力及智能发育的影响

Effects of visual music intervention combined with sequential therapy on adaptive behavior and intelligence development in children with mental retardation

目的探讨可视音乐干预联合调序疗法对精神发育迟缓儿童适应行为能力及智能发育的影响。方法选取2017年2月—2019年4月株洲市中心医院收治的精神发育迟缓患儿94例,根据入院时间顺序分为对照组(给予常规康复干预)与观察组(给予常规康复干预+可视音乐干预联合调序疗法),每组47例,干预时间均为6个月。利用格塞尔发育量表(Gesell developmental schedules,GDS)、儿童感觉综合评定量表(children sensory integration rating scale,CSIRS)及美国智力低下协会适应行为量表(American Association on Mental Deficiency adaptive behavior scale,AAMD-ABS)评估2组患儿的康复效果,采用PZB服务质量量表(service quality,SERVQUAL)评估2组的家属干预满意度。结果干预6个月后,观察组康复总有效率显著高于对照组(78.72%vs 55.32%,P=0.009);观察组CSIRS中前庭失衡、触觉功能不良和本体感失调子量表得分,GDS中个人社交、大运动、精细动作、适应性及语言能区的发育商(developmental quotient,DQ)和发育年龄(developmental age,DA)得分,AAMD-ABS中独立功能因子、认知功能因子和社会/自制因子得分,均显著高于对照组(P<0.05或P<0.001);观察组SERVQUAL中可靠性、移情性、有形性、反应性和保证性维度得分均显著高于对照组(均P<0.001)。结论采用可视音乐干预联合调序疗法对精神发育迟缓儿童进行康复治疗,效果显著,能有效增强感觉统合能力,促进智力发育,提高适应行为能力,改善家属干预满意度。

Objective To investigate the effects of visual music intervention combined with sequential therapy on the adaptive behavior and intelligence development of children with mental retardation(MR).Methods A total of 94 children with MR in Zhuzhou Central Hospital from February 2017 to April 2019 were enrolled.The patients were divided into control group and observation group according to the order of admission.They were given conventional rehabilitation intervention(n=47)and visual music intervention combined with sequential therapy(n=47)for 6 months,respectively.Comparisons were made among the rehabilitation effects of the two groups and the pre-intervention and 6 months post-intervention children sensory integration rating scale(CSIRS)scores,the developmental quotient(DQ)and developmental age(DA)of the five energy regions in the Gesell developmental schedule,and American Association on Mental Deficiency adaptive behavior scale(AAMD-ABS)scores.The satisfaction of family intervention was compared between the two groups by PZB service quality scale(SERVQUAL).Results The total effective rate of the observation group(78.72%)was significantly higher than that of the control group(55.32%,P=0.009).The vestibular imbalance,tactile dysfunction,and proprioception dysfunction were significantly higher in the observation group than those in the control group after 6 months of intervention(P<0.05).After intervention for 6 months,the DQ and DA scores of the observation group were significantly higher than those of the control group(P<0.05).The scores of independent functional factors,cognitive function factors and social/self-made factors in the observation group were significantly higher than those of the control group(P<0.001)after intervention for 6 months.In SERVQUAL results,the scores of reliability,empathy,tangibility,reactivity and assurance of the observation group were significantly higher than those in the control group(all P<0.001).Conclusion The visual music intervention combined with the sequential therapy is effective to children with MR.It can effectively enhance the ability of sensory integration,promote intellectual development,improve the ability to adapt to behavior,and improve the satisfaction of family intervention.