关键反应训练联合视频反馈法家长培训对孤独症谱系障碍儿童的疗效研究

A study on the efficacy of pivotal response treatment combined with video-feedback intervention of parent training on children with autism spectrum disorders

目的:探究关键反应训练(pivotal response training,PRT)联合视频反馈法家长培训对孤独症谱系障碍(autism spectrum disorders,ASD)儿童干预的疗效。方法:选取浙江大学医学院附属儿童医院康复科2020年4—12月诊断为ASD的92例儿童,按照就诊先后顺序分为对照组44例与观察组48例。两组儿童均接受PRT训练,观察组家长接受PRT联合视频反馈法培训,持续8周,每周1次,1次2h。对亲子互动视频采用PRT忠实度检核表测评,儿童康复疗效评价采用Griffiths量表,分别于家长培训前、培训6个月后对两组儿童进行评估。结果:干预后,观察组儿童家长经过2次的家长培训后,PRT忠实度分值与干预前有显著差异(P<0.05),且分值随着培训的次数而提高;观察组儿童Griffiths量表的个人与社会、听力和语言、手眼协调、视觉表现领域进步月龄显著高于对照组(P<0.05),两组儿童运动领域无显著改善(P>0.05)。结论:关键反应训练联合视频反馈法培训对ASD儿童家长有较好的指导作用,能有效提高亲子互动质量,对儿童的个人与社会、听力和语言、手眼协调、视觉领域也具有积极的影响。

Objective:To study the efficacy of pivotal response treatment(PRT) combined with video-feedback intervention of parent training on interventions for children with autism spectrum disorders.Method: Ninety-two children diagnosed with ASD from April 2020 to December 2020 in the rehabilitation department of the Children’s Hospital of Zhejiang University School of Medicine were selected and divided into in control group(44 cases) and observation group(48 cases) according to the order of consultation. The children in both groups were trained in PRT,and the parents in the observation group received pivotal response treatment combined with Video-feedback Intervention for 8 weeks,once a week for 2 hours. The pivotal response treatment fidelity checklist was used for the parent-child interaction video;the Griffiths scale was used for the evaluation of child rehabilitation efficacy,and the two groups of children were assessed before and 6months after the first training.Result:After the intervention,parents of children in the observation group had significantly different Pivotal Response Treatment fidelity scores after 2 parent training sessions than before the intervention(P<0.05),and the scores increased with the number of training sessions;the children in the observation group had significantly higher age of progress in the personal and social, hearing and language, hand-eye coordination, and visual performance domains of the Griffiths scale than those in the control group(P<0.05). No significant improvement in the motor domain for children in both groups(P>0.05).Conclusion:Pivotal response treatment combined with video-feedback intervention is a good guide for parents with autism spectrum disorder,which can effectively improve the quality of parent-child interaction,and also has a positive effect on children’s personal and social,hearing and language,hand-eye coordination,and visual domains.