团体认知行为治疗联合家庭早期干预在孤独症谱系障碍中的临床应用

Clinical application of parents group cognitive-behavior therapy combined with early family intervention on children with autism spectrum disorders

目的:探究团体认知行为治疗联合家庭早期干预在孤独症谱系障碍(autism spectrum disorders,ASD)干预中的临床应用价值。方法:回顾性分析在徐州医科大学附属徐州儿童医院接受治疗的63例ASD患者及其家庭的资料,按照不同的干预方式分为对照组(n=30)与研究组(n=33)。两组均实施团队指导下的家庭早期干预,研究组在此基础上联合父母团体认知行为治疗。比较两组患者盖塞尔发育量表(Gesell量表)、孤独症疗效评估量表(Autism Treatment Evaluation Checklist,ATEC)、孤独症行为量表(Autism Behavior Checklist,ABC)评分及家长焦虑自评量表(Self-rating Anxiety Scale,SAS)评分。结果:与干预前相比,干预后两组Gesell量表5个领域(适应性、粗大运动、精细运动、语言、个人社会)评分均明显升高(均P<0.05),且研究组Gesell量表的适应性、语言、个人社会领域较对照组明显升高(P<0.05);与干预前相比,干预后两组ATEC 4个领域(语言、社交、感知、行为)及ABC评分均明显降低(均P<0.05),且与对照组比较,研究组明显降低(P<0.05);与干预前相比,干预后,研究组家长SAS评分降低(P<0.05),而对照组无改变(P>0.05);单因素方差分析显示:干预前,家长SAS得分F值为22.454,P<0.05,干预后两组间比较F值为414.596,P<0.05。结论:团体认知行为治疗联合家庭早期干预可有效改善ASD患儿临床症状及家长焦虑指数,提高疗效。

Objective: To explore the clinical effects of parents group cognitive-behavior therapy combined with early family intervention on the children with autism spectrum disorders(ASD). Methods: A total of 63 children with ASD who received treatment in Xuzhou Children’s Hospital Affiliated to Xuzhou Medical University and their family were retrospectively divided into a control group(n=30) and a study group(n=33). The 2 groups were received team-guided family early intervention, and the study group combined with the parents group cognitive behavioral therapy on this basis. Gesell scale, Autism Treatment Evaluation Checklist(ATEC) and Autism Behavior Checklist(ABC) were used to evaluate the abilities of children with ASD. And the Self-rating Anxiety Scale(SAS) was used to measure the severity of anxiety in parents of these children. Results: Compared with before intervention, the scores of five functional areas(adaptability, gross motor, fine motor, language and personal-social) of the Gesell scale in the 2 groups increased significantly a?ter intervention(all P<0.05), and the adaptability, language and personal-social areas of Gesell scale in the study group increased significantly compared with the control group(P<0.05). Compared with before intervention, ATEC domains(language, social, perception, behavior) and ABC scores in the 2 groups were significantly reduced a?ter intervention(P<0.05), and compared with the control group, the study group was significantly reduced(all P<0.05). Compared with parents’ SAS score before the intervention, the study group significantly decreased(P<0.05), while the control group did not significantly decrease(P>0.05). One-way analysis of variance showed that the F value of parents’ SAS score before intervention was 22.454(P<0.05), and the comparison F value between the 2 groups after the intervention was 414.596(P<0.05). Conclusion: Group cognitive behavior therapy for patients combined with early family intervention with ASD can effectively improve the clinical symptoms of autism patients and parental anxiety index.