基于体脑综合评价的3~6岁ASD儿童动作技能测评体系构建与实证研究

Construction and empirical study of motor skills evaluation system for 3-6 years old ASD children with body brain comprehensive evaluation

采用德尔菲(Delphi)法和层次分析(AHP)法构建3~6岁ASD儿童动作技能测评体系;采用实验法对8名3~6岁轻度ASD儿童进行动作技能、体质水平和脑电图(EEG)的综合分析.结果表明:1)依据儿童生长发育里程碑、动作发展顺序规律、ASD儿童核心症状和生活技能发展,采用Delphi法构建3~6岁ASD动作技能测评体系,包括一级指标4项、二级指标15项、三级指标39项.本研究立足ASD儿童动作技能教育与干预建立测评指标,是针对ASD儿童发育规律和核心症状开展评测→干预→教育→反馈→提升的结合体.测评体系通过信效度检验,具有科学性和实用性,便于一线ASD融合教育工作者开展测评和教育活动.2)ASD儿童存在显著的动作技能、体质水平、脑电活动的异常和低下状态.其动作技能均分由高到低依次为BCS、BMS、OCS、HFS,其中OCS和HFS受认知发展影响大.各脑区多波段的异常激活、delta和theta波能量高,alpha波能量低,导致儿童注意力无法集中、感觉加工异常.体质评分及格率低,影响ASD儿童健康相关入学准备水平和未来参与学校教育的能力.ASD儿童亟待开展以动作技能为切入点的体脑发育综合干预和教育,以促进ASD儿童融入学校教育,获得康复和发展.

The Delphi and analytic hierarchy process methods were used to establish a motor skill evaluation system for ASD children from 3-6 years old,to assess their level of body and brain development.Eight children with mild ASD(M:F=6:2)aged 3-6 years were examined for their motor skills,physical fitness and EEG.The motor skill evaluation system includes:4 first level indicators,15 second level indicators and 39 third level indicators.The motor skills are divided into:body control skills(BCS)>body movement skills(BMS)>object control skills(OCS)>hand fine skills(HFS).OCS and HFS are greatly affected by ASD disease characteristics and cognitive development.The unqualified rate of ASD children was 87.5%.ASD children showed higher power in delta waves in prefrontal and occipital cortex,theta waves in parietal,prefrontal and occipital lobes,alpha waves in parietal lobes,beta and gamma waves in left and right temporal lobes.Whole brain relative power topographic maps revealed higher energy delta and theta waves in ASD children,but lower energy alpha and gamma waves,these were correlated with ASD children’s inability to focus and to abnormal sensory processing.ASD children need comprehensive intervention and education on body and brain development,to promote their integration into school education,rehabilitation and development.