早期介入丹佛模式下个性化训练联合行为分析疗法在孤独症谱系障碍患儿中的应用研究

Effects of personalized training based on early start Denver model combined with applied behavior analysis in children with autism spectrum disorder

目的按探讨早期介入丹佛模式(early startDenvermodel,ESDM)下个性化训练联合行为分析疗法(applied behaviour analysis,ABA)对孤独症谱系障碍(autism spectrum disorder,ASD)患儿的干预效果。方法采用便利抽样法,选取于2021年1月-2023年1月在绍兴市第七人民医院就诊的90例ASD患儿及其照顾者为研究对象。采用随机数字表法按1:1比例将其分为两组,对照组给予常规康复训练,观察组给予ESDM下个性化训练联合ABA。两组均干预6个月。分别采用儿童孤独症评定量表(CARS)、孤独症行为量表(ABC)、Gesell儿童发育量表(GDS)、S-S语言发育迟缓评估、婴儿-初中学生社会生活能力(S-M)量表和改良Barthel指数(MBI)记录两组ASD患儿干预前后的效果。结果干预6个月后,观察组ASD患儿CARS和ABC评分低于对照组,GDS各维度及总发育商得分、S-S语言发育迟缓评估得分、S-M量表和MBI评分均高于对照组,差异均具有统计意义(均P<0.05)。结论ESDM下个性化训练联合ABA康复模式效果良好,能够改善ASD患儿的孤独症状,减轻认知、语言、行为功能障碍,提高社会适应能力和日常生活活动能力。

Objective To explore the effect of personalized training based on early start Denver model(ESDM)combined with applied behavior analysis(ABA)in children with autism spectrum disorder(ASD).Methods From January 2021 to January 2023,convenience sampling was used to select 90 children with ASD who received treatment at the Shaoxing Seventh People's Hospital and their caregivers as research subjects.The children were divided into two groups using a random number table method in a 1:1 ratio.The control group received routine rehabilitation,while the observation group was treated with personalized training based on ESDM combined with ABA.Both groups were intervened for six months.Children's Autism Rating Scale(CARS),Autism Behavior Checklist(ABC),Gesell Developmental Schedule(GDS),Sign-Significate Relation(S-S)Language Development Delay Assessment,Social Life Ability Scale for Infant-Junior Middle School Students(S-M),and Modified Barthel Index(MBI)were used to evaluated the effects of intervention on two groups of ASD children before and after intervention.Results After six months of intervention,the CARS and ABC scores of ASD children in the observation group were lower than those in the control group,and the scores of CDS dimensions and total developmental quotient,S-S Language Development Delay Assessment score,S-M score,and MBI score were higher than those in the control group,and the differences were statistically significant(all P<0.05).Conclusions Personalized training based on ESDM combined with ABA has a good effect,which can improve loneliness symptoms of children with ASD,alleviate cognitive,language,and behavioral dysfunction,enhance social adaptation ability and activities of daily living.