孤独症儿童在象征性游戏中的典型行为分析

doi:10.3969/j.issn.1006-9771.2023.01.002

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (1): 6-11.doi: 10.3969/j.issn.1006-9771.2023.01.002

• 专题儿童心理与行为康复 • 上一篇下一篇

孤独症儿童在象征性游戏中的典型行为分析

吕攀攀, 徐冲锋, 高文婷, 刘聪聪, 耿立蒙, 刘芳()

滨州医学院附属医院儿童保健科，山东滨州市 256603

收稿日期:2022-11-22 修回日期:2022-12-19 出版日期:2023-01-25 发布日期:2023-02-17
通讯作者: 刘芳，女，汉族，山东滨州市人，副主任医师，主要研究方向：孤独症谱系障碍筛查及干预，E-mail： zhshlldy@163.com。
作者简介:吕攀攀(1985-)，女，汉族，山东淄博市人，主治医师，主要研究方向：孤独症谱系障碍筛查及干预。
基金资助:
1.山东省自然科学基金项目(ZR2022MH036);2.山东省医药卫生科技发展计划项目(202006040694)

Typical behavior analysis of children with autism in symbolic play

LÜ Panpan, XU Chongfeng, GAO Wenting, LIU Congcong, GENG Limeng, LIU Fang()

Department of Children's Health Care, Binzhou Medical University Hospital, Binzhou, Shandong 256603, China

Received:2022-11-22 Revised:2022-12-19 Published:2023-01-25 Online:2023-02-17
Contact: LIU Fang, E-mail: zhshlldy@163.com
Supported by:
Natural Science Foundation of Shandong Province(ZR2022MH036);Health Science and Technology Development Program of Shandong Province(202006040694)

摘要/Abstract

摘要：

目的探讨孤独症儿童在象征性游戏中的典型行为特点，并分析象征性游戏测试(SPT)在孤独症早期识别中的价值。

方法收集2021年11月至2022年9月在滨州医学院附属医院儿童保健科以语言问题就诊的儿童260例，确诊孤独症患儿193例为观察组，健康儿童67例为对照组，均行SPT，探讨孤独症儿童SPT中的典型行为特点，并对SPT结果进行信效度分析。采用Gesell发育量表(GDS)适应性及个人社交进行评分，与SPT总分进行相关性分析。

结果孤独症儿童SPT评估Cronbach α系数为0.835~0.935，SPT总分以及以物代物、虚构属性、虚构客体评分之间均呈正相关(r > 0.607, P < 0.001)。观察组SPT评分显著低于对照组(t > 9.615, P < 0.001)。SPT总分与GDS适应性和个人社交发育商均呈正相关(r > 0.609, P < 0.001)。

结论孤独症儿童典型行为可以在象征性游戏中得到体现，SPT可以为孤独症早期识别提供线索。

关键词: 孤独症, 象征性游戏, 典型行为

Abstract:

Objective To explore the typical behavior characteristics of children with autism in symbolic play and the value of Symbolic Play Test (SPT) in the early identification of autism.

Methods From November, 2021 to September, 2022, a total of 260 children with language problems were collected from Department of Children's Health Care of Binzhou Medical University Hospital. A total of 193 children with autism were as observation group and 67 normal children were as control group. All children played symbolic games. The typical behavioral characteristics of children with autism in SPT were explored, and a reliability and validity analysis based on the results of SPT was conducted. They were assessed with the adaptive and personal social scores of Gesell Development Scale, and the correlation of the scores of Gesell Development Scale and the score of SPT was analyzed.

Results The Cronbach's α coefficient of SPT of children with autism was 0.835 to 0.935, and the total score of SPT, the scores of surrogate object, fictional attribute and fictional object were positively correlated with each other (r> 0.607, P< 0.001). The SPT scores decreased in the observation group (t> 9.615, P< 0.001), and SPT score positively correlated with adaptability and personal-social development quotient (r> 0.609, P< 0.001).

Conclusion Typical behavior of children with autism can be reflected in symbolic play, and SPT can provide clues for early identification of autism.

Key words: autism, symbolic play, typical behavior

中图分类号:

R749.93

吕攀攀, 徐冲锋, 高文婷, 刘聪聪, 耿立蒙, 刘芳. 孤独症儿童在象征性游戏中的典型行为分析[J]. 《中国康复理论与实践》, 2023, 29(1): 6-11.

LÜ Panpan, XU Chongfeng, GAO Wenting, LIU Congcong, GENG Limeng, LIU Fang. Typical behavior analysis of children with autism in symbolic play[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(1): 6-11.

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组别	n	性别(男/女)/n	年龄/月
对照组	67	46/21	29.85±7.56
观察组	193	138/55	31.63±7.41
χ²/F值		0.171	1.389
P值		0.680	0.240

组别	n	以物代物	虚构属性	虚构客体	总分
对照组	67	3.87±1.41	5.24±2.08	3.01±1.63	13.30±4.78
观察组	193	2.13±0.73	2.74±1.38	0.83±0.87	5.71±2.63
t值		13.754	9.615	11.014	17.434
P值		< 0.001	< 0.001	< 0.001	< 0.001

指标	r值	P值
以物代物vs.总体行为	0.820	< 0.001
虚构属性vs.总体行为	0.922	< 0.001
虚构客体vs.总体行为	0.851	< 0.001
以物代物vs.虚构属性	0.649	< 0.001
以物代物vs.虚构客体	0.607	< 0.001
虚构属性vs.虚构客体	0.653	< 0.001

组别	n	SPT月龄/月	GDS
组别	n	SPT月龄/月	适应性发育商	适应性月龄/月	个人社交发育商	个人社交月龄/月
对照组	67	23.50±6.04	82.57±10.96	24.40±6.41	86.40±10.98	25.50±6.38
观察组	193	10.49±7.44	48.75±9.47	16.06±4.01	42.20±10.64	14.24±4.07
t值		-12.901	-14.156	-12.289	-19.062	-16.655
P值		< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

孤独症儿童在象征性游戏中的典型行为分析

Typical behavior analysis of children with autism in symbolic play

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行为	Cronbach α
以物代物	0.928
虚构属性	0.854
虚构客体	0.835
总体行为	0.935

GDS	r值	P值
适应性发育商	0.609	< 0.001
个人社交发育商	0.672	< 0.001

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