不同引导行为下中重度孤独症谱系障碍幼儿回应共同注意的特征

doi:10.3969/j.issn.1006-9771.2024.08.002

《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (8): 882-887.doi: 10.3969/j.issn.1006-9771.2024.08.002

不同引导行为下中重度孤独症谱系障碍幼儿回应共同注意的特征

韩旭伶¹, 赵航¹, 孙睦迪¹, 赵梅萍¹, 王艳霞¹, 刘敏², 瞿璐², 刘巧云¹()

1.华东师范大学教育学部康复科学系，上海市 200062
2.上海智能教育研究院，上海市 200062

收稿日期:2024-07-10 出版日期:2024-08-25 发布日期:2024-09-11
通讯作者: 刘巧云，女，博士，教授，主要研究方向：儿童语言评估、发展与促进。E-mail： qyliu@spe.ecnu.edu.cn
作者简介:韩旭伶(1998-)，女，汉族，山西运城市人，硕士研究生，主要研究方向：沟通障碍康复。
基金资助:
上海市教育委员会科研创新计划项目(2023SKZD07);中国博士后科学基金面上项目(2023M731103);中国博士后科学基金面上项目(2023M731104);国家语委"十四五"科研规划一般项目(YB145-21);国家重点研发计划项目(2022YFC2705201)

Characteristics of response to joint attention under diverse guiding behaviors in preschoolers with moderate to severe autism spectrum disorder

HAN Xuling¹, ZHAO Hang¹, SUN Mudi¹, ZHAO Meiping¹, WANG Yanxia¹, LIU Min², QU Lu², LIU Qiaoyun¹()

1. Department of Rehabilitation Sciences, Faculty of Education, East China Normal University, Shanghai 200062, China
2. Shanghai Institution of AI Education, Shanghai 200062, China

Received:2024-07-10 Published:2024-08-25 Online:2024-09-11
Supported by:
Shanghai Municipal Education Commission Research and Innovation Program(2023SKZD07);China Postdoctoral Science Foundation (General)(2023M731103);China Postdoctoral Science Foundation (General)(2023M731104);National Language Commission 14th Five Year Plan for Scientific Research (General)(YB145-21);National Key Research and Development Program(2022YFC2705201)

摘要/Abstract

摘要：

目的探究不同引导行为下中重度孤独症谱系障碍(ASD)幼儿回应共同注意的特征。

方法 2023年3月到5月，从嘉兴市阳光康教园选取21例中重度ASD幼儿、16例与其同龄的发育迟缓幼儿，从附近幼儿园选择16例与其同龄的典型发育幼儿，进行回应共同注意试验，观察回应人数、回应率、回应所需引导行为的变异系数。

结果 ASD幼儿中，约半数能在转头引导下回应，其余需在提示度更高的引导行为下回应；转头引导下，ASD组回应率低于典型发育组(χ² > 6.170, P < 0.05)；ASD组引导行为的变异系数大于典型发育组(d = 4.039, P < 0.001)。

结论中重度ASD幼儿具备回应共同注意的基本能力，但弱于典型发育儿童。评估和干预ASD幼儿的回应共同注意能力时应关注主试的引导行为。

关键词: 孤独症谱系障碍, 回应共同注意, 引导行为, 幼儿

Abstract:

Objective To explore the characteristics of response to joint attention (RJA) under diverse guiding behaviors for preschoolers with moderate to severe autism spectrum disorder (ASD).

Methods From March to May, 2023, 21 children with moderate to severe ASD and 16 children with developmental delays matched the physiological ages were selected from Jiaxing Sunlight Rehabilitation Kindergarten, and 16 typical developmental children matched the physiological ages were selected from the kindergartens nearby. They accepted a behavioral experiment on RJA. The number of RJA, frequence of RJA and the coefficient of variation of guiding behaviors needed to RJA were compared among the three groups.

Results About half of the ASD group responded after guiding of head-turning, and the others required higher levels of guiding. The frequence of RJA after guiding of head-turning was less in the ASD group than in the typical development group (χ² > 6.170, P < 0.05), and the coefficient of variation of guiding behaviors was more (d = 4.039, P < 0.001).

Conclusions Preschoolers with moderate to severe ASD are able to respond to joint attention, and this ability is poorer than typically developing children. The guiding behavior of the evaluator should be considered in assessing and intervening RJA in preschoolers with ASD.

Key words: autism spectrum disorder, response to joint attention, guiding behavior, preschooler

中图分类号:

R749.93

韩旭伶, 赵航, 孙睦迪, 赵梅萍, 王艳霞, 刘敏, 瞿璐, 刘巧云. 不同引导行为下中重度孤独症谱系障碍幼儿回应共同注意的特征[J]. 《中国康复理论与实践》, 2024, 30(8): 882-887.

HAN Xuling, ZHAO Hang, SUN Mudi, ZHAO Meiping, WANG Yanxia, LIU Min, QU Lu, LIU Qiaoyun. Characteristics of response to joint attention under diverse guiding behaviors in preschoolers with moderate to severe autism spectrum disorder[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(8): 882-887.

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变量	ASD组(n = 21)		DD组(n = 16)		TD组(n = 16)
变量	中位数	四分位距	中位数	四分位距	中位数	四分位距
月龄/月	63.00	16.00	57.00	18.00	53.50	19.00
MSEL/年龄当量
视觉理解	29.00	12.00	53.00	25.00	60.00	18.00
精细运动	26.00	20.00	43.50	33.00	65.00	21.00
语言理解	25.00	22.00	36.50	21.00	59.00	14.00
语言表达	16.00	22.00	38.00	23.00	58.00	17.00
韦氏智商	58.00^a	9.12	69.81	14.29	106.69	15.17

变量	H值	P值	ASD vs. DD		ASD vs. TD		DD vs. TD
变量	H值	P值	Z值	P值	Z值	P值	Z值	P值
月龄	4.171	0.124
MSEL/年龄当量
视觉理解	21.500	< 0.001	-2.457	0.042	4.608	< 0.001	2.019	0.130
精细运动	19.790	< 0.001	-2.002	0.136	4.448	< 0.001	2.295	0.065
语言理解	26.839	< 0.001	-1.766	0.232	5.155	< 0.001	3.181	0.004
语言表达	28.375	< 0.001	-1.257	0.626	5.211	< 0.001	3.711	0.001
韦氏智商	34.303	< 0.001	-1.944	0.156	5.813	< 0.001	3.671	0.001

引导目标	χ²值	P值	ASD vs. DD		ASD vs. TD		DD vs. TD
引导目标	χ²值	P值	χ²值	P值	χ²值	P值	χ²值	P值
右前海报	6.356	0.042	0.108	1.000	6.170	0.039	4.571	0.099
左后海报	9.025	0.011	0.271	1.000	8.819	0.009	6.000	0.042
正前海报	6.284	0.043	1.271	0.780	6.170	0.039	2.133	0.432
右侧海报	7.782	0.020	1.975	0.480	7.439	0.018	2.133	0.432
玩具鸭	2.164	0.339	0.567	1.000	0.689	1.000	2.133	0.432

组别	n	中位数	四分位距
ASD组	21	0.50	0.28
DD组	16	0.37	0.41
TD组	16	0.00	0.00

组别	H值	P值	d值	P值
总体	16.324	< 0.001
ASD vs. DD			-1.665	0.288
ASD vs. TD			4.039	< 0.001
DD vs. TD			2.228	0.078

不同引导行为下中重度孤独症谱系障碍幼儿回应共同注意的特征

Characteristics of response to joint attention under diverse guiding behaviors in preschoolers with moderate to severe autism spectrum disorder

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引导目标	组别	n	①	②	③	④	⑤
右前海报(A-1)	ASD	21	12	3	2	1	3
	DD	16	10	3	1	2	0
	TD	16	15	1	0	0	0
左后海报(B-2)	ASD	21	10	5	2	4	0
	DD	16	9	4	1	1	1
	TD	16	15	1	0	0	0
正前海报(C-3)	ASD	21	12	4	4	1	0
	DD	16	12	3	0	0	1
	TD	16	15	0	0	1	0
右侧海报(D-4)	ASD	21	11	4	0	3	3
	DD	16	12	2	1	1	0
	TD	16	15	1	0	0	0
玩具鸭	ASD	20	17	2	1	0	0
	DD	16	12	2	1	1	0
	TD	16	15	1	0	0	0

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