目的 分析孤独症儿童功能发展与病理行为的相关性。方法 2011年至2014年，采用心理教育评定量表中文修订版(C-PEP)对本中心154例孤独症儿童进行测试。结果 孤独症女童的功能发展中，精细动作、手眼协调、口语认知的得分低于男童(t>2.120, P<0.05)；2~7岁孤独症儿童中，较高年龄组功能发展好于较低年龄组(P<0.05)，但8~10岁组、10岁以上组功能发展得分并未高于6~7岁组。男童与女童的各项病理评分均无显著性差异(P>0.05)；较高年龄组患儿的部分病理行为轻于较低年龄组(P<0.05)。功能发展中“P”(通过)的得分与病理行为中“A”(没有)的得分呈明显正相关(P<0.01)，与病理行为中“S”(严重)的得分呈明显负相关(P<0.01)；功能发展中“F”(不通过)的得分与病理行为中“A”(没有)的得分呈明显负相关(P<0.01)，与病理行为中“S”(严重)的得分呈明显正相关(P<0.01)。结论 孤独症儿童的功能发展与病理行为密切相关，应关注7岁以上孤独症儿童的康复和教育问题。
Objective To investigate the correlation between developmental function and pathological behavior in children with autism. Methods A total of 154 children with autism were tested with Revised Chinese Version Psycho-Educational Profile (C-PEP) during 2011 to 2014. Results The scores of fine movement, hand-eye coordination, and oral language of developmental function were lower in the girls than in the boys (t>2.120, P<0.05). Among the children with autism aged 2-7 years, the developmental function was better in the older group than in the younger group (P<0.05); however, it was not better in the children aged 8-10 years and >10 years than in those aged 6-7 years. There was no difference in the scores of pathological behavior between the girls and the boys (P>0.05). Some pathological behaviors were milder in the older group than in the younger group (P<0.05). The scores of "P" (pass) in developmental function were positively correlated with the scores of "A" (absence) in pathological behavior (P<0.01), and negatively correlated with the scores of "S" (severe) in pathological behavior (P<0.01). The scores of "F" (fail) in developmental function were negatively correlated with the scores of "A" (absence) in pathological behavior (P<0.01), and positively correlated with the scores of "S" (severe) in pathological behavior (P<0.01). Conclusion Developmental function of children with autism is highly correlated with pathological behavior, and the rehabilitation and education of children with autism aged above 7 years should be concerned.
[1] 徐云, 杨健. 自闭症早期发现研究进展[J]. 中国临床心理学杂志, 2014, 22(6): 1023-1027.
[2] 梁兵,马洪卓,邱卓英,等. 3~6岁脑性瘫痪、智力残疾、孤独症儿童活动和参与功能障碍比较[J]. 中国康复理论与实践, 2015, 21(9): 993-995.
[3] 倪伟,熊哲宏. 假装游戏研究:过去、现在及未来[J]. 心理科学, 2007, 30(4): 1020-1022.
[4] 李清,王晓辰,程利国,等. 幼儿攻击性行为装扮游戏矫正的多基线实验研究[J]. 中国心理卫生杂志, 2008, 22(3): 175-178.
[5] 王小英. 学前儿童的游戏与学习:内在的连结性[J]. 学前教育研究, 2013(7): 3-7.
[6] 钟云辉,唐宏. 假想伙伴对5~6岁儿童分享行为的影响[J]. 中国儿童保健杂志, 2014, 22(9): 969-971.
[7] 兰继军,王利平,贾兆娜,等. 中度智力障碍儿童装扮游戏与心理理论发展水平的关系[J]. 中国康复理论与实践, 2013, 19(7): 686-690.
[8] 兰继军,杨伶,张秀,等. 装扮游戏对中度智障儿童心理理论水平的干预[J]. 中国健康心理学杂志, 2013, 21(3): 334-336.
[9] Lillard AS, Kavanaugh RD. The contribution of symbolic skills to the development of an explicit theory of mind [J]. Child Dev, 2014, 85(4): 1535-1551.
[10] Orr E, Geva R. Symbolic play and language development [J]. Infant Behav Dev, 2015, 38: 147-161.
[11] 傅锐,李丹. 儿童的假想伙伴：理论与实证研究[J]. 心理科学, 2010, 33(1): 78-82.
[12] 倪伟. 假装游戏与儿童发展：观点、争论与展望[J]. 南京师范大学学报(社会科学版), 2014(5): 111-118.
[13] Weisberg DS. Pretend play [J]. Wiley Interdiscip Rev Cogn Sci, 2015, 6(3): 249-261.
[14] 毛颖梅. 国外自闭症儿童游戏及游戏干预研究进展[J]. 中国特殊教育, 2011(8): 66-71.
[15] Hobson RP, Lee A, Hobson JA. Qualities of symbolic play among children with autism: a social-developmental perspective [J]. J Autism Dev Disord, 2009, 39(1): 12-22.
[16] 郭家俊. 自闭症儿童装扮游戏能力的研究进展[J]. 中国特殊教育, 2011(6): 52-57.
[17] 王玥, 苏彦. 孤独症儿童的假装理解[J]. 中国特殊教育, 2013(2): 64-70.
[18] 徐云,柴浩. 孤独症儿童心智解读能力训练[M]. 北京:科学出版社, 2015: 11-20.
[19] 肖晓,杨娜,钱乐琼,等. 假装游戏训练对自闭症儿童心理理论的干预研究[J]. 中国临床心理学杂志, 2014, 22(4): 742-745.
[20] Bai Z, Blackwell AF, Coulouris G. Using augmented reality to elicit pretend play for children with autism [J]. IEEE Trans Vis Comput Graph, 2015, 21(5): 598-610.
[21] Hobson JA, Hobson RP, Malik S, et al. The relation between social engagement and pretend play in autism [J]. Br J Dev Psychol, 2013, 31(31): 114-127.
[22] Wolfberg P, Dewitt M, Young GS, et al. Integrated play groups: promoting symbolic play and social engagement with typical peers in children with ASD across settings [J]. J Autism Dev Disord, 2015, 45(3): 830-845.
[23] Hobson JA, Hobson RP, Cheung Y, et al. Symbolizing as interpersonally grounded shifts in meaning: social play in children with and without autism [J]. J Autism Dev Disord, 2015, 45(1): 42-52.
[24] Stagnitti K, Connor C, Sheppard L. Impact of the Learn to Play program on play, social competence and language for children aged 5-8 years who attend a specialist school [J]. Aust Occup Ther J, 2012, 59(4): 302-311.
[25] Pfeifer LI, Queiroz MA, Santos JL, et al. Cross-cultural adaptation and reliability of Child-initiated Pretend Play Assessment (ChIPPA) [J]. Can J Occup Ther, 2011, 78(3): 187-195.
[26] Murdock LC, Hobbs JQ. Picture me playing: increasing pretend play dialogue of children with autism spectrum disorders [J]. J Autism Dev Disord, 2011, 41(7):870-878.
