不同方法干预3~6岁轻中度孤独症谱系障碍儿童共同注意的效果

doi:10.3969/j.issn.1006-9771.2024.08.003

Abstract

Abstract:

Objective To compare the effect of discrete trial training (DTT), pivotal response treatment (PRT) and a combination of DTT and PRT on joint attention in children aged three to six years with mild to moderate autism spectrum disorder (ASD).

Methods From January, 2023 to March, 2024, 39 children with ASD aged 36 to 72 months in Tiger Children's Rehabilitation Center in Shanghai were randomly divided into DTT, PRT and combination groups, who received DTT, PRT and a combination of DTT and PRT, respectively, for ten weeks. They were assessed with Joint Attention Assessment Scale for children with ASD before and after intervention.

Results Two cases in DTT group and one case in PRT group dropped down, resulting in a final sample of 36 cases. The main effects of group (F= 11.225, P< 0.001) and time (F= 416.935, P< 0.001) were significant, as well as the interaction (F= 10.501, P< 0.001), and the combination group was the best during intervention and follow-up (P < 0.05).

Conclusions Both DTT and PRT may improve joint attention in children with ASD, and the combination of DTT and PRT is the best.

Key words: autism spectrum disorder, children, joint attention, discrete trial training, pivotal response treatment

CLC Number:

R749.93

YANG Yuran, WANG Qian, CHEN Cuicui, DU Xiaoxin. Effect of different interventions on joint attention in children aged three to six years with mild to moderate autism spectrum disorder[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(8): 888-893.

Figures/Tables 6

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References 35

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儿童目标行为	提示等级	举例
完全失败	T1：语言+肢体动作提示	当幼儿无法跟随指示去看目标时，再次重复指导语“你看这只兔子”，并且轻轻扶住孩子头部，调整角度，看向训练者，再面向目标。
连续3次使用T1提示成功或肢体提示力度很轻	T2：语言+动作示范提示	当轻微触碰幼儿头部就可以成功看向目标时，再次重复指导语，并演示动作，告诉幼儿“可以向我一样，看着这只兔子”。
连续3次使用T2成功或主动关注教师行为	T3：语言提示	当幼儿主动观察教师动作或有视线接触时，教师可以再次重复指导语，“你看这只兔子，它有雪白的皮毛”。
有成功迹象但持续时间很短	T4：物理空间线索提示	幼儿目光在“兔子”上短暂停留但很快飘走，可以将“兔子”移近或用手指再次轻点目标。

变量	组别	n	$\bar{x}\pm s$	F值	P值
实际月龄	DTT组	11	58.727±8.223	0.797	0.459
	PRT组	12	53.667±10.021
	混合组	13	56.308±10.291
心理月龄	DTT组	11	40.818±7.222	0.429	0.655
	PRT组	12	43.583±7.452
	混合组	13	43.077±8.005

组别	n	基线	干预期	迁移期
DTT组	11	20.061±1.775	58.909±11.772	49.273±10.403
PRT组	12	20.057±1.255	67.667±17.159	59.667±15.156
混合组	13	20.103±0.810	81.539±11.200	76.000±11.343

变量	SS	df	MS	ηp²	F值	P值
干预方法	5001.042	2	2500.521	0.405	11.225	< 0.001
干预阶段	50384.234	2	25192.117	0.927	416.935	< 0.001
交互作用	2437.875	4	634.469	0.389	10.501	< 0.001

干预阶段		平均值差值(I-J)	标准误差	P值
基线期	干预期	-49.298	2.296	< 0.05
基线期	迁移期	-41.573	2.098	< 0.05
干预期	迁移期	7.725	0.667	< 0.05

Effect of different interventions on joint attention in children aged three to six years with mild to moderate autism spectrum disorder

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因素			平均值差值 (I-J)	标准误差	P值
干预阶段	干预方法		平均值差值 (I-J)	标准误差	P值
基线期	DTT组	PRT组	0.004	0.547
	DTT组	混合组	-0.042	0.537
	PRT组	混合组	-0.046	0.525
干预期	DTT组	PRT组	-8.758	5.689
	DTT组	混合组	-22.629	5.583	< 0.05
	PRT组	混合组	-13.872	5.456	< 0.05
迁移期	DTT组	PRT组	-10.394	5.216
	DTT组	混合组	-26.727	5.119	< 0.05
	PRT组	混合组	-16.333	5.002	< 0.05

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