摘要
目的:观察奖励法语言训练对孤独症儿童语言交流障碍的疗效。方法:将35例孤独症儿童分为奖励语言训练组(2003-10/2005-05佛山市第一人民医院康复科的20例病例)和对照组(2001-09/2003-10佛山市第一人民医院康复科的15例病例)。奖励语言训练组采用奖励法进行语言训练,包括对视、注意力、配对、模仿口部肌肉运动和发音、家庭的强化训练,每项训练均给予奖励,利用奖品训练。训练采用一对一方式,每周训练五六次,45min/次,疗程为3～6个月。对照组采用常规言语训练,无奖品。训练前后根据CRRC版S-S法语言发育迟缓检查法对患儿进行评定,分4个阶段进行,阶段1-事物、事物状态理解困难阶段;阶段2-事物的基础概念阶段;阶段3-对事物用符号理解表达阶段;阶段4-组句(语言规则)阶段。日常生活交流态度评估,共分7大项进行,①对他人行为的注视。②视线交流。③对他人的指示、问候、招呼的反应。④向他人表达意愿。⑤感情起伏的表现。⑥提问-回答关系。⑦特征性言语。疗效评定:语言状态在同一阶段有进步者为好转,上升一阶段者为显效,无进步者为无效。每月评估1次。结果:35例患儿均进入结果分析。①语言发育阶段评估:治疗前奖励语言训练组和对照组为第1阶段的患者分别为11例(55%)、8例(53.3%)(z=0.097,P=0.934),治疗后仍为第1阶段者分别为1例(5%)、3例(20%),奖励语言训练组有8例达到第3阶段,1例达到第4阶段,而对照组只有1例达到第3阶段(z=2.571,P=0.010),奖励语言训练组治疗前后比较差异显著(z=4.102,P<0.001);对照组治疗前后比较差异显著(z=1.983,P=0.047)。②临床疗效:奖励语言训练组显效14例(70%),总有效率95%,对照组显效6例(40%),总有效率73.3%(P<0.05)。③日常生活交流态度:奖励语言训练组和对照组治疗前均为交流态度不良(Ⅱ群),治疗后奖励语言训练组19例(95%)交流态度良好,对照
AIM： To observe the effect of language therapy with encouragement on communicative disability in autistic children.
METHODS： Thirty-five children with autism .in the Department of Rehabilitation, Foshan First People＇s Hospital were divided into test group （20 cases admitted between October 2003 and May 2005） and control group （15 cases admitted between September 2001 and October 2003）. The children in the test group were given language therapy with encouragement, including eye contact, attention, matching, imitating mouth muscular movement and pronunciation, and family reinforced training, which encouraged them to do well and trained with prize food or toy. The training was given one to one, 5 or 6 time a week, 45 minutes for each time, and the course was 3-6 months. The children in the control group were treated with conventional language therapy without prize. All the children were evaluated with CRRC sign-signification relations assessment and communication attitude of daily living before and after training, it had 4 stages： stage 1 was difficult to understand, stage 2 was basic concept, stage 3 was understanding and expression with symbol, stage 4 was expression with regular language. ,The assessment of communication attitude of daily living had 7 items： （1） visual fixation on other＇s behavior; （2） eye communication; （3） reaction to other＇s instruction, regards and greeting; （4）expression of will to others; （5） manifestation of affective fluctuation; （6） question-answer relation; （7） characteristic words. Effect evaluation： improvement of language status at the same stage was taken as turn to better; improved by one stage as significant effect, and no improvement as valid. They were evaluated once a month.
RESULTS： All the 35 children were involved in the result analysis. （1） Language development stage： Before training, there were 11 cases （55%） and 8 cases （53.3%） on stage 1 in the test group and control group respectively （z=0.097, P=
出处
《中国临床康复》
CSCD
北大核心
2006年第10期69-71,共3页
Chinese Journal of Clinical Rehabilitation
