摘要
目的:探讨早期介入丹佛模式(ESDM)对不同病情程度孤独症儿童康复的效果。方法:120例孤独症患儿随机分为试验组及对照组,每组60例;根据美国《精神障碍诊断与统计手册》第5版(DSM-5)病情分级标准(Ⅰ~Ⅲ级)对入组者进行评估;试验组采用ESDM治疗,对照组采用传统康复治疗,持续6个月。分别于干预前及干预6个月后采用儿童孤独症评定量表(CARS)、心理教育量表第3版(PEP-3)对入组者进行评估;以PEP-3评分提高≥5%为有效。结果:干预前两组各级患儿间CARS、PEP-3得分比较差异无统计学意义。干预后,两组各级患儿CARS评分均较治疗前明显升高;试验组中Ⅰ、Ⅱ级患儿CARS得分明显低于对照组(P<0.05或P<0.01);试验组Ⅰ、Ⅱ级患儿PEP-3中的模仿、情感表达、社交互动、非语言行为特征的有效率显著高于对照组(P均<0.05);两组Ⅲ级患儿间CARS、PEP-3评分差异无统计学意义。结论:与常规干预模式相比,ESDM对轻、中度孤独症儿童干预效果更佳,尤其改善模仿及不良行为效果明显;但对重度孤独症患儿无明显优势。
Objective:To explore the effect of early intervention Denver model(ESDM) on the rehabilitation of autistic children with different severity.Method:120 children with autism were randomly divided into trial group and control group,with 60 cases in each group.The participants were assessed according to the criteria of disease classification(grade I-Ⅲ) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders(DSM-5);The trial group was treated with ESDM,and the control group was treated with traditional rehabilitation for 6 months.Before and 6 months after the intervention,the participants were assessed with the Children Autism Rating Scale(CARS) and the Psychological Education Scale version 3(PEP-3).It was regarded as effective to improve PEP-3 score by ≥ 5%.Results:There were no significant differences in the scores of CARS and PEP-3 between the two groups before intervention.After the intervention,the CARS scores of children at all levels in both groups were significantly improved compared with those before treatment.The scores of CARS of grade Ⅰ and Ⅱ children in the trial group were significantly lower than those in the control group(P<0.05 or P<0.01).The effective rates of imitation,emotional expression,social interaction and non-verbal behavior characteristics of PEP-3 in children of grade Ⅰ and Ⅱ in the trial group was significantly higher than that in the control group(P<0.05).There was no significant difference in the scores of CARS and PEP-3 between the two groups.Conclusion:Compared with conventional intervention mode,ESDM has better effect on children with mild and moderate autism,especially in improving imitation and bad behavior.But it has no obvious advantage for children with severe autism.
作者
季倩倩
王敏
仇爱珍
鲍克秀
王军
JI Qian-qian;WANG Min;QIU Ai-zhen;BAO Ke-xiu;WANG Jun(Department of Rehabilitation,Xuzhou Children’s Hospital Affiliated to Xuzhou Medical University,Xuzhou 221006,China)
出处
《临床精神医学杂志》
CAS
2022年第6期458-461,共4页
Journal of Clinical Psychiatry
基金
江苏省妇幼健康科研项目(F201355)。
关键词
早期介入丹佛模式
孤独症谱系障碍
干预效果
early intervention Denver mode
autism spectrum disorder
intervention effect
