学龄前期孤独症谱系障碍儿童交叉式团体与个体沙盘干预的疗效比较

Clinical efficacy of interactive group sandplay versus individual sandplay in the treatment of preschool children with autism spectrum disorder

摘要:

目的 探讨学龄前期孤独症谱系障碍（ASD）儿童交叉式团体与个体沙盘干预的疗效。方法 将80例4~6岁ASD儿童随机分成试验组和对照组，每组40例。试验组患儿与正常儿童以1：3配比交叉式加入团体沙盘，对照组患儿采用一对一个体沙盘干预。以异常行为评定量表（ABC）和孤独症治疗评估量表（ATEC）评估治疗3个月后的整体疗效。结果 实际入选试验组33例，对照组28例。试验组干预3个月后ABC量表情绪不稳、社交退缩、刻板行为因子得分及总分较干预前下降；对照组干预后刻板行为、言语失当得分及总分较干预前下降（P < 0.05）。试验组社交退缩和总分的干预前后差值大于对照组（P < 0.05）。试验组干预3个月后ATEC量表社交、感知觉、行为及总分较干预前下降，对照组语言、社交、行为及总分较干预前下降（P < 0.05）。试验组语言、社交、感知觉和总分的干预前后差值大于对照组（P < 0.01）。干预后试验组目光交流和沙具刻板排列的改善优于对照组（P < 0.05）。结论 个体沙盘和交叉式团体沙盘干预均可改善学龄前ASD患儿的症状。交叉式团体沙盘对ASD患儿的干预效能优于个体沙盘，以社交、情绪及刻板行为改善为著。

Abstract:

Objective To study the clinical efficacy of interactive group sandplay versus individual sandplay in the treatment of preschool children with autism spectrum disorder (ASD). Methods A total of 80 ASD children, aged 4-6 years, were enrolled and randomly divided into experimental and control groups, with 40 children in each group. The children in the experimental group joined group sandplay with normal children at a ratio of 1:3, and those in the control group were treated with individual sandplay. The Aberrant Behavior Checklist (ABC) and Autism Treatment Evaluation Checklist (ATEC) were used to evaluate the treatment outcome after three months of intervention. Results There were 33 children in the experimental group and 28 in the control group. After three months of intervention, the experimental group had significant reductions in the scores of irritability, social withdrawal, and stereotypic behavior and the total score of the ABC scale (P < 0.05), and the control group had significant reductions in the scores of behavior and inappropriate speech and the total score of the ABC scale (P < 0.05). Compared with the control group, the experimental group had significantly greater improvements in the score of social withdrawal and the total score of the ABC scale after three months of intervention (P < 0.05). After three months of intervention, the experimental group had significant reductions in the scores of sociability, sensory and cognitive awareness, and physical/health behavior and the total score of the ATEC scale (P < 0.05), and the control group had significant reductions in the scores of speech, sociability, and physical/health behavior and the total score of the ATEC scale (P < 0.05). Compared with the control group, the experimental group had significantly greater improvements in the scores of speech, sociability, and sensory and cognitive awareness and the total score of the ATEC scale after intervention (P < 0.01). Compared with the control group, the experimental group also had significantly greater improvements in eye contact and sand stereotyped arrangement (P < 0.05). Conclusions Both interactive group sandplay and individual sandplay are effective in the treatment of ASD in preschool children. Interactive group sandplay is better than individual sandplay in the treatment of ASD, with significant improvements in sociability, emotion and stereotypic behavior.