儿童自闭症的综合干预及影响因素研究

发布时间：2018-03-23 14:10

本文选题：儿童　切入点：自闭症　出处：《锦州医科大学》2017年硕士论文

【摘要】：目的研究在综合干预前后自闭症患儿各方面能力的变化,比较不同性别、年龄等背景条件对综合干预的影响,探讨综合干预效果及影响自闭症患儿康复效果的因素,为进一步提高康复效果以及改进康复方案提供依据与指导。方法选取2014-2016学年在辽宁省锦州地区两所特殊教育学校进行康复训练的89例自闭症儿童作为研究对象。自闭症儿童接受训练时的年龄在2-7岁之间,其中男孩68名、女孩21名。综合干预的措施主要有:运动综合训练、语音训练、认知训练、游戏训练、生活自理训练、艺术训练和电脑游戏等课程。每周周一到周六上课,其中大课上午为4课时,下午为3课时,定期开展一对一个训课,每次课半小时。每次课后训练教师会对课程情况及每个孩子的表现作出评估记录,患儿接受训练前进行第一次评估,训练1个学期后进行第二次评估,训练1个学年后进行第三次评估。评估工具采用中残联统一发行使用的《孤独症儿童发展评估表》。数据分析采用t检验、方差分析等方法对评估结果进行分析,对比三次评估得分是否存在显著差异,比较患儿背景因素对综合干预康复效果是否有显著影响。结果1、89名患儿在感知觉、粗大动作、精细动作、语言与沟通、认知、社会交往、生活自理、情绪与行为等8项评估中,干预训练前后及两次训练之间得分差异均有统计学意义。8项得分训练后半年均高于训练前,训练后1年均高于训练后半年。2、对感知觉的干预在患儿性别(t=4.267,P=0.000)、独生与否(t=4.180,P=0.000)、睡眠情况(t=2.065,P=0.042)、饮食情况(t=2.795,P=0.008)、家庭经济状况(t=2.626,P=0.011)、父母婚姻状况(t=3.649,P=0.001)因素中差异有统计学意义。其中男孩、非独生子女、睡眠较差、饮食较好、家庭经济状况较差和父母未离异的患儿评估分数差值较大。3、对粗大动作的干预在患儿居住地(t=4.410,P=0.000)、独生与否(t=6.023,P=0.000)、家长信心(t=2.655,P=0.010)、年龄(F=6.584,P=0.002)因素中差异有统计学意义。其中农村、非独生子女、家长无信心、6-7岁的患儿评估分数差值较大。4、对精细动作的干预在患儿性别(t=2.225,P=0.031)、居住地(t=3.485,P=0.001)、父母学历(t=5.905,P=0.000)、家长重视程度(t=7.429,P=0.000)、家长信心(t=2.375,P=0.021)、病情(F=15.222,P=0.000)、年龄(F=4.484,P=0.014)因素中差异有统计学意义。其中男孩、城镇、父母低学历、家长重视、家长有信心、轻度病情、4-6岁的患儿评估分数差值较大。5、对语言与沟通的干预在患儿性别(t=3.137,P=0.004)、独生与否(t=4.357,P=0.000)、睡眠情况(t=4.054,P=0.000)、饮食情况(t=5.405,P=0.000)、家庭经济状况(t=2.443,P=0.020)、父母学历(t=4.361,P=0.000)、父母婚姻状况(t=5.750,P=0.000)、家长信心(t=2.199,P=0.031)、病情(F=50.802,P=0.000)、年龄(F=11.537,P=0.000)因素中差异有统计学意义。其中女孩、独生子女、睡眠较好、饮食较差、家庭经济状况较好、父母低学历、父母离异、家长无信心、轻度病情、2-4岁的患儿评估分数差值较大。6、对认知能力的干预在患儿性别(t=3.117,P=0.004)、饮食情况(t=2.504,P=0.019)、父母婚姻状况(t=7.437,P=0.000)、家长重视程度(t=2.392,P=0.019)、家长信心(t=3.376,P=0.001)、病情(F=8.012,P=0.001)、年龄(F=10.319,P=0.000)因素中差异有统计学意义。其中女孩、饮食较差、父母离异、家长不重视、家长无信心、轻度病情、2-4岁的患儿评估分数差值较大。7、对社会交往的干预在患儿性别(t=3.450,P=0.002)、居住地(t=2.951,P=0.004)、独生与否(t=4.308,P=0.000)、饮食情况(t=2.379,P=0.025)、父母学历(t=3.827,P=0.000)、父母婚姻状况(t=4.109,P=0.000)、家长信心(t=2.192,P=0.031)、病情(F=5.792,P=0.004)、年龄(F=9.511,P=0.000)因素中差异有统计学意义。其中女孩、城镇、独生子女、饮食较差、父母低学历、父母离异、家长无信心、轻度病情、2-4岁的患儿评估分数差值较大。8、对生活自理能力的干预在患儿居住地(t=3.409,P=0.002)、睡眠情况(t=3.697,P=0.000)、饮食情况(t=2.113,P=0.038)、父母学历(t=4.113,P=0.000)、父母婚姻状况(t=5.364,P=0.000)、家长信心(t=3.130,P=0.002)、病情(F=22.210,P=0.000)、年龄(F=3.941,P=0.023)因素中差异有统计学意义。其中城镇、睡眠较差、饮食较差、父母低学历、父母离异、家长无信心、轻度病情、2-4岁的患儿评估分数差值较大。9、对情绪与行为的干预在患儿居住地(t=4.938,P=0.000)、家庭经济状况(t=5.284,P=0.000)、家长重视程度(t=9.193,P=0.000)、家长信心(t=4.269,P=0.000)、病情(F=7.375,P=0.001)、年龄(F=3.722,P=0.028)因素中差异有统计学意义。其中城镇、家庭经济状况较差、家长重视、家长有信心、轻度病情、4-6岁的患儿评估分数差值较大。结论1、综合干预对自闭症患儿感知觉、粗大动作、精细动作、语言与沟通、认知、社会交往、生活自理、情绪与行为能力均有明显的改善。2、自闭症患儿的背景因素对综合干预训练的康复效果均有影响,其中家长信心与患儿年龄影响的项目最多,均为7项;患儿病情影响的项目为6项;性别、居住地、饮食情况、父母婚姻状况影响的项目为5项;独生与否、父母学历影响的项目为4项;睡眠情况、家庭经济状况和家长重视程度影响的项目最少为3项。
[Abstract]:Objective to study the changes of autistic children in all aspects of comprehensive ability before and after the intervention, comparison of different gender, age and background conditions on the influence of comprehensive intervention, comprehensive intervention effect and influence factors of rehabilitation of children with autism in effect, to further improve the effect of rehabilitation and improvement of rehabilitation program provides basis and guidance. Methods 2014-2016 year rehabilitation training in two areas of Jinzhou special education schools in Liaoning province in 89 cases of children with autism as the research object. The training of autistic children at the age of 2-7 years old, 68 boys and 21 girls. The comprehensive intervention measures mainly include: Sports comprehensive training, speech training, cognitive training, game training, life self-care training, art training and computer game courses. Every Monday to Saturday school, which is 4 hours in the morning, afternoon for 3 hours, regularly carry out to a Training class, each class for half an hour. Each class of training teachers curriculum and each child's performance assessment records, were trained before the first assessment, second assessment training after 1 semesters, third assessment training. After 1 year evaluation tool is made use of CDPF uniform distribution "autistic children development assessment scale. Data were analyzed by t test, variance analysis and other methods of evaluation results were analyzed and compared the three assessment score whether there are significant differences, whether there is a significant effect compared with background factors on rehabilitation of comprehensive intervention. Results 1,89 patients in fine motion perception, gross motor, language and communication., cognition, social interaction, self-care, emotional and behavioral assessment in 8, and two times between before and after the training intervention training score differences were statistically significant.8 scores after training The average is higher than that before the training, after training at an average annual rate of 1 higher than half a year after the.2 training, the perception of the intervention on children with gender (t=4.267, P=0.000), the only child or not (t=4.180, P=0.000), sleep (t=2.065, P=0.042), diet (t=2.795, P=0.008), family economic status (t=2.626, P=0.011), parents marital status (t=3.649, P=0.001) were statistically significant differences in the factors. The boy, non child, poor sleep, eating better, and family economic status of poor parents not divorced children score difference.3, on gross motor intervention in children (t=4.410, P=0.000), the only child or not (t=6.023, P=0.000), parents (t=2.655, P=0.010) confidence, age (F=6.584, P=0.002) were statistically significant differences in the factors. The rural areas, not only children, parents have no confidence, 6-7 year old children with a large difference between the scores of.4, fine motor intervention on children with gender (t =2.225, P=0.031) (t=3.485, P=0.001), residence, educational level of parents (t=5.905, P=0.000), the degree of attention of parents (t=7.429, P=0.000), parents (t=2.375, P=0.021), heart disease (F=15.222, P=0.000), age (F=4.484, P=0.014) were statistically significant differences in the factors. The boy, towns, parents of low education, parents attention, confidence, parents mild illness, 4-6 year old children with a large difference between the.5 scores, the language and communication intervention in children with gender (t=3.137, P=0.004), the only child or not (t=4.357, P=0.000), sleep (t=4.054, P=0.000), diet (t=5.405, P=0.000), family economic condition (t=2.443, P=0.020), educational level of parents (t=4.361, P=0.000), parents' marital status (t=5.750, P=0.000), parents (t=2.199, P=0.031), heart disease (F=50.802, P=0.000), age (F=11.537, P=0.000) were statistically significant differences in the factors. The girl child, sleep well, drink Poor food, family economic situation is good, the parents of low degree, divorced parents, parents have no confidence, mild illness, 2-4 year old children with larger difference of.6 scores, cognitive intervention on children with gender (t=3.117, P=0.004), diet (t=2.504, P=0.019), the parent marital status (t=7.437, P=0.000). The degree of attention of parents (t=2.392, P=0.019), parents (t=3.376, P=0.001), heart disease (F=8.012, P=0.001), age (F=10.319, P=0.000) were statistically significant differences in factors. Among girls, poor diet, divorced parents, parents do not pay attention, parents have no confidence, mild illness, 2-4 year old children score difference the larger.7, for community intervention on children with gender (t=3.450, P=0.002) (t=2.951, P=0.004), place of residence, only child or not (t=4.308, P=0.000), diet (t=2.379, P=0.025), educational level of parents (t=3.827, P=0.000), parents' marital status (t=4.109, P=0.000), parents Confidence (t=2.192, P=0.031) (F=5.792, P=0.004), disease, age (F=9.511, P=0.000) were statistically significant differences in factors. Among girls, towns, only children, poor diet, low educated parents, divorced parents, parents have no confidence, mild illness, 2-4 year old children with a large difference between the scores of.8, self-care ability the life of the intervention in children (t=3.409, P=0.002), sleep (t=3.697, P=0.000), diet (t=2.113, P=0.038), educational level of parents (t=4.113, P=0.000), parents' marital status (t=5.364, P=0.000), parents (t=3.130, P=0.002), heart disease (F=22.210, P=0.000), age (F=3.941 P=0.023), there was statistical significance difference. The factors in town, poor sleep, poor diet, low educated parents, divorced parents, parents have no confidence, mild illness, 2-4 year old children with a large difference between the scores of.9, emotional and behavioral intervention in children (t=4.938, P =0.000), family economic status (t=5.284, P=0.000), the degree of attention of parents (t=9.193, P=0.000), parents (t=4.269, P=0.000), heart disease (F=7.375, P=0.001), age (F=3.722, P=0.028) were statistically significant differences in factors. Among them the town, poor family economic status of parents attention, confidence, parents mild illness, 4-6 year old children with larger difference. Conclusion the evaluation score of 1, the fine movement of comprehensive intervention on autistic children perception, coarse, action, language and communication, cognition, social communication, daily life, improve the.2 ability of emotion and behavior were significantly affected, the effect of rehabilitation training on the background factors of children with autism comprehensive intervention, the influence of parents confidence and age of children, the largest number of projects, all 7 children with the disease; influence of 6 projects; gender, residence, diet, influence of parents' marital status for the 5 projects; the only child or not, parents 4 items were affected by educational background, and at least 3 items were affected by sleep conditions, family economic conditions and parents' attention.

【学位授予单位】：锦州医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.94

【相似文献】