论文部分内容阅读
目的了解社区康复在孤独症谱系障碍儿童中的作用,探索康复效果的相关影响因素,为更好地改善患儿的相关缺陷提供依据。方法采用克氏孤独症行为量表(CABS)和儿童孤独症行为量表(ABC)进行筛查,采用精神疾病诊断和统计手册(第5版)(DSM-V)及儿童孤独症评定量表(CARS)进行诊断,选取参加了天津市孤独症谱系障碍儿童社区康复项目的 8所幼儿园已完成《孤独症儿童发展评估表》1年3次完整评估的19例孤独症谱系障碍儿童,年龄为24~82个月,对其家长进行调查并收集相关信息。采用重复测量方差分析及Pearson线性相关分析进行统计处理。结果孤独症谱系障碍儿童的8个领域3次评估的得分,每一次较前一次都有不同程度提高(P值均<0.05)。随时间递进的3次评估的康复效果实际年龄与各领域发展年龄的差值呈下降趋势,差异均有统计学意义(P值均<0.05),且康复手段越多元、越有针对性,效果越好。发现疑似症状的年龄、最终确诊的年龄、首发语言的年龄、能独立行走的年龄、CARS智力功能得分、CARS总分与康复效果在不同领域之间存在统计学意义的相关性(P值均<0.05)。结论天津市的社区康复对孤独症谱系障碍儿童的预后有积极作用,具有针对性的长期系统综合干预的效果显著。
Objective To understand the role of community-based rehabilitation in children with autistic spectrum disorders and to explore the influencing factors of rehabilitation, so as to provide evidences for better improvement of related defects in children. Methods The Kirschner Autism Behavior Checklist (CABS) and Children Autism Behavior Checklist (ABC) were used for screening. The Diagnostic and Statistical Manual of Mental Illness (5th Edition) (DSM-V) and Children’s Autism Rating Scale (CARS), selected from 8 kindergartens participated in the community rehabilitation project of children with autism spectrum disorder in Tianjin, completed 19 autism spectrum disorder children with autism spectrum assessment completed three times a year 24 to 82 months, investigate their parents and collect relevant information. Statistical analysis was performed using repeated measures ANOVA and Pearson’s linear correlation analysis. Results The scores of 3 assessments in 8 fields of children with autism spectrum disorder were improved to some extent each time (P <0.05). The difference between the actual effect of rehabilitation and the developmental age in all fields showed a decreasing trend with the three evaluations over time. The differences were statistically significant (P <0.05), and the more the means of rehabilitation were, the more pertinent, The better Age of suspected symptoms, age of final diagnosis, age at first language, age at which independent walking was performed, CARS score, CARS score and rehabilitation outcome were statistically significant in different areas (P < 0.05). Conclusion Community rehabilitation in Tianjin plays a positive role in the prognosis of children with autistic spectrum disorders. Targeted long-term systemic intervention has a significant effect.