【摘要】 目的:观察应用行为分析法对孤独症患儿的干预效果。方法:选择2003-01/2005-12在天津市孤独症康复训练中心进行应用行为分析疗法训练的孤独症患儿85例,年龄2岁2个月～6岁1个月,患儿监护人均知情同意。运用应用行为分析疗法进行训练,设计个体化的治疗方案,内容包括:语言、模仿、自理能力、社交技能、大运动、精细动作和认知能力7个方面。每周训练30～40h,3个月为1个疗程,患儿训练3～12个月不等。分别于训练前、后应用Gesell发育量表(包括5个能区,计算每个能区的发育商及平均发育商,发育正常儿童的平均发育商≥85)、孤独症行为评定量表(分5大因素57条项目,按其在量表中的负荷大小分别记4,3,2,1分,相加计算总分,分数的高低表明孤独症行为严重程度的高低)、孤独症评定量表(共设14项行为表现,每项根据表现的程度及频率记0,1,2分,相加计算总分,分数的高低表明疾病程度的高低)对患儿进行评估。于治疗后3个月对完成训练后能联络到的患儿进行随访观察。结果:85例孤独症患儿全部进入结果分析,无脱落。①孤独症患儿训练后Gesell发育检查各能区发育商及平均发育商均高于训练前(P<0.01);训练后孤独症行为评定量表各因子分及总分均低于训练前(P<0.01);训练后孤独症评定量表评分低于训练前(13.96±3.81,20.96±3.48,t=-11.18,P<0.01)。②训练完成后3个月对能联系到的48例当地患儿进行随访发现,有43例仍继续进步,其中29例入正常幼儿园或小学。结论:应用行为分析疗法是治疗儿童孤独症的一种非常有效的方法。更多还原

【Abstract】 AIM: To discuss the effect of the applied behavioral analysis (ABA) treatment for autism. METHODS: A total of 85 children aged from 2 to 6 years were enrolled from Tianjin Center of Rehabilitation Training for Autism and trained with the ABA between January 2003 and December 2005, with the informed consents of their guardians. The treatments included seven aspects: language, imitation, taking care of oneself ability, the public relations skill, the big movement, the fine movement and the cognition ability. The training time was 30-40 hours per week, 3 months as one course and lasted for 3-12 months. Before and after the training, the autism children were evaluated with Gesell development scale (functional areas, the development quotient and average development quotient of each area, the average development quotient of normal children≥85), autistic behavior checklist (ABC, 57 items of 5 factors, scored as 4, 3, 2, 1 according to loading of the scale, the total scores indicated the severity of autism behavior) and childhood autism rating scale (CARS, 14 performances, scored as 0, 1, 2 according to degree and frequency of performance, the total scores indicated the severity of disease). Three months after the treatment, the patient children were followed-up. RESULTS: All 85 autism children were involved in the result analysis without drop.①After the training, the Gesell development test showed that each of the development quotient and the average development quotient were higher than those before the training (P < 0.01); the total score and the each factor score of the ABC scale were lower than those before the training (P < 0.01); the results of the CARS scale displayed that the mean of the score was lower than that before the training (13.96±3.81, 20.96±3.48, t =-11.18, P < 0.01).②We made a follow-up visit to 48 cases, 43 examples continued to make progress, 29 examples of them entered the normal kindergarten or the elementary school. CONCLUSION: The ABA is an effective treatment for autism.更多还原