发育医学电子杂志 Vol. 8 246-251，256 DOI: 10.3969/j.issn.2095-5340.2020.03.010
生长发育
论著
孤独症儿童早期介入丹佛模式的家庭治疗 效果研究
于婷 高迪 张雪城 刘雪静 杜琳
吉林大学第一医院 发育行为儿科，吉林 长春 130021
Research on family therapy effects of early start Denver model on children with autism spectrum disorder
Yu Ting, Gao Di, Zhang Xuecheng, Liu Xuejing, Du Lin
Department of Development-Behavioral Pediatrics, the First Hospital of Jilin University, Jilin, Changchun 130021, China
摘要
【摘要】 目的 探讨早期介入丹佛模式（early start Denver model，ESDM）的家庭治疗对孤独症谱系障碍
(autism spectrum disorder，ASD) 儿童的干预效果。 方法 选取 2017 年 7 月至 2018 年 7 月来吉林大学 第一医院发育行为儿科进行诊断的 2 ～ 5 岁 ASD 儿童 93 例，将其随机分为密集干预组（46 例）和家长 培训组（47 例）。密集干预组接受 ESDM 密集训练，每天 1 h，共 6 个月。家长培训组接受该康复机构的 家长培训（每次 1 h，每周 1 次），然后由家长在家中按教学计划进行每天 1 h 的康复训练，并在日常生活 中随机教学，共 6 个月。两组干预前及干预 6 个月后均进行孤独症行为量表（autism behavior checklist， ABC）、儿童孤独症评定量表（childhood autism rating scale，CARS）、孤独症治疗评估量表（autism treatment evaluation checklist，ATEC）、Gesell发育量表(Gesell developmental scale, GDS)的评估，比较两组的疗效。
结果 干预 6 个月后，密集干预组与家长培训组两组 ASD 儿童的 ABC 总分、ABC 的 5 个分区分值、CARS 总分、AETC 总分均较干预前下降，差异有统计学意义（P 均 <0.05），两组 GDS 中 5 个能区的发育 商（development quotient，DQ）值较干预前提高，差异有统计学意义（P<0.05）。家长培训组干预后 ABC 总分、ABC 量表中生活自理分区分值优于密集干预组，差异有统计学意义（P<0.05）；密集干预组干预后
CARS 总分、GDS 中语言能区 DQ 值优于家长培训组，差异有统计学意义（P<0.05）。干预后密集干预组
ABC 量表中感觉分区、交往分区、躯体运动分区、语言分区分值、ATEC 总分及 GDS 中适应性、大运动、
精细动作、个人社交的 DQ 值未明显优于家长培训组，差异无统计学意义（P>0.05）。 结论 康复机构指
导下的 ESDM 家庭治疗可明显改善 ASD 儿童的感觉、交往、运动、适应性、个人社交方面的能力，改善
程度与康复机构密集训练相近。
关键词:
孤独症谱系障碍')" href="#">
Abstract:
【Abstract】 Objective To explore the effect of family therapy of early start Denver model (ESDM)
on children with autism spectrum disorder (ASD). Methods 93 children with ASD aged 2-5 years old
were selected from Department of Development-Behavioral Pediatrics, the First Hospital of Jilin University
between July 2017 and July 2018. They were randomly divided into intensive intervention group (n=46)
and parent training group (n=47). The intensive intervention group received intensive training of ESDM
from early period in the rehabilitation institution, one hour per day for 6 months. The parent training group received the parent training (one hour each time, one time each week) in the rehabilitation institution, and then the parents conducted the rehabilitation training for one hour each day according to the teaching plan at home, and were randomly taught in daily life for 6 months. Before and after 6 months of intervention,
the effect of the two groups were compared by evaluating the autism behavior checklist (ABC), childhood
autism rating scale (CARS), autism treatment evaluation checklist (ATEC) and Gesell developmental scale
(GDS). Results After 6 months, the total scores of ABC, CARS, ATEC and 5 partitions of ABC were
signifificantly decreased in both groups, the differences were statistically signifificant (all P<0.05). Development
quotient(DQ) of GDS were signifificantly improved in both groups, the differences were statistically signifificant
(all P<0.05). The ABC total score and life self-care partition score in ABC in the parent training group after
training were better than those in the intensive intervention group, the differences were statistically signifificant
(all P<0.05). The CARS total score, the DQ of language of GDS in the intensive intervention group after
training were better than those in the parent training group, the differences were statistically signifificant (all
P<0.05). The sensory division, communication division, body movement division, language partition score in
ABC, ATEC total score, DQ of adaptive, body movement, fifine movement and individual social skills of GDS
after training in the intensive intervention group were not signifificantly better than those in the parent training
group, the differences were not statistically signifificant (P>0.05). C onclusion Family therapy of ESDM by
the guidance of rehabilitation institution can improve the feeling, communication, movement, adaptability and
individual social skills of ASD children. The degree of improvement is similar to that of intensive training in
rehabilitation institutions.
Key words:
Autism spectrum disorder')" href="#">
收稿日期: 2019-02-25
出版日期: 2020-07-30
发布日期: 2020-07-28
期的出版日期: 2020-07-30
基金资助:
吉林省教育厅项目（JJKH20170857KJ）
通讯作者:
杜琳
E-mail: zlzdulin@126.com
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