团体语言训练联合图片交换沟通系统对孤独症谱系障碍儿童的效用

The efficacy of group language training combined with picture exchange communication system for children with autism spectrum disorder

摘要

目的 分析团体语言训练联合图片交换沟通系统(PECS)对孤独症谱系障碍(ASD)儿童核心症状及康复效果的影响,为临床干预提供理论依据。方法 随机选取自2023年7月—2025年4月在东莞市妇幼保健院就诊的2~6岁ASD儿童86例,采用随机数字表法随机分为试验组和对照组,每组各43例。对所有参与试验的儿童均进行每天1h,每周5d,共持续6个月的康复训练。对照组仅进行常规化一对一言语康复治疗,试验组常规化一对一语言治疗内容改为图片交换沟通系统,并增加团体语言训练,两种形式每天各30min。干预前后采用孤独症行为量表(ABC)、儿童孤独症评定量表(CARS)和Gesell发育诊断量表对所有儿童进行评估。结果 最终共纳入80例,对照组40例,干预组40例。干预后,两组儿童在ABC量表及CARS量表评分上差异无统计学意义(P>0.05)。对照组和试验组儿童的语言发育商(DQ)和个人-社交DQ均比干预前提升,且差异均有统计学意义(对照组语言:t=7.42,P<0.001,社交:t=6.96,P<0.001;试验组语言:t=15.29, P<0.001,社交:t=11.43,P<0.001),组间比较显示,试验组的语言DQ和个人-社交DQ评分进步值均高于对照组,差异有统计学意义(语言:t=6.61,P<0.001;社交:t=5.44,P<0.001)。结论 团体语言训练和PECS能够明显提高ASD儿童的语言能力并改善社交能力,效果优于常规语言训练,但对ASD核心症状的改善不显著,仍需进一步研究。

Abstract

Objective To explore the efficacy of group language training combined with the picture exchange communication system (PECS) on core symptoms and rehabilitation outcomes in children with autism spectrum disorder (ASD), in order to provide theoretical reference for clinical intervention. Methods A total of 86 children aged 2 - 6 years with ASD, treated at Dongguan Maternal and Child Healthcare Hospital from July 2023 to April 2025, were recruited in this study.They were randomly assigned to experimental group and control group, with 43 cases in each group.Both groups underwent rehabilitation training for 1 hour per day, 5 days per week, for a total duration of 6 months.The control group received conventional one-on-one speech rehabilitation.The experimental group received a combined intervention of PECS and group language training.Assessments included the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Gesell Development Diagnosis Scales(GDDS) before and after intervention. Results Finally 80 children completed the intervention,with 40 cases in control group and 40 cases in experimental group.Post-intervention analysis showed no statistically significant differences in ABC or CARS scores between the two groups (P>0.05).However, both groups demonstrated significant improvements in language and personal-social developmental quotients (DQ) (control group: language DQ t=7.42, P＜0.001, personal-social t=6.96, P＜0.001; experimental group: language DQ t=15.29, P＜0.001, personal-social t=11.43, P<0.001).Notably, the experimental group exhibited significantly greater improvements in language DQ (t=6.61, P<0.001) and personal-social DQ (t=5.44, P<0.001) compared to the control group. Conclusions The combination of group language training and PECS is superior to conventional language training in enhancing language and personal-social development in children with ASD.However, its effects on core symptoms remain inconclusive and warrant further investigation.

关键词

孤独症谱系障碍 / 团体语言训练 / 图片交换沟通系统 / 联合应用

Key words

autism spectrum disorder / group language training / picture exchange communication system / combination intervention

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基金资助

东莞市社会发展科技项目(20231800938092)