孤独症儿童语言障碍治疗方法

语言障碍是孤独症儿童最显著的特征之一,主要表现为与人的目光接触少和专注力弱,学舌式说话,多方面的发音问题,语言理解能力弱,对抽象问题难于理解,缺少逻辑性,语言表达障碍,混淆代名词你/我/他等。按照语言训练的基本原则,在语言前期,通过视觉搜索追踪、目光对视训练、沟通欲望的培养、听觉训练、理解训练让孤独症儿童理解音字之间的联系,尝试发出音节,为正确发音做准备;通过呼吸训练、口面部穴位按摩刺激、正确使用构音器官的练习,可以逐渐学习词组、简单的句子;通过修饰词的学习及理解和逻辑能力的提高,准确的说出句子,从而达到学会语言的目的。在孤独症儿童的语言训练中,要通过正确的评估,找准存在的问题,应用正确的训练方法。     

Elicited Imitation in Children and Adults With Autism: the Effect of Different Types of Actions

Background It was proposed by Rogers & Pennington (1991 ) that an early deficit in imitation, together with a cascade of developmental disorders in emotion sharing and Theory of Mind, could be important in understanding autism. Having already found that imitation appeared not to be specifically or universally impaired in autism, the present study tested whether there were distinctions between different types of actions, such as symbolic versus non‐symbolic, one‐handed versus two‐handed or symmetrical versus asymmetrical actions, on a test of elicited imitation. Methods A large battery of tasks was used to elicit imitation from three groups of autistic children and adults (aged 4–34 years of age), two groups of typically developing children and a group of children with mild‐to‐moderate intellectual disabilities. Results The majority of children and adults with autism had few impairments relative to the controls, although certain actions did seem more difficult, especially for the youngest children. For example, actions within the categories of ‘symbolic actions’ and ‘asymmetrical actions’ seemed to give some groups more problems. Certain types of errors such as hand reversals and using body parts as objects were found in both autistic and non‐autistic groups, but, for the most part, in the youngest children in the whole sample. A final analysis compared the number of partial imitations for eight specific actions. Conclusions The overall picture was not one of an autism‐specific deficit in imitation, but rather of a normal (i.e. age‐related) developmental trend. These results are discussed in terms of Rogers & Pennington's theory and other leading theories.     

Siblings and Family Environments of Persons With Autism Spectrum Disorder: A Review of the Literature

OBJECTIVES: The purpose of this literature review is to summarize studies on siblings of individuals with autism spectrum disorders (ASD) in four major areas, to identify gaps in the literature, and to propose future directions for research of siblings of persons with ASD. DESIGN AND METHODS: A systematic review of research published within the past 10 years in peer review journals includes investigations on siblings' and parental characteristics, as well as sibling behaviors, relationships, and adaptation. Twelve studies are synthesized to include purpose, findings, and discussion relating it to previous work. RESULTS: Siblings are influenced by the context of their families that are impacted by biological, psychological, sociological, and ecological factors. Research studies are primarily exploratory and no intervention studies are identified. CONCLUSION: The literature review of parental and sibling characteristics, relationships, and adaptation support intervention measures for siblings and family members of persons with autism. Assessment of siblings is necessary to identify those who may be at risk for future adjustment problems and maladaptive behaviors.     

Parent Perceptions of Efficacy for Strategies used to Facilitate Sleep in Children with Autism

Autism is a relatively common developmental disability that has neurobiological origins and is characterized by pervasive deficits in social interaction, communication and range of interests. In a previously published article, the authors described commonly occurring sleep problems in children with autism [Williams, P. G., Sears, L. L., and Allard, A. (2004). J. Sleep Res. 13: 265–268.] Current estimates of sleep disorders in this population range from 44 to 83% [Richdale, A. (1999). Develop. Med. Child Neurol. 41: 60–66]. Parents often have to devise their own strategies for dealing with sleep problems. This study surveyed interventions being used by families of children with autism. Likert-based surveys were sent out to 500 families of autistic children with 210 returned. Based on records of psychological testing, survey responses for these children were categorized into mental retardation (MR) or not mental retardation (not MR) groups. Among the most frequently used behavior interventions for both groups were establishing a regular bedtime and waking time, providing a darkened room, reading to the child, and providing toys to play with in bed. Behavioral strategies considered most effective included establishing a regular bedtime, bringing the child into the parents’ bed, wrapping the child, using a noise masker, and allowing the child to have toys in his bed. When surveys were divided into MR/not MR groups, some differences in perceived effectiveness of behavioral interventions for sleep were noted. Reading a story and using a nightlight were perceived as much less effective for the MR group as compared to those in the not MR group. In general, medications were used much less frequently than behavioral interventions to help with sleep. When comparisons between the MR/not MR groups were made, no statistically significant differences were seen for perceived effectiveness of medications. This study points to the need for more systematic study of sleep problems and interventions for children with autism.     

Positive Experiences of Mothers and Fathers of Children with Autism

Background The present study examined the positive experiences of parents raising school‐aged children with autism within the context of parenting stress. Materials and Methods Participants included 23 mother/father pairs raising children with autism (ages 5 to 11 years, M = 7.39). Parents completed measures of parenting stress and positive experiences of raising their children. Results Consistent with previous research in a pre‐school aged population of children with autism, mothers reported significantly more positive experiences than did fathers. Mothers’ and fathers’ reports of their positive experiences were negatively related to their reports of parenting stress. Fathers’, but not mothers’, positive experiences were negatively related to their partners’ reports of parenting stress. Conclusion Findings are discussed within a positive psychology framework suggesting that a focus on positive experiences may buffer against negative well‐being.     

图片交换沟通系统在儿童孤独症康复护理中的应用

目的探讨图片交换沟通系统(PECS)在儿童孤独症康复护理中的应用效果。方法孤独症患儿40 例随机分为观察组(n=20)和对照组(n=20)。对照组接受常规护理,观察组在常规护理的基础上给予以PECS为指导的康复护理。治疗前、治疗6 个月后使用心理教育量表(PEP-3)进行评估。结果两组患儿治疗6 个月后,与各自治疗前相比PEP-3 评分均有提高(P<0.05);治疗后观察组沟通与行为评分高于对照组(P<0.05)。结论采取PECS指导的康复护理措施能够有效改善孤独症患儿社交功能和语言功能。     

Attribution Model of Stigma towards Children with Autism in Hong Kong

Background Accounting for the effects of knowledge of and experience with autism, the relationships of cognitive attribution (perceived controllability), emotions (anger and sympathy), as well as helping and punitive behavioural intentions towards children with autism were examined. Based on the attribution model, mediating effects of anger and sympathy on cognitive attributions and behavioural intentions were tested. Materials and Methods 123 frontline staff in educational settings completed a modified version of the Attribution Questionnaire after reading a hypothetical vignette and completing a quiz on autism. Results Knowledge and experience were only significantly related to punitive behavioural intention towards children with autism. Anger and sympathy mediated the effect between perceived controllability on both helping and punitive behavioural intentions. Conclusions The intentional responses towards children with autism were strongly related to their emotional reactions. Thus, in addition to educating frontline staff about autism, training them on emotion regulation is equally important in autism stigma reduction.     

24例儿童孤独症行为干预的效果观察

目的观察行为干预对儿童孤独症的治疗效果。方法对24例孤独症患儿实施行为训练,采用克氏孤独症行为量表（CABS）及孤独症儿童行为检查量表（ABC）于训练前及训练6个月进行量表评定。结果患儿在训练6个月后,CABS的13种目标行为有明显的改善（P〈0.01）,ABC得分差异有统计学意义（P〈0.01）。结论行为干预对改善孤独症患儿生活自理、躯体运动、感觉、交往、语言能力等具有不可代替的作用。     

儿童孤独症的临床及危险因素分析

目的：进行儿童孤独症临床分析,探讨围产期及发育期的危险因素。方法：按照CCMD-3儿童孤独症标准做诊断,采用儿童孤独症家长评定量表及克氏行为量表,收集2001年-2004年在四川大学华西医院心理卫生中心及华西医院第二医院儿保科就诊的儿童孤独症患儿108例。结果：家长虽较关注孩子语言、社交障碍,但患儿得到确诊的时间较晚。在其早期发育中存在较高比率的躯体疾病,且孤独症与妊娠期某些危险因素如父母的生育年龄、妊娠反应、腹部X射线及早期罹患躯体疾病相关。结论：加强儿童保健,减少围产期及发育期存在的一些危险因素,可能减少孤独症的发病。     

Effects of Exercise Interventions on Stereotypic Behaviours in Children with Autism Spectrum Disorder

Purpose:

The purpose of this systematic review was to synthesize evidence from studies examining the effect of exercise interventions on stereotypic behaviours in children with autism spectrum disorder (ASD).

Methods:

Only exercise-related physical therapy (PT) interventions were included. A multifaceted search strategy identified studies published between 1980 and 2007. Quality was assessed using the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) Study Quality Scale, the Clinical Relevance Tool for Case Studies, and the Quality, Rigour or Evaluative Criteria tool.

Results:

Seven studies (1982–2003) met our inclusion criteria; four of these used single-subject research designs, two were group studies, and one was a case study. Ages and behavioural characteristics of the children (N = 25) varied among the studies. Levels of evidence ranged from II to V (of a possible I–V). Study quality scores ranged from 2 to 5 (range: 0 to 7); mean = 3.9, mode = 5. Few studies in this area of PT practice have been published, and those identified scored low levels of rigour on the AACPDM criteria.

Conclusions:

Research suggests that exercise provides short-term reductions of stereotypic behaviours in children with ASD. Future research with stronger evidence levels, greater rigour, and longer-term outcome assessment is required to determine specific exercise parameters.     

Fathers' Perceptions of Their Roles During In‐Home Training for Children With Autism

PROBLEM: Currently, most research related to parents of children with autism has focused on mothers, and little is known about the fathers' interaction with their children. PURPOSE: The purpose of the qualitative study is to assist in more fully describing and understanding fathers' perceptions of their roles, relationships with their children with autism, and participation in an in‐home training intervention designed to enhance parent–child interactions as well as child language and social interactions. METHODS: In depth semi‐structured interviews with 10 fathers were conducted at home, videotaped, transcribed, and reviewed for common themes and significant statements FINDINGS: Five common themes were discovered, fathers expressed their view of their roles, and fathers reported the father‐directed in‐home intervention was effective in enhancing father–child relationships. CONCLUSION: Communication between fathers and their children appears to be the key to a successful relationship. Although verbal communication deficit is a predominant feature of autism, these fathers noted other ways of effective communicating including time spent playing or just being with the child.     

Assessment of Children With Pervasive Developmental Disorders

TOPIC: Pervasive developmental disorders, a group of conditions marked by impaired social reciprocity, communication deficits, and restricted, repetitive behaviors. PURPOSE: Advanced practice nurses (APNs) are in a unique position to assess these children, make appropriate diagnoses, and refer parents for further consultation and intervention. SOURCES: Current literature, formal training on diagnostic instruments, and clinical experience. CONCLUSIONS: Diagnosis of pervasive developmental disorders requires knowledge of normal growth and development and other childhood psychiatric disorders. The role of the APN includes counseling parents regarding their child's legal right to intervention and guiding parents to make empirically based choices for intervention.     

针刺治疗孤独症谱系障碍儿童便秘的效果

目的 观察针刺对孤独症谱系障碍(ASD)儿童便秘问题及核心症状的治疗效果。方法 2019年1月至2020年11月,黑龙江中医药大学附属第二医院康复中心收治50例ASD并发便秘患儿,随机分为针康组(n = 25)和药康组(n = 25)。针康组采用头针、体针结合康复训练法;药康组采用口服益生菌结合康复训练法;两组均进行便秘和核心症状的康复训练。便秘治疗8周,核心症状治疗12周。治疗前,治疗8周、12周后进行便秘疗效判定和便秘主症评分,并采用孤独症儿童行为量表(ABC)和孤独症治疗评估表(ATEC)对核心症状进行评估。结果 治疗前两组便秘主症评分、ABC评分和ATEC总分比较均无显著性差异(P > 0.05)。治疗8周,两组主症评分均显著降低(t > 5.473, P < 0.001);治疗12周,针康组便秘疗效和主症评分均优于药康组(Z = 2.848, t = -2.139, P < 0.05)。治疗8周后,两组ABC评分和ATEC总分均较治疗前显著降低(t > 7.139, P < 0.001),两组间比较均无显著性差异(P > 0.05);针康组ATEC行为评分明显降低(t = 3.849, P < 0.01),优于药康组(t = -2.643, P < 0.05),两组间其他项评分无显著性差异(P > 0.05);治疗12周,针康组ABC评分、ATEC总分及各项评分均低于药康组(|t| > 2.156, P < 0.05)。结论 针刺结合康复训练法可改善ASD儿童便秘问题,疗效较持久,也可改善孤独症的核心症状,均优于药物结合康复训练法。     

Early Categorization of Animate/Inanimate Concepts in Young Children with Autism

Categorization and concept formation deficits along with other cognitive processing deficits have been suggested in individuals with Autism Spectrum Disorders (ASD). A compelling early cognitive deficit is the formation of coherent concepts for animates and inanimates. Development of such concepts is thought to be a crucial building block for young children’s emerging understanding that different object kinds possess different physical, psychological, biological, and motion-related properties [Rakison, D. H., and Poulin-Dubois, D. (2001). Psychol. Bull. 127(2): 209–228]. In this preliminary study, 11 preschoolers with ASD participated in two experiments that tested early concept formation. A visually-based habituation paradigm was used to test whether young children with ASD could detect correlations among static and dynamic cues and whether they were selective in the correlations to which they attend. A more interactive imitation task was used to test children’s knowledge of simple linear and nonlinear motions of animates and inanimates. Results suggest that the preschoolers with autism are delayed in the processes by which they form categories but nonetheless possess relevant knowledge about the motion properties of animates and inanimates. Implications of this preliminary study are discussed.     

Visual Perspective Taking as a Measure of Working Memory in Participants With Autism

There is mounting evidence that people with autism have executive function deficits and that those deficits are linked to the social impairment characteristic of autism. Bennetto et al. Child Dev.(1996) 67: 1817–1835 suggest that, more specifically, people with autism may have a deficit in working memory. This hypothesis was tested using a visual perspective-taking task whose working memory load could be systematically varied. The performance of participants with autism on this task was significantly worse than that of the control participants.     

Changing Children’s Attitudes Toward Autism: A Process of Persuasive Communication

The purposes of this paper are two-fold. First, the initial introduction of a child with autism to typically developing peers is conceptualized as a process of persuasive communication. Second, relevant literature is organized and reviewed according to important components and processes involved in persuasive communication, including effects of source, message, receiver, and channel. Research about perceptions of children with autism is highlighted when available. When findings for autism were unavailable, literature on children’s perceptions of peers with physical and medical disabilities is reviewed as well as perceptions of adults with severe mental illness. From the perspective of persuasion theory, limitations of the literature and future research questions are identified that are relevant to introducing children with autism to peers for the first time.