高功能孤独症儿童抑制功能研究

【目的】比较高功能孤独症儿童与正常儿童反应抑制功能的差异。【方法】运用反应/不反应任务(Go/no-go task)和Stroop色字任务分别对26名高功能孤独症儿童和20名对照组儿童进行抑制功能的行为学测试,运用多变量方差分析进行统计分析。【结果】高功能孤独症儿童在执行no-go任务中的误按数及平均反应时均高于对照组(P0.05);在Stroop色字任务中两组错按数及平均反应时差异无统计学意义(P0.05)。控制智商因素后,两组儿童在no-go任务中的平均反应时差异仍有统计学意义(P0.05)。【结论】高功能孤独症儿童存在部分抑制功能缺陷。     

孤独症患儿家庭疾病负担和家长的应对方式

目的:了解孤独症儿童主要照顾者(母亲或父亲)的家庭疾病负担以及应对方式,为更好地开展孤独症患儿康复服务工作提供理论依据。方法:收集郑州大学第三附属医院儿童心理行为中心咨询并接受康复训练的患儿128例,健康儿童131例为对照组。结果:两组在家庭照顾负担总分和各维度间的差异均有统计学意义(P<0.01),病例组采用消极应对方式约为对照组的2倍,消极应对方式与疾病照顾负担各维度间呈正相关关系,积极应对方式与家庭照顾负担各维度间呈负相关关系。结论:相比于正常儿童家庭的主要照顾者,孤独症家庭主要照顾者的家庭负担更重,他们大多采用消极的应对方式。这一结果提示完善孤独症康复服务体系,为这些主要照顾者提供健康干预措施。     

高功能孤独症儿童对真人和卡通面部表情识别特点

了解高功能孤独症儿童对真人和卡通面部表情的识别情况,为孤独症儿童研究提供实证依据.方法 从南昌市2所孤独症儿童特殊教育机构筛选出10名高功能孤独症儿童,对照组为心理年龄匹配组和生理年龄匹配组(各10名).通过呈现标准化的实验材料,记录被试儿童的各种反应指标.结果 高功能孤独症儿童愤怒表情识别率为(0.63±0.24)%,低于生理匹配组的(0.84±0.09)%和心理匹配组的(0.78±0.10)%(F=4.665,P=0.018).组内比较表明,高功能孤独症儿童和正常儿童均对喜悦表情的识别率高于对悲伤、愤怒、恐惧等负性表情,对高强度图片识别率高于低强度图片(P值均<0.05).正常儿童在喜悦、悲伤、愤怒和恐惧表情的识别反应时比高功能孤独症儿童更短;被试儿童均对高强度图片的识别反应时短于低强度图片(P值均<0.05).结论 高功能孤独症儿童在愤怒表情的识别存在缺陷;不同强度的情绪图片会对儿童的情绪认知有重要影响.     

'Everybody just freezes. Everybody is just embarrassed': felt and enacted stigma among parents of children with high functioning autism

Abstract This paper reports the results of a study of felt and enacted stigma among a sample of parents of children with high functioning autism. The results indicate that a majority of the parents experienced both types of stigma, but that mothers were more likely to do so than fathers. This was especially true in the case of enacted stigma, where a majority of mothers, but only a minority of fathers, encountered avoidance, hostile staring and rude comments from others. The child's type of autistic symptoms was also related to the stigmatisation of their parents, with parents of aggressive children more likely to experience stigma than the parents of passive children. The study also found that the distinction between felt and enacted stigma was more distinct analytically than it was in practice, as many parents tended to conflate the different types of stigma. The results of the study are considered in the context of the changing conceptualisations of, and treatments for, high functioning autism and their implications for the stigmatisation of parents.     

高功能孤独症和Asperger综合征儿童的中央凝聚性研究

【目的】探讨高功能孤独症（high function autism，HFA）和Asperger综合征（Asperger syndrom，AS）儿童在中央凝聚性方面的认知神经心理特征，为其治疗提供理论依据。【方法】应用视觉和言语语义记忆任务和木块图形测验分别对19例学龄前及学龄期HFA儿童、26例AS儿童和20例正常健康儿童（normal controls，NC）进行测试，为其治疗提供理论依据。【结果】在视觉模式或言语模式下，给予语义相关系列的刺激时，三组儿童组能回忆的正确图片或词语数目均比非相关系列刺激能回忆正确的图片或词语数目显著增多（P〈0．05）；各组儿童在视觉模式下能回忆的图片数目均比在言语模式下能回忆的词语数目显著增多（P〈0．01）；HFA组儿童在视觉模式相对言语的记忆优势比正常组更明显。HFA组木块图量表分明显低于正常儿童组（P〈0．05），AS组量表分与正常儿童组差异无显著性（P〉0．05）。【结论】学龄前及学龄期HFA和AS儿童的中央凝聚性薄弱并不明显，推测HFA和AS患者的中央凝聚性薄弱的认知特征可能会随着年龄的增长逐渐明显。     

孤独症与正常儿童父母泛自闭症表型特征分析

探讨孤独症儿童父母与正常儿童父母个性特征是否存在差异,为更好地开展孤独症的临床干预提供依据.方法 利用泛自闭症表型问卷(Broader Autism Phenotype Questionnaive,BAPQ),对2013年3月至2014年11月期间在哈尔滨医科大学儿童发育行为研究中心进行康复训练的57名孤独症儿童和57名幼儿园正常儿童父母进行问卷调查,问卷包括自评量表和他评量表,内容分为冷漠、语用障碍、刻板个性3个分量表.结果 自评量表中孤独症组儿童母亲冷漠、语用障碍和刻板个性3个分量表得分均高于对照组(t值分别为3.92,2.68,2.09,P值均<0.05),且孤独症组儿童母亲冷漠、语用障碍分量表的最佳预测值高于对照组(t值分别为2.90,2.06,P值均<0.05);孤独症组儿童母亲自评的冷漠、语用障碍发生率高于对照组(20.0%与5.4%,23.6%与7.1%)(x2值分别为5.398,5.820,P值均<0.05);最佳预测值孤独症组母亲冷漠的发生率也高于对照组(18.8%与5.7%)(x2=4.122,P<0.05);而他评量表中仅见孤独症组儿童父亲语用障碍分量表得分高于对照组(t=2.04,P<0.05).结论 孤独症儿童母亲更容易表现出冷漠、语用障碍和刻板个性的特征,在对孤独症干预的同时,也应关注其母亲的心理和个性特征,开展有针对性的指导.     

孤独症儿童家长的应对方式与心理健康的相关性研究

目的探讨孤独症儿童父母的应对方式与心理健康的关系,为孤独症儿童的康复治疗营造更有利的家庭环境。方法使用90项症状清单、应对方式问卷对72例孤独症儿童的父母和64例健康儿童父母进行对照研究。结果研究组"解决问题"的应对方式少于对照组,幻想、退避的应对方式多于对照组,差异有统计学意义。多因素回归分析的结果显示应对方式对SCL-90的总分及各因子均有影响。结论孤独症儿童父母易出现心理健康问题,他们的应对方式会增加出现强迫状态、人际关系敏感、恐怖等精神症状的危险。     

Social support and coping strategies of parents raising a child with autism spectrum disorder

The current study sought to explore the psychological and social needs of parents within the same family unit raising a child with autism spectrum disorder (ASD). Mothers (N?=?10) and fathers (N?=?9) of children with ASD attending an early intervention centre completed a semi-structured interview investigating their experiences of raising a child with ASD. Both genders reported adopting problem-focused coping strategies, engaging in ‘me time’ activities, and disengaging from a stressor in an effort to cope. More mothers reported engaging in emotion-focused strategies and accessing social support for emotional and practical support. The presence of traditional gender roles emerged as a potentially significant factor in understanding how mothers and fathers adopt different types of coping strategies.     

孤独症儿童母亲心理健康状况与应对方式研究

目的 探讨孤独症儿童母亲的心理健康状况、应对方式以及两者的相关性.方法 2014年8至12月随机选择沈阳市某孤独症训练中心31例孤独症儿童母亲及同期就诊于中国医科大学附属盛京医院发育儿科的31例正常发育儿童的母亲采用症状自评量表及应对方式问卷进行评定,并对结果进行分析.结果 孤独症儿童母亲症状自评量表的10项各因子分均显著高于对照组(t =2.20 ～4.55,均P＜0.05);应对方式问卷中解决问题及求助因子分显著低于对照组(t值分别为-3.09、-2.04,P＜0.05),自责、幻想因子分显著高于对照组(t值分别为2.97、2.70,均P＜0.05);研究组应对方式问卷中解决问题因子分与症状自评量表中强迫、焦虑、敌对因子分别呈负相关(r值分别为-0.303、-0.332、-0.380,均P＜0.05),自责与症状自评量表中除恐怖外的躯体化、强迫、人际敏感、抑郁、焦虑、敌对、偏执、精神病性及其它因子分均存在明显的正相关(r值分别为0.271、0.488、0.559、0.492、0.304、0.556、0.352、0.292、0.467,均P＜0.05),幻想与强迫、人际敏感、抑郁、焦虑、敌对、偏执及其他因子分存在正相关(r值分别为0.313、0.369、0.280、0.256、0.295、0.355、0.275,均P＜0.05).结论 孤独症患儿母亲存在明显的心理健康问题且多采取消极的应对方式.     

高功能孤独症儿童情绪理解与社会适应能力关系研究

目的 探讨高功能孤独症儿童面部表情识认和归因能力与其社会适应能力的关系,为其康复训练提供更全面的依据。方法 对19例高功能孤独症[男17例、女2例,年龄(9.0±1.8)岁]做了本次评估。采用静态中国人物面部表情图片测试被试的表情识别和情绪归因能力,用韦氏儿童智力量表中国修订版评估他们的言语智商、操作智商和总智商,用孤独症行为评定量表评定其症状,用儿童适应行为评定量表评估其社会适应能力。 结果 入组儿童各表情识别及归因得分与社会适应评估各因子得分无相关性,中性、讨厌配对归因得分及伤心目标归因得分与ABC评分呈负相关关系(P＜0.05),认知因子、社会自制因子和适应商与ABC症状评定得分呈负相关关系(P＜0.01),独立因子与操作智商(P＜0.01)、总智商(P＜0.05)呈正相关关系,认知因子与总智商呈正相关关系(P＜0.05),适应商与言语智商、操作智商、总智商均呈正相关关系(P均<0.05)。 结论 症状严重程度影响入组儿童表情理解能力发展及其社会适应能力,其日常生活自理能力可相对独立于情绪理解能力发展。     

高功能孤独障碍患儿感兴趣脑区组织密度的对照研究

目的:探讨高功能孤独障碍患儿与正常儿童在结构磁共振成像上感兴趣脑区组织密度的差异。方法:在SPM平台上使用Anatomy工具箱测量了18名年龄6～14岁的高功能孤独障碍患儿和16名年龄、性别、智商、身高、体重与之相匹配的正常对照儿童结构磁共振成像上感兴趣脑区的组织密度。结果:高功能孤独障碍患儿左侧初级视觉皮层V1区的组织密度显著大于正常对照组(P<0.005);双侧海马内嗅皮质、右侧杏仁基底外侧核的组织密度显著小于正常对照组(P<0.005)。结论:学龄高功能孤独障碍患儿枕叶视觉皮层以及边缘系统的脑组织密度存在多处异常。     

Medical care experiences of children with autism and their parents: A scoping review

Children with autism spectrum disorder (ASD) and their families may benefit from the provision of additional supports in health care settings, particularly when preparing for and attending medical appointments. This review examined literature that describes experiences in medical care settings from the perspective of patients under age 18 with ASD and their caregivers. A scoping review was conducted to examine the experiences of children with ASD and their families in medical care settings. Twenty‐nine studies meeting inclusion criteria were identified and reviewed. The review indicated a number of challenges (e.g., parent‐reported problems in parent‐provider communication and overwhelming environments) as well as factors that facilitate positive experiences (e.g., providing positive reinforcement and explaining exam steps) during medical appointments. Children with ASD and their families are faced with many challenges while receiving care in medical settings. The present review identified many challenges families face, as well as facilitators of positive experiences. Understanding the unique experiences of patients with ASD and their parents will help to improve experiences in medical care settings for children, caregivers, and health care providers.     

Beliefs about causes of autism and vaccine hesitancy among parents of children with autism spectrum disorder

Vaccine hesitancy may be more common among parents of children with autism spectrum disorder (ASD). We examined factors associated with ASD-specific vaccine hesitancy among caregivers of children with ASD who participated in the SPARK study (Simons Foundation Powering Autism Research for Knowledge). 225 participants completed an online survey containing the Parent Attitudes About Childhood Vaccines (PACV) questionnaire (measure of vaccine hesitancy) and the Illness Perception Questionnaire revised for parents of children with ASD (IPQ-R-ASD; measure of parents’ views about ASD). 65 participants (28.8%) were vaccine hesitant (PACV score ≥ 50); children of vaccine-hesitant parents (VHPs) were less likely to be first born (n = 27, 41.5%), had greater ASD-symptom severity (mean Social Communication Questionnaire score = 23.9, SD = 6.9), and were more likely to have experienced developmental regression (n = 27, 50.9%) or plateau (n = 37, 69.8%). Compared to non-hesitant parents, VHPs significantly more often endorsed accident/injury, deterioration of the child’s immune system, diet, environmental pollution, general stress, parents’ negative views, parents’ behaviors/decisions, parents’ emotional state, and vaccines as causes for ASD. VHPs also had higher scores on the Personal Control, Treatment Control, Illness Coherence, and Emotional Representations subscales of the IPQ-R than did non-hesitant parents. In the final model, ASD-related vaccine hesitancy was significantly associated with higher scores on the Emotional Representations subscale (OR = 1.13, p = 0.10), agreement with deterioration of the child’s immunity as a cause of ASD (OR = 12.47, p < 0.001), the child not having achieved fluent speech (OR = 2.67, p = 0.17), and the child experiencing a developmental plateau (OR = 3.89, p = 0.002). Findings suggest that a combination of child functioning and developmental history, as well as parents’ negative views about and their sense of control over ASD, influence vaccine hesitancy among parents of children with ASD.     

Satisfaction with formal support and education for children with autism spectrum disorder: the voices of the parents

INTRODUCTION: The aim of the present study was to identify and describe factors associated with variations in the level of parental satisfaction with formal support and education for children with autism spectrum disorder (ASD) in Flanders. METHODS: Participants were recruited by a mailing from a diagnostic centre for pre-schoolers and by advertisements dispersed in the Flemish parent organization for ASD and in services and special schools. The sample consisted of 244 parents of children with ASD (age range: 2.69-17.81 years, male/female sex ratio 4:1). The data were collected using a questionnaire on experiences with education and support, which was compiled for the purpose of this study. The data resulting from the questionnaire were supplemented with information obtained from semi-structured in-depth interviews with a stratified sample of 15 parents. RESULTS AND CONCLUSIONS: The study revealed that parents experienced difficulties with the diagnostic process, with support and education provided by mainstream settings and with the accessibility of autism-specific service provisions. Conversely, parents reported to be satisfied with the quality of autism-specific support and education. Predictors of overall satisfaction were parental involvement in formal support, knowledge of available service provisions and time between first consultation and final diagnosis. Practical implications of the results are discussed.     

Exploring stigma: medical knowledge and the stigmatisation of parents of children diagnosed with autism spectrum disorder

This paper analyses 12 parent interviews to investigate the stigmatisation of parents of children diagnosed with an autism spectrum disorder. Drawing on poststructural accounts of the relationship between knowledge and subjectivity, the stigma concept is critically interrogated in order to address previous individualistic constructions of stigmatisation and to place stigma within the power dynamics of social control. The results of the study indicate that a child's diagnosis with an autism spectrum disorder (ASD) is critical for parents to resist stigmatisation. Parents experienced considerable enacted stigma, but successfully resisted felt stigma by deploying medical knowledge to articulate unspoiled subject positions. The institutionalisation of medical knowledge within the autism community was critical to this process. Resistance to enacted stigma was successful to the degree that medical constructions of deviance deployed by parents were accepted by others, notably those in power within institutions. It is concluded that poststructural accounts of subjectivity and social control provide a useful way of conceptualising stigmatisation. An acceptance of the painful nature of stigma as lived experience co-exists with an emphasis on the constantly negotiated nature of embodied subjectivity as a contingent social process to illustrate the conditions for active resistance to stigmatisation.     

ASD儿童父母的亲职压力及心理影响因素研究

目的 探讨孤独症谱系障碍(ASD)儿童父母的亲职压力及心理影响因素.方法 选取2014至2015年由福建省福州儿童医院心理科和福建医科大学附属协和医院儿童神经专科高年资主治以上医师确诊、并其父母完成问卷调查的ASD儿童134例,采用亲职压力指标简表(包括父母困扰、亲子失功能及困难儿童3个分量表)、一般自我效能感量表、特质应对方式问卷对134名ASD儿童父母(实验组)进行调查,同时对115名正常儿童父母(对照组)施测,对结果进行分析.结果 实验组亲职压力总分及各维度得分均高于对照组(t =8.40 ～9.95,P＜0.05);实验组一般自我效能感低于对照组(t=-6.61,P＜0.05),且采用更多的消极应对方式和更少的积极应对方式(t值分别为6.39、-4.72,P＜0.05).相关分析显示:ASD儿童父母的亲职压力与消极应对呈正相关(r=0.328,P＜0.01),ASD儿童父母的亲职压力总分、父母困扰及困难儿童得分与患儿父母一般自我效能感均呈负相关(r值分别为-0.222、-0.251、-0.177,P＜0.05).结论 ASD儿童父母普遍存在较高水平的亲职压力,其亲职压力与家长的一般自我效能感及消极应对方式有关.     

The importance of emotions: the socialisation of emotion in parents of children with autism spectrum disorder

Parents play a critical role in the development of children's emotional competence; however, little research examines parents’ emotion socialisation practices among children with autism spectrum disorder (ASD). In this study, we compared the emotion socialisation practices of parents of children with ASD and to those of parents of children that are typically developing. The Coping with Children's Negative Emotions Scale was used to assess parents’ reactions to children's emotions in both the typically developing sample (n?=?138) and the sample of children with ASD (n?=?22). An analysis of covariance revealed significant differences in responses to anger and fear. Group was entered as the independent variable and the dependent variable was parents’ responses to children's expressions of negative emotion. Covariates included child gender and child age. These results demonstrate a need for research examining the relationship between, and moderators of, parents’ emotional reactions and the development of emotional competence in children with ASD. Furthermore, these results have implications for early intervention practice as parent–child interactions have been shown to affect child outcomes.     

The information and support needs of Iranian parents of children with autism spectrum disorders

Internationally, increasing numbers of children are being diagnosed with an autism spectrum disorder (ASD), but there is a dearth of studies outside more affluent countries as to parents’ understanding of this condition and the support they receive. Forty-three parents were recruited from schools and clinics in Tehran and interviewed individually using a structured interview schedule. Thematic content analyses identified a lack of parental understanding about autism and its causes, along with parents’ reactions to the diagnostic process and the dearth of information available to them. The majority of parents were dissatisfied with the professional assistance provided for their children and many lacked informal support from their families. The provision of accurate information through informal parent-to-parent support seems to be the most feasible means of assisting Iranian families to adjust to having a child with ASD within the family.