随班就读孤独症儿童的个案教育康复

背景孤独症是一种发生在婴幼时期比较严重的生长发育障碍.其基本特征为不同程度的社会交往障碍、语言发育障碍、兴趣范围狭窄和刻板重复的行为,在世界范围内有日益增高的趋势.孤独症的康复治疗仍然以教育训练为主.目的通过案例剖析,为孤独症儿童的随班就读教育训练提供启发,为教育工作者和患儿家长提供适当的建议.设计个案分析.单位南京特殊教育职业技术学院康复系及南京市上新河小学.对象孤独症患儿,男,1998-06生,于2001-02在沈阳市儿童医院被诊断为孤独症,符合1994年美国精神障碍诊断统计手册第4版自闭症的诊断标准.方法对孤独症患儿采用综合干预措施5个月.教育措施内容包括①良好接受课堂学习.②课堂上展示优点.③在生活中良好运用学习内容.④建立友善情感.⑤建立良好行为和消褪异常行为.⑥提高课堂注意力.⑦训练课堂环节的理解力.⑧选择适宜的考试办法.⑨建立愉快融合的板块时间.实施过程每天与患儿的老师、家长进行电话访谈1次,每周与老师、家长、患儿的同学进行面对面的交流1次,针对患儿的具体情况及时的调整教育策略.实验开始结束时进行全韦氏智商测定.并总结患儿课堂和课间行为表现的变化.主要观察指标①实验结束时患儿的全韦氏智商测定结果.②患儿课堂行为表现的变化.③患儿课间行为表现的变化.结果①实验结束时患儿的全韦氏智商测定结果为言语智商80分、操作智商110分、总智商95分.操作智商与言语智商相差30分,智力分项中的最高分与最低分相差9分,智力发育的不平衡现象已经有所好转.②课堂行为表现的变化基本上可以与其他同学一样,安静听课,跟随老师的节奏学习,无扰乱课堂的行为,能以适当的方式展示自己的才华.③课间行为的变化结交好朋友;关注参与同学的游戏;听铃声进入教室,不用老师提醒.结论在经过5个月的康复训练后,孤独症患儿随班就读的状况比干预前有明显的改善.运用多种康复训练方法可以改善随班就读孤独症儿童的教育效果.

Case study on the education rehabilitation of mainstreaming children with autism

BACKGROUND: Autism is a kind of severe growth and development disorder that occurs in the infant period. It is basically characterized by social communication disorder, language development disorder, narrow area of interest, and stereotyped and repeated behavior to different extents, and is increasing in the worldwide. Education training is still taken as the major for the rehabilitation therapy of autism.OBJECTIVE: Case analysis is performed to provide elicitation for mainstreaming education training of children with autism and proper suggestions for education worker and children patients' parents.DESIGN: Case analysis.SETTING: Department of Rehabilitation, Nanjing Technical College of Special Education; Nanjing Shangxinhe Primary School.PARTICIPANTS: One male child patient, born in June 1998, was diagnosed as autism by Shenyang Children's Hospital. They met the diagnostic criteria of infantile autism of the 4th edition of diagnostic and statistical manual of mental disorders (1994, USA).METHODS: Comprehensive intervention was performed in the child with autism for 5 months. Education measures consist of: ① to well accept class learning. ② showing merits in class. ③ to well apply learning contents in life. ④ to establish friendship. ⑤ to establish good behaviors and eliminate abnormal behaviors. ⑥ to pay more attention in class.⑦ to train the perceptivity in class. ⑧ to choose proper examination methods. ⑨ to establish pleasant and confluent plate time. The procedures were as follows: we had one telephone interview to the teachers and parents of child patient every day, one face-to-face communication with the teachers, parents and classmates of child patient every week. Education strategy was regulated in time aiming to the concrete condition of child patient.Wechsler Intelligence scale was used to measure the intelligence quotient (IQ) at the beginning and end of the experiment. The changes in behavioral performance in class and playtime of patient were summed up.MAIN OUTCOME MEASURES: ① The measurement results of Wechsler IQ of patient at the end of the experiment. ② Changes in the behavioral performance of patient in class. ③ Changes in the behavioral performance of child patient in playtime.RESULTS: ① Measurement results of Wechsler IQ of patients at the end of the experiment were as follows: verbal IQ 80 points, performance IQ 110 points, full scale IQ 95 points. There was 30-point discrepancy between performance IQ and verbal IQ, and 9 points between the highest and lowest scores. The imbalance of intelligence development had turned better.② Changes in behavioral performance in class: The child patient was basically the same as other children. He could attend a class silently, followed the teacher to learn, did not disturb class, and show his brilliance with proper style. ③ Changes in the behaviors in playtime: made friends; was interested and participated in the games of the classmates, entered the classroom when he heard the ring without the help from the teacher.CONCLUSION: After 5-month rehabilitation training, the mainstreaming status of patient with autism is significantly improved as compared with before intervention. Application of various rehabilitation-training methods can improve the education effect of patient with autism.