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考察基于小组的社交技能干预对8至15岁自闭症儿童的影响。

Examining the Impact of Group-Based Social Skills Intervention in Autistic Children Aged Eight to 15 Years.

作者信息

Gajre Mona P, Shah Mansi, Pradhan Shreeya V, Aseri Harshna

机构信息

Department of Pediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, IND.

出版信息

Cureus. 2024 Feb 1;16(2):e53376. doi: 10.7759/cureus.53376. eCollection 2024 Feb.

DOI:10.7759/cureus.53376
PMID:38435203
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10907971/
Abstract

Introduction Autism spectrum disorder (ASD) is a neurological and developmental disorder, which poses challenges to social communication and behavior, particularly affecting social functioning. Individuals with ASD face significant social challenges, including difficulty understanding social cues and body language, limited ability to engage in reciprocal social interactions, and challenges with establishing empathy. A preference for routines and repetitive behaviors limits their ability to adapt to new or unexpected social situations. These problems tend to escalate during adolescence. These often cause distress to the individual as well as the caregivers. Group-based social skills interventions (GSSIs) are a widely used and effective modality for addressing core social impairments in children with autism. This study aims to assess the impact of GSSI on the broad age group of eight to 15 years, involving parents to enhance the transferability of children's social skills. Methods This was a single-arm interventional study where 30 verbal autistic children, aged eight to 15 years, with intelligence quotient (IQ) > 70 were enrolled after utilizing the Binet Kamat Test of Intelligence (BKT) to assess IQ and the Indian Scale for Assessment of Autism (ISAA) to grade severity of autism. The children received GSSI from interdisciplinary therapists for 12 sessions, on a weekly basis, lasting 90 minutes each for a period of three months. After each therapy session, parents received summaries of each session and were delegated reinforcing homework assignments to enable generalization and maintenance of the skills taught. Outcome measures were taken at three points in time by utilizing the Social Communication Questionnaire (SCQ) and the parent-rated Social Responsiveness Scale 2 (p-SRS-2): T1: pre-therapy at the time of enrolment; T2: immediately post-therapy at the end of three months of training; and T3: long-term follow-up, three months after the end of training. Results Mean SCQ scores were as follows: T1 = 21.87, T2 = 18.57, and T3 = 18.57 (p = 0.000). This progressive decline at T1, T2, and T3 indicated a decreasing trend in the severity of difficulties in the social communication domain. Mean p-SRS-2 scores were as follows: T1 = 73.00, T2 = 64.57, and T3 = 64.30 (p < 0.0001). This declining trend at T1, T2, and T3 suggested a statistically significant decrease in the severity of difficulties faced in various social aspects tested by the p-SRS-2, i.e., social awareness, social cognition, social communication, and social motivation, along with a reduction in restricted interests and repetitive behaviors (RRBs). Very strong correlation coefficients were obtained for SCQ scores (T1-T2 = 0.921, T1-T3 = 0.921, and T2-T3 = 1.000), as well as for p-SRS-2 scores (T1-T2 = 0.743, T1-T3 = 0.746, and T2-T3 = 0.989), which reinforced the statistical significance of the data. Conclusion GSSI is an effective parent-assisted intervention for adolescents with ASD, with effects lasting up to three months post-intervention.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c5e/10907971/e974b2000d1a/cureus-0016-00000053376-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c5e/10907971/7053d6e73246/cureus-0016-00000053376-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c5e/10907971/e974b2000d1a/cureus-0016-00000053376-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c5e/10907971/7053d6e73246/cureus-0016-00000053376-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c5e/10907971/e974b2000d1a/cureus-0016-00000053376-i02.jpg
摘要

引言

自闭症谱系障碍(ASD)是一种神经发育障碍,对社交沟通和行为构成挑战,尤其影响社交功能。患有ASD的个体面临重大社交挑战,包括难以理解社交线索和肢体语言、进行双向社交互动的能力有限以及建立同理心方面存在困难。对常规和重复行为的偏好限制了他们适应新的或意外社交情境的能力。这些问题在青春期往往会加剧。这通常会给个体及其照顾者带来困扰。基于小组的社交技能干预(GSSIs)是一种广泛使用且有效的方式,用于解决自闭症儿童的核心社交障碍。本研究旨在评估GSSI对8至15岁这个广泛年龄组的影响,并让家长参与以提高儿童社交技能的可转移性。

方法

这是一项单臂干预研究,在使用比奈 - 卡马特智力测验(BKT)评估智商以及印度自闭症评估量表(ISAA)评估自闭症严重程度后,招募了30名年龄在8至15岁、智商(IQ)>70的言语自闭症儿童。这些儿童由跨学科治疗师进行为期12节的GSSI干预,每周一次,每次持续90分钟,为期三个月。每次治疗 session 后,家长会收到每次 session 的总结,并被分配强化家庭作业,以促进所学技能的泛化和维持。通过使用社交沟通问卷(SCQ)和家长评定的社交反应量表2(p - SRS - 2)在三个时间点进行结果测量:T1:入组时治疗前;T2:训练三个月结束时治疗后立即测量;T3:训练结束三个月后的长期随访。

结果

SCQ平均得分如下:T1 = 21.87,T2 = 18.57,T3 = 18.57(p = 0.000)。T1、T2和T3时的这种逐渐下降表明社交沟通领域困难严重程度呈下降趋势。p - SRS - 2平均得分如下:T1 = 73.00,T2 = 64.57,T3 = 64.30(p < 0.0001)。T1、T2和T3时的这种下降趋势表明,p - SRS - 2所测试的各个社交方面(即社交意识、社交认知、社交沟通和社交动机)所面临困难的严重程度在统计学上有显著下降,同时受限兴趣和重复行为(RRBs)也有所减少。SCQ得分(T1 - T2 = 0.921,T1 - T3 = 上文中“session”未翻译准确,这里统一翻译为“疗程”。

结果

SCQ平均得分如下:T1 = 21.87,T2 = 18.57,T3 = 18.57(p = 0.000)。T1、T2和T3时的这种逐渐下降表明社交沟通领域困难严重程度呈下降趋势。p - SRS - 2平均得分如下:T1 = 73.00,T2 = 64.57,T3 = 64.30(p < 0.0001)。T1、T2和T3时的这种下降趋势表明,p - SRS - 2所测试的各个社交方面(即社交意识、社交认知、社交沟通和社交动机)所面临困难的严重程度在统计学上有显著下降,同时受限兴趣和重复行为(RRBs)也有所减少。SCQ得分(T1 - T2 = 0.921,T1 - T3 = 0.921,T2 - T3 = 1.000)以及p - SRS - 2得分(T1 - T2 = 0.743,T1 - T3 = 0.746,T2 - T3 = 0.989)都获得了非常强的相关系数,这加强了数据的统计学意义。

结论

GSSI是一种有效的家长辅助干预措施,对患有ASD的青少年有效,干预效果可持续到干预后三个月。

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本文引用的文献

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Short-term Outcome of Social Skills Group Therapy Intervention in School Aged Children With Autism.社交技能团体治疗干预对学龄期自闭症儿童的短期疗效。
Indian Pediatr. 2023 Oct 15;60(10):839-842.
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