本文選題：兒童　切入點：自閉癥　出處：《錦州醫(yī)科大學》2017年碩士論文

【摘要】：目的研究在綜合干預前后自閉癥患兒各方面能力的變化,比較不同性別、年齡等背景條件對綜合干預的影響,探討綜合干預效果及影響自閉癥患兒康復效果的因素,為進一步提高康復效果以及改進康復方案提供依據(jù)與指導。方法選取2014-2016學年在遼寧省錦州地區(qū)兩所特殊教育學校進行康復訓練的89例自閉癥兒童作為研究對象。自閉癥兒童接受訓練時的年齡在2-7歲之間,其中男孩68名、女孩21名。綜合干預的措施主要有:運動綜合訓練、語音訓練、認知訓練、游戲訓練、生活自理訓練、藝術訓練和電腦游戲等課程。每周周一到周六上課,其中大課上午為4課時,下午為3課時,定期開展一對一個訓課,每次課半小時。每次課后訓練教師會對課程情況及每個孩子的表現(xiàn)作出評估記錄,患兒接受訓練前進行第一次評估,訓練1個學期后進行第二次評估,訓練1個學年后進行第三次評估。評估工具采用中殘聯(lián)統(tǒng)一發(fā)行使用的《孤獨癥兒童發(fā)展評估表》。數(shù)據(jù)分析采用t檢驗、方差分析等方法對評估結果進行分析,對比三次評估得分是否存在顯著差異,比較患兒背景因素對綜合干預康復效果是否有顯著影響。結果1、89名患兒在感知覺、粗大動作、精細動作、語言與溝通、認知、社會交往、生活自理、情緒與行為等8項評估中,干預訓練前后及兩次訓練之間得分差異均有統(tǒng)計學意義。8項得分訓練后半年均高于訓練前,訓練后1年均高于訓練后半年。2、對感知覺的干預在患兒性別(t=4.267,P=0.000)、獨生與否(t=4.180,P=0.000)、睡眠情況(t=2.065,P=0.042)、飲食情況(t=2.795,P=0.008)、家庭經(jīng)濟狀況(t=2.626,P=0.011)、父母婚姻狀況(t=3.649,P=0.001)因素中差異有統(tǒng)計學意義。其中男孩、非獨生子女、睡眠較差、飲食較好、家庭經(jīng)濟狀況較差和父母未離異的患兒評估分數(shù)差值較大。3、對粗大動作的干預在患兒居住地(t=4.410,P=0.000)、獨生與否(t=6.023,P=0.000)、家長信心(t=2.655,P=0.010)、年齡(F=6.584,P=0.002)因素中差異有統(tǒng)計學意義。其中農(nóng)村、非獨生子女、家長無信心、6-7歲的患兒評估分數(shù)差值較大。4、對精細動作的干預在患兒性別(t=2.225,P=0.031)、居住地(t=3.485,P=0.001)、父母學歷(t=5.905,P=0.000)、家長重視程度(t=7.429,P=0.000)、家長信心(t=2.375,P=0.021)、病情(F=15.222,P=0.000)、年齡(F=4.484,P=0.014)因素中差異有統(tǒng)計學意義。其中男孩、城鎮(zhèn)、父母低學歷、家長重視、家長有信心、輕度病情、4-6歲的患兒評估分數(shù)差值較大。5、對語言與溝通的干預在患兒性別(t=3.137,P=0.004)、獨生與否(t=4.357,P=0.000)、睡眠情況(t=4.054,P=0.000)、飲食情況(t=5.405,P=0.000)、家庭經(jīng)濟狀況(t=2.443,P=0.020)、父母學歷(t=4.361,P=0.000)、父母婚姻狀況(t=5.750,P=0.000)、家長信心(t=2.199,P=0.031)、病情(F=50.802,P=0.000)、年齡(F=11.537,P=0.000)因素中差異有統(tǒng)計學意義。其中女孩、獨生子女、睡眠較好、飲食較差、家庭經(jīng)濟狀況較好、父母低學歷、父母離異、家長無信心、輕度病情、2-4歲的患兒評估分數(shù)差值較大。6、對認知能力的干預在患兒性別(t=3.117,P=0.004)、飲食情況(t=2.504,P=0.019)、父母婚姻狀況(t=7.437,P=0.000)、家長重視程度(t=2.392,P=0.019)、家長信心(t=3.376,P=0.001)、病情(F=8.012,P=0.001)、年齡(F=10.319,P=0.000)因素中差異有統(tǒng)計學意義。其中女孩、飲食較差、父母離異、家長不重視、家長無信心、輕度病情、2-4歲的患兒評估分數(shù)差值較大。7、對社會交往的干預在患兒性別(t=3.450,P=0.002)、居住地(t=2.951,P=0.004)、獨生與否(t=4.308,P=0.000)、飲食情況(t=2.379,P=0.025)、父母學歷(t=3.827,P=0.000)、父母婚姻狀況(t=4.109,P=0.000)、家長信心(t=2.192,P=0.031)、病情(F=5.792,P=0.004)、年齡(F=9.511,P=0.000)因素中差異有統(tǒng)計學意義。其中女孩、城鎮(zhèn)、獨生子女、飲食較差、父母低學歷、父母離異、家長無信心、輕度病情、2-4歲的患兒評估分數(shù)差值較大。8、對生活自理能力的干預在患兒居住地(t=3.409,P=0.002)、睡眠情況(t=3.697,P=0.000)、飲食情況(t=2.113,P=0.038)、父母學歷(t=4.113,P=0.000)、父母婚姻狀況(t=5.364,P=0.000)、家長信心(t=3.130,P=0.002)、病情(F=22.210,P=0.000)、年齡(F=3.941,P=0.023)因素中差異有統(tǒng)計學意義。其中城鎮(zhèn)、睡眠較差、飲食較差、父母低學歷、父母離異、家長無信心、輕度病情、2-4歲的患兒評估分數(shù)差值較大。9、對情緒與行為的干預在患兒居住地(t=4.938,P=0.000)、家庭經(jīng)濟狀況(t=5.284,P=0.000)、家長重視程度(t=9.193,P=0.000)、家長信心(t=4.269,P=0.000)、病情(F=7.375,P=0.001)、年齡(F=3.722,P=0.028)因素中差異有統(tǒng)計學意義。其中城鎮(zhèn)、家庭經(jīng)濟狀況較差、家長重視、家長有信心、輕度病情、4-6歲的患兒評估分數(shù)差值較大。結論1、綜合干預對自閉癥患兒感知覺、粗大動作、精細動作、語言與溝通、認知、社會交往、生活自理、情緒與行為能力均有明顯的改善。2、自閉癥患兒的背景因素對綜合干預訓練的康復效果均有影響,其中家長信心與患兒年齡影響的項目最多,均為7項;患兒病情影響的項目為6項;性別、居住地、飲食情況、父母婚姻狀況影響的項目為5項;獨生與否、父母學歷影響的項目為4項;睡眠情況、家庭經(jīng)濟狀況和家長重視程度影響的項目最少為3項。
[Abstract]:Objective to study the changes of autistic children in all aspects of comprehensive ability before and after the intervention, comparison of different gender, age and background conditions on the influence of comprehensive intervention, comprehensive intervention effect and influence factors of rehabilitation of children with autism in effect, to further improve the effect of rehabilitation and improvement of rehabilitation program provides basis and guidance. Methods 2014-2016 year rehabilitation training in two areas of Jinzhou special education schools in Liaoning province in 89 cases of children with autism as the research object. The training of autistic children at the age of 2-7 years old, 68 boys and 21 girls. The comprehensive intervention measures mainly include: Sports comprehensive training, speech training, cognitive training, game training, life self-care training, art training and computer game courses. Every Monday to Saturday school, which is 4 hours in the morning, afternoon for 3 hours, regularly carry out to a Training class, each class for half an hour. Each class of training teachers curriculum and each child's performance assessment records, were trained before the first assessment, second assessment training after 1 semesters, third assessment training. After 1 year evaluation tool is made use of CDPF uniform distribution "autistic children development assessment scale. Data were analyzed by t test, variance analysis and other methods of evaluation results were analyzed and compared the three assessment score whether there are significant differences, whether there is a significant effect compared with background factors on rehabilitation of comprehensive intervention. Results 1,89 patients in fine motion perception, gross motor, language and communication., cognition, social interaction, self-care, emotional and behavioral assessment in 8, and two times between before and after the training intervention training score differences were statistically significant.8 scores after training The average is higher than that before the training, after training at an average annual rate of 1 higher than half a year after the.2 training, the perception of the intervention on children with gender (t=4.267, P=0.000), the only child or not (t=4.180, P=0.000), sleep (t=2.065, P=0.042), diet (t=2.795, P=0.008), family economic status (t=2.626, P=0.011), parents marital status (t=3.649, P=0.001) were statistically significant differences in the factors. The boy, non child, poor sleep, eating better, and family economic status of poor parents not divorced children score difference.3, on gross motor intervention in children (t=4.410, P=0.000), the only child or not (t=6.023, P=0.000), parents (t=2.655, P=0.010) confidence, age (F=6.584, P=0.002) were statistically significant differences in the factors. The rural areas, not only children, parents have no confidence, 6-7 year old children with a large difference between the scores of.4, fine motor intervention on children with gender (t =2.225, P=0.031) (t=3.485, P=0.001), residence, educational level of parents (t=5.905, P=0.000), the degree of attention of parents (t=7.429, P=0.000), parents (t=2.375, P=0.021), heart disease (F=15.222, P=0.000), age (F=4.484, P=0.014) were statistically significant differences in the factors. The boy, towns, parents of low education, parents attention, confidence, parents mild illness, 4-6 year old children with a large difference between the.5 scores, the language and communication intervention in children with gender (t=3.137, P=0.004), the only child or not (t=4.357, P=0.000), sleep (t=4.054, P=0.000), diet (t=5.405, P=0.000), family economic condition (t=2.443, P=0.020), educational level of parents (t=4.361, P=0.000), parents' marital status (t=5.750, P=0.000), parents (t=2.199, P=0.031), heart disease (F=50.802, P=0.000), age (F=11.537, P=0.000) were statistically significant differences in the factors. The girl child, sleep well, drink Poor food, family economic situation is good, the parents of low degree, divorced parents, parents have no confidence, mild illness, 2-4 year old children with larger difference of.6 scores, cognitive intervention on children with gender (t=3.117, P=0.004), diet (t=2.504, P=0.019), the parent marital status (t=7.437, P=0.000). The degree of attention of parents (t=2.392, P=0.019), parents (t=3.376, P=0.001), heart disease (F=8.012, P=0.001), age (F=10.319, P=0.000) were statistically significant differences in factors. Among girls, poor diet, divorced parents, parents do not pay attention, parents have no confidence, mild illness, 2-4 year old children score difference the larger.7, for community intervention on children with gender (t=3.450, P=0.002) (t=2.951, P=0.004), place of residence, only child or not (t=4.308, P=0.000), diet (t=2.379, P=0.025), educational level of parents (t=3.827, P=0.000), parents' marital status (t=4.109, P=0.000), parents Confidence (t=2.192, P=0.031) (F=5.792, P=0.004), disease, age (F=9.511, P=0.000) were statistically significant differences in factors. Among girls, towns, only children, poor diet, low educated parents, divorced parents, parents have no confidence, mild illness, 2-4 year old children with a large difference between the scores of.8, self-care ability the life of the intervention in children (t=3.409, P=0.002), sleep (t=3.697, P=0.000), diet (t=2.113, P=0.038), educational level of parents (t=4.113, P=0.000), parents' marital status (t=5.364, P=0.000), parents (t=3.130, P=0.002), heart disease (F=22.210, P=0.000), age (F=3.941 P=0.023), there was statistical significance difference. The factors in town, poor sleep, poor diet, low educated parents, divorced parents, parents have no confidence, mild illness, 2-4 year old children with a large difference between the scores of.9, emotional and behavioral intervention in children (t=4.938, P =0.000), family economic status (t=5.284, P=0.000), the degree of attention of parents (t=9.193, P=0.000), parents (t=4.269, P=0.000), heart disease (F=7.375, P=0.001), age (F=3.722, P=0.028) were statistically significant differences in factors. Among them the town, poor family economic status of parents attention, confidence, parents mild illness, 4-6 year old children with larger difference. Conclusion the evaluation score of 1, the fine movement of comprehensive intervention on autistic children perception, coarse, action, language and communication, cognition, social communication, daily life, improve the.2 ability of emotion and behavior were significantly affected, the effect of rehabilitation training on the background factors of children with autism comprehensive intervention, the influence of parents confidence and age of children, the largest number of projects, all 7 children with the disease; influence of 6 projects; gender, residence, diet, influence of parents' marital status for the 5 projects; the only child or not, parents 4 items were affected by educational background, and at least 3 items were affected by sleep conditions, family economic conditions and parents' attention.

【學位授予單位】：錦州醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R749.94

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