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

【摘要】：目的研究在綜合干預(yù)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(duì)綜合干預(yù)的影響,探討綜合干預(yù)效果及影響自閉癥患兒康復(fù)效果的因素,為進(jìn)一步提高康復(fù)效果以及改進(jìn)康復(fù)方案提供依據(jù)與指導(dǎo)。方法選取2014-2016學(xué)年在遼寧省錦州地區(qū)兩所特殊教育學(xué)校進(jìn)行康復(fù)訓(xùn)練的89例自閉癥兒童作為研究對(duì)象。自閉癥兒童接受訓(xùn)練時(shí)的年齡在2-7歲之間,其中男孩68名、女孩21名。綜合干預(yù)的措施主要有:運(yùn)動(dòng)綜合訓(xùn)練、語(yǔ)音訓(xùn)練、認(rèn)知訓(xùn)練、游戲訓(xùn)練、生活自理訓(xùn)練、藝術(shù)訓(xùn)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(shí),下午為3課時(shí),定期開(kāi)展一對(duì)一個(gè)訓(xùn)課,每次課半小時(shí)。每次課后訓(xùn)練教師會(huì)對(duì)課程情況及每個(gè)孩子的表現(xiàn)作出評(píng)估記錄,患兒接受訓(xùn)練前進(jìn)行第一次評(píng)估,訓(xùn)練1個(gè)學(xué)期后進(jìn)行第二次評(píng)估,訓(xùn)練1個(gè)學(xué)年后進(jìn)行第三次評(píng)估。評(píng)估工具采用中殘聯(lián)統(tǒng)一發(fā)行使用的《孤獨(dú)癥兒童發(fā)展評(píng)估表》。數(shù)據(jù)分析采用t檢驗(yàn)、方差分析等方法對(duì)評(píng)估結(jié)果進(jìn)行分析,對(duì)比三次評(píng)估得分是否存在顯著差異,比較患兒背景因素對(duì)綜合干預(yù)康復(fù)效果是否有顯著影響。結(jié)果1、89名患兒在感知覺(jué)、粗大動(dòng)作、精細(xì)動(dòng)作、語(yǔ)言與溝通、認(rèn)知、社會(huì)交往、生活自理、情緒與行為等8項(xiàng)評(píng)估中,干預(yù)訓(xùn)練前后及兩次訓(xùn)練之間得分差異均有統(tǒng)計(jì)學(xué)意義。8項(xiàng)得分訓(xùn)練后半年均高于訓(xùn)練前,訓(xùn)練后1年均高于訓(xùn)練后半年。2、對(duì)感知覺(jué)的干預(yù)在患兒性別(t=4.267,P=0.000)、獨(dú)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(jì)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(jì)學(xué)意義。其中男孩、非獨(dú)生子女、睡眠較差、飲食較好、家庭經(jīng)濟(jì)狀況較差和父母未離異的患兒評(píng)估分?jǐn)?shù)差值較大。3、對(duì)粗大動(dòng)作的干預(yù)在患兒居住地(t=4.410,P=0.000)、獨(dú)生與否(t=6.023,P=0.000)、家長(zhǎng)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(jì)學(xué)意義。其中農(nóng)村、非獨(dú)生子女、家長(zhǎng)無(wú)信心、6-7歲的患兒評(píng)估分?jǐn)?shù)差值較大。4、對(duì)精細(xì)動(dòng)作的干預(yù)在患兒性別(t=2.225,P=0.031)、居住地(t=3.485,P=0.001)、父母學(xué)歷(t=5.905,P=0.000)、家長(zhǎng)重視程度(t=7.429,P=0.000)、家長(zhǎng)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(jì)學(xué)意義。其中男孩、城鎮(zhèn)、父母低學(xué)歷、家長(zhǎng)重視、家長(zhǎng)有信心、輕度病情、4-6歲的患兒評(píng)估分?jǐn)?shù)差值較大。5、對(duì)語(yǔ)言與溝通的干預(yù)在患兒性別(t=3.137,P=0.004)、獨(dú)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(jì)狀況(t=2.443,P=0.020)、父母學(xué)歷(t=4.361,P=0.000)、父母婚姻狀況(t=5.750,P=0.000)、家長(zhǎng)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(jì)學(xué)意義。其中女孩、獨(dú)生子女、睡眠較好、飲食較差、家庭經(jīng)濟(jì)狀況較好、父母低學(xué)歷、父母離異、家長(zhǎng)無(wú)信心、輕度病情、2-4歲的患兒評(píng)估分?jǐn)?shù)差值較大。6、對(duì)認(rèn)知能力的干預(yù)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(zhǎng)重視程度(t=2.392,P=0.019)、家長(zhǎng)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(jì)學(xué)意義。其中女孩、飲食較差、父母離異、家長(zhǎng)不重視、家長(zhǎng)無(wú)信心、輕度病情、2-4歲的患兒評(píng)估分?jǐn)?shù)差值較大。7、對(duì)社會(huì)交往的干預(yù)在患兒性別(t=3.450,P=0.002)、居住地(t=2.951,P=0.004)、獨(dú)生與否(t=4.308,P=0.000)、飲食情況(t=2.379,P=0.025)、父母學(xué)歷(t=3.827,P=0.000)、父母婚姻狀況(t=4.109,P=0.000)、家長(zhǎng)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(jì)學(xué)意義。其中女孩、城鎮(zhèn)、獨(dú)生子女、飲食較差、父母低學(xué)歷、父母離異、家長(zhǎng)無(wú)信心、輕度病情、2-4歲的患兒評(píng)估分?jǐn)?shù)差值較大。8、對(duì)生活自理能力的干預(yù)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(xué)歷(t=4.113,P=0.000)、父母婚姻狀況(t=5.364,P=0.000)、家長(zhǎng)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(jì)學(xué)意義。其中城鎮(zhèn)、睡眠較差、飲食較差、父母低學(xué)歷、父母離異、家長(zhǎng)無(wú)信心、輕度病情、2-4歲的患兒評(píng)估分?jǐn)?shù)差值較大。9、對(duì)情緒與行為的干預(yù)在患兒居住地(t=4.938,P=0.000)、家庭經(jīng)濟(jì)狀況(t=5.284,P=0.000)、家長(zhǎng)重視程度(t=9.193,P=0.000)、家長(zhǎng)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(jì)學(xué)意義。其中城鎮(zhèn)、家庭經(jīng)濟(jì)狀況較差、家長(zhǎng)重視、家長(zhǎng)有信心、輕度病情、4-6歲的患兒評(píng)估分?jǐn)?shù)差值較大。結(jié)論1、綜合干預(yù)對(duì)自閉癥患兒感知覺(jué)、粗大動(dòng)作、精細(xì)動(dòng)作、語(yǔ)言與溝通、認(rèn)知、社會(huì)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(duì)綜合干預(yù)訓(xùn)練的康復(fù)效果均有影響,其中家長(zhǎng)信心與患兒年齡影響的項(xiàng)目最多,均為7項(xiàng);患兒病情影響的項(xiàng)目為6項(xiàng);性別、居住地、飲食情況、父母婚姻狀況影響的項(xiàng)目為5項(xiàng);獨(dú)生與否、父母學(xué)歷影響的項(xiàng)目為4項(xiàng);睡眠情況、家庭經(jīng)濟(jì)狀況和家長(zhǎng)重視程度影響的項(xiàng)目最少為3項(xiàng)。
[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(xué)位授予單位】：錦州醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R749.94

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