| 摘要: |
| ［摘要］ 目的 分析针对家长的团体与个体认知行为治疗（CBT）联合家庭早期干预训练对孤独症谱系障碍（ASD）患儿的临床疗效。方法 招募2024年1月至2025年2月徐州医科大学附属徐州儿童医院收治的ASD患儿100例，采用随机数字表法将其分为团体CBT组（接受团体CBT联合家庭早期干预训练，34例）、个体CBT组（接受个体CBT联合家庭早期干预训练，33例）和对照组（接受家庭早期干预训练，33例）。家庭早期干预训练，1次/周，训练周期为3个月；CBT每周1次，共8次。比较三组患儿干预前后的盖塞尔发育量表（GDS）评分、孤独症行为评定量表（ABC）评分以及孤独症治疗评估量表（ATEC）评分。比较三组患儿家长干预前后的焦虑自评量表（SAS）评分和育儿自我效能感测评工具（TOPSE）评分。结果 三组患儿干预后GDS中适应性、精细动作、语言和个人社交领域的评分均较干预前显著提高（P<0.05），且团体CBT组适应性、语言和个人社交领域评分较个体CBT组和对照组更高，差异有统计学意义（P<0.05）。三组患儿干预后ATEC各维度评分均较干预前显著降低（P<0.05），且团体CBT组语言、社交和行为维度评分均低于个体CBT组和对照组，差异有统计学意义（P<0.05）。三组患儿干预后的ABC评分均较干预前显著降低（P<0.05），且团体CBT组评分较个体CBT组和对照组更低，差异有统计学意义（P<0.05）。团体CBT组和个体CBT组患儿家长干预后的SAS评分较干预前显著降低（P<0.05），而对照组SAS评分在干预前后无显著变化（P>0.05）。团体CBT组干预后的SAS评分低于个体CBT组和对照组，差异有统计学意义（P<0.05）。团体CBT组患儿家长干预后TOPSE各维度评分及总分均高于个体CBT组和对照组，差异有统计学意义（P<0.05）。结论 对ASD患儿家长予以CBT干预可改善其心理健康状况，提升育儿自我效能，从而促进ASD患儿的行为发展，且团体CBT的干预效果较个体CBT更优。 |
| 关键词: 孤独症谱系障碍 家庭早期干预训练 认知行为治疗 家长 |
| DOI：10.3969/j.issn.1674-3806.2026.01.11 |
| 分类号:R 493 |
| 基金项目:江苏省卫生健康委科研项目（编号：Z2023002） |
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| Analysis on clinical efficacy of parent-oriented group and individual cognitive-behavioral therapy combined with family-based early intervention training in children with autism spectrum disorder |
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MENG Lulu, BAO Kexiu, QIU Aizhen, WANG Min, WANG Yan, LI Jie, WANG Ya
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Department of Rehabilitation, Xuzhou Children′s Hospital Affiliated to Xuzhou Medical University, Xuzhou 221000, China
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| Abstract: |
| ［Abstract］ Objective To analyze the clinical efficacy of parent-oriented group and individual cognitive-behavioral therapy(CBT) combined with family-based early intervention training in children with autism spectrum disorder(ASD). Methods A total of 100 pediatric patients with ASD who were admitted to Xuzhou Children′s Hospital Affiliated to Xuzhou Medical University from January 2024 to February 2025 were recruited. The pediatric patients were divided into group-CBT group(receiving group CBT combined with family-based early intervention training, 34 patients), individual-CBT group(receiving individual CBT combined with family-based early intervention training, 33 patients) and control group(receiving family-based early intervention training, 33 patients) by random number table method. Family-based early intervention training was conducted once weekly, with a training period of 3 months. CBT was conducted once weekly, for a total of 8 times. Gesell Developmental Schedules(GDS) scores, Autism Behavior Checklist(ABC) scores and Autism Treatment Evaluation Checklist(ATEC) scores were compared among the pediatric patients in the three groups before and after the intervention. Self-Rating Anxiety Scale(SAS) scores and Tool to Measure Parenting Self-Efficacy(TOPSE) scores were compared among the pediatric patients′ parents in the three groups before and after the intervention. Results After intervention, the scores of adaptability, fine motor skills, language and personal social domains in the GDS of the pediatric patients in the three groups were significantly higher than those before intervention(P<0.05), and the scores of adaptability, language and personal social domains in the group-CBT group were higher than those in the individual-CBT group and the control group, with statistically significant differences(P<0.05). After intervention, the scores of each dimension of ATEC in the pediatric patients in the three groups were significantly lower than those before intervention(P<0.05), and the scores of language, social interaction and behavior dimensions in the group-CBT group were lower than those in the individual-CBT group and the control group, with statistically significant differences(P<0.05). After intervention, the scores of ABC in the pediatric patients in the three groups were significantly lower than those before intervention(P<0.05), and the scores of ABC in the group-CBT group were lower than those in the individual-CBT group and the control group, with statistically significant differences(P<0.05). After intervention, the scores of SAS in the pediatric patients′ parents in the group-CBT group and the individual-CBT group were significantly lower than those before intervention(P<0.05), while the scores of SAS in the control group showed no significant changes before and after intervention(P>0.05). After intervention, the scores of SAS in the group-CBT group were lower than those in the individual-CBT group and the control group, with statistically significant differences(P<0.05). After intervention, the scores of each dimension and the total scores of TOPSE in the pediatric patients′ parents in the group-CBT group were higher than those in the individual-CBT group and the control group, with statistically significant differences(P<0.05). Conclusion CBT intervention for parents of pediatric patients with ASD can improve their mental health status, enhance their self-efficacy in parenting, thereby promoting the behavioral development of the pediatric patients with ASD. Moreover, the intervention effect of group CBT is better than that of individual CBT. |
| Key words: Autism spectrum disorder(ASD) Family-based early intervention Cognitive-behavioral therapy(CBT) Parents |
