陈雪萍,张庆英,吴毅,王鸿武,饶文旺,李多,欧燕,苏少媛,刘桂敏.以VB-MAPP为基础的家庭密集行为干预对孤独症谱系障碍患儿语言能力的影响[J].四川精神卫生杂志,2023,36(5):422-427.Chen Xueping,Zhang Qingying,Wu Yi,Wang Hongwu,Rao Wenwang,Li Duo,Ou Yan,Su Shaoyuan,Liu Guimin,Effect of home-based early intensive behavioral intervention using VB-MAPP on verbal ability in children with autism spectrum disorder[J].SICHUAN MENTAL HEALTH,2023,36(5):422-427

以VB-MAPP为基础的家庭密集行为干预对孤独症谱系障碍患儿语言能力的影响

Effect of home-based early intensive behavioral intervention using VB-MAPP on verbal ability in children with autism spectrum disorder

投稿时间：2022-12-29

DOI：10.11886/scjsws20221229004

中文关键词: 孤独症谱系障碍语言行为里程碑评估及安置程序家庭训练早期密集行为干预语言能力

英文关键词:Autism spectrum disorder VB-MAPP Home-based intervention Early intensive behavioral intervention Verbal ability

基金项目:2020广东省科技专项资金（项目名称：基于IEP及治疗师督导下的自闭症家庭干预模式探讨，项目编号：20200601）

作者	单位	邮编
陈雪萍	汕头大学医学院第二附属医院，广东汕头 515041	515041
张庆英	汕头大学医学院公共卫生与预防医学教研室，广东汕头 515041	515041
吴毅^*	汕头大学医学院第二附属医院，广东汕头 515041	515041
王鸿武	汕头大学医学院第二附属医院，广东汕头 515041	515041
饶文旺	汕头大学医学院公共卫生与预防医学教研室，广东汕头 515041	515041
李多	汕头大学医学院第二附属医院，广东汕头 515041	515041
欧燕	汕头大学医学院第二附属医院，广东汕头 515041	515041
苏少媛	汕头大学医学院第二附属医院，广东汕头 515041	515041
刘桂敏	汕头大学医学院第二附属医院，广东汕头 515041	515041

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中文摘要:

背景家庭干预是对孤独症谱系障碍（ASD）患儿进行干预的重要组成部分，既往关于以家庭为主导的密集行为干预对ASD患儿语言能力影响的研究不足。目的研究以语言行为里程碑评估及安置程序（VB-MAPP）为基础的家庭密集行为干预对ASD患儿语言能力的影响，为制定ASD患儿的家庭干预策略提供参考。方法选取2020年9月-2021年12月在汕头大学医学院第二附属医院儿童康复科就诊、符合《精神障碍诊断与统计手册（第5版）》（DSM-5）ASD诊断标准的2~3岁患儿为研究对象。采用同期非随机对照试验，将ASD患儿分为研究组（n=24）和对照组（n=14），研究组接受以VB-MAPP为基础的家庭密集行为干预，对照组接受其他特殊机构或早教机构培训，两组干预均持续6个月。干预前后，对两组患儿进行VB-MAPP里程碑评估，选取VB-MAPP里程碑总评分、提要求、命名和听者反应作为研究指标。比较两组干预效果的差异，采用多元线性回归考查干预效果的影响因素。结果干预后，研究组VB-MAPP里程碑总评分、提要求、命名和听者反应评分均高于对照组，差异均有统计学意义（Z=-4.339~-2.195，P<0.05或0.01）。多元线性回归分析结果显示，前三个月平均每周家庭训练时长对听者反应能力有影响（β=1.029，P<0.05）。结论以VB-MAPP为基础的早期家庭密集行为干预可能有助于ASD患儿提要求、命名、听者反应等语言能力的改善。

英文摘要:

Background Home-based intervention occupies a prominent place in the treatment of autism spectrum disorder （ASD） in children， whereas previous studies on the effect of home-based early intensive behavioral intervention on verbal ability of children with ASD are somewhat inadequate.Objective To study the effects of intensive family behavioral of intervention based on Verbal Behavior Milestones Assessment and Placement Program （VB-MAPP） on the language ability of children with ASD， so as to provide references for the development of family intervention strategies for children with ASD.Methods Children aged 2 to 3 years old who attended the Children's Rehabilitation Department of the Second Affiliated Hospital of Shantou University Medical College from September 2020 to December 2021 and met the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） diagnostic criteria for ASD were selected as the study objects. A non-randomized concurrent control trial was conducted to compare a study group （n=24） receiving home-based early intensive behavioral intervention using VB-MAPP with a control group （n=14） receiving training from other special institutions or early childhood education institutions. The intervention lasted for 6 months in both groups. Before and after the intervention， the VB-MAPP milestone assessment was performed in the two groups， and the VB-MAPP milestone score， mand， trac and listener responds were selected as the study indicators. Then the intervention effect was compared between two groups， and the multiple linear regression was performed to screen the related influencing factors.Results After intervention， the total milestone assessment score， mand， tact and listener responds scores of study group were higher than those of control group， with statistical difference （Z=-4.339~-2.195， P<0.05 or 0.01）. Multiple linear regression analysis denoted that the average weekly hours of home-based intervention in the first three months had certain effect on listener responds （β=1.029， P<0.05）.Conclusion Application of home-based early intensive behavior intervention using VB-MAPP may contribute to the improvement of verbal abilities such as mand， tact and listener responds in children with ASD. ［Funded by 2020 Guangdong Provincial Science and Technology Innovation Strategy Special Fund （number， 20200601）］

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