高功能孤独症谱系障碍儿童社交能力团体技能训练干预效果  

Effectiveness of group skills training intervention on social ability of high functional autism spectrum disorder children

作　　者：胡莎莎[1] 赵啸 朱珍珍 刘晓丽[1] 王蓉 胡珍玉 张文武 HU Shasha;ZHAO Xiao;ZHU Zhenzhen;LIU Xiaoli;WANG Rong;HU Zhenyu;ZHANG Wenwu(Children and Adolescents Diagnosis and Treatment Center,the Affiliated Kangning Hospital of Ningbo University,Ningbo(315201),Zhejiang Province,China)

机构地区：[1]宁波大学附属康宁医院儿童青少年诊疗中心,浙江315201

出　　处：《中国学校卫生》2025年第2期167-171,共5页Chinese Journal of School Health

基　　金：浙江省医药卫生科技计划项目(2021KY1064)。

摘　　要：目的 评估整合式团体社交技能训练对学龄期高功能孤独症谱系障碍(ASD)患儿社交能力的干预效果,为提高高功能ASD患儿社交能力提供参考。方法 招募2021年1月—2023年12月在宁波大学附属康宁医院儿童精神科门诊就诊的7~12岁高功能ASD儿童62例,采用随机数字表法分为训练组和对照组各31例;训练组完成为期20周的结构化团体社交训练课程(包括心智解读课程和社交课程),对照组只进行常规治疗。干预前后采用中文版Griffith共情测验父母评定版(GEM-PR)、社交反应量表(SRS)评估ASD儿童社交缺陷症状,使用情绪面孔识别任务及眼动轨迹测试社会性视觉注意的特征。组间比较采用t检验和Mann-Whitney U检验。结果 基线时两组儿童GEM-PR评分(t=-1.20~-0.81)、SRS评分(t=-0.36~1.75)、情绪面孔识别率及反应时(t=-0.58~1.85)、眼动轨迹相关指标差异(U/t=-1.63~0.29)均无统计学意义(P值均>0.05)。干预后训练组GEM-PR总分和认知因子评分[18.00(10.00,24.00),9.00(8.00,13.00)]均高于对照组[12.00(-1.00,18.00),2.00(-2.00,7.00)],SRS总分及社交认知、社交知觉、社交沟通、社交动机因子评分(73.23±14.20,16.16±2.72,6.58±2.50,24.29±5.61,9.52±3.73)均低于对照组(95.26±15.29,19.90±2.84,12.58±2.49,31.94±6.38,13.74±4.81)(U/t值分别为-2.38,-4.59;-5.88,-5.29,-9.47,-5.01,-3.87,P值均<0.05);训练组情绪面孔识别总正确率及愤怒、恐惧、平静面孔识别率[(81.55±6.62)%,(76.86±12.06)%,(79.61±12.42)%,(94.27±6.26)%]均高于对照组[(70.55±13.82)%,(62.82±18.77)%,(67.18±18.85)%,(79.60±20.05)%],反应时[(2 226.70±274.43)ms]低于对照组[(2 417.27±324.10)ms](t值分别为4.00,3.50,3.07,3.89,-2.42,P值均<0.05);训练组眼动轨迹首次注视面孔的时间[764.74(748.64,793.73)ms]低于对照组[810.92(782.86,877.42)ms],对面孔中高强度关注区域占比[(37.37±1.27)%]高于对照组[(30.34±1.23)%],差异均有统计学意义(U/t值分别为3.44,8.89,P值均<0.05)Objective To evaluate the intervention efficacy of integrated group social skills training on social ability in school-age patients with high-functioning ASD,so as to provide a reference for improving social skills in children with high-functioning ASD.Methods From January 2021 to December 2023,62 children aged 7-12 with high-functioning ASD who visited the Children's Psychiatry Outpatient Department of the Affiliated Kangning Hospital of Ningbo University were recruited,and were randomly divided into a training(n=31)and a control group(n=31)by a random number table method.The training group received a 20-week structured group social training program(mental interpretation courses and social courses),while the control group received only conventional treatment.Chinese version of Griffith Empathy Measure Parent Ratings(GEM-PR)and Social Response Scale(SRS)were used to assess the symptoms of social deficits before and after treatment.Emotional face recognition tasks and eye movement trajectories were used to test the characteristics of social visual attention in children with ASD.Group comparison was conducted using t-test and Mann-Whitney U test.Results At baseline,there were no significant differences in GEM-PR score(t=-1.20 to-0.81),SRS score(t=-0.36-1.75),emotional face recognition accuracy and reaction time(t=-0.58-1.85),and eye movement trajectory(U/t=-1.63-0.29)between the two group(P>0.05).After intervention,the total GEM-PR score and empathic cognitive factor score of training group[18.00(10.00,24.00),9.00(8.00,13.00)]were significantly higher than those of the control group[12.00(-1.00,18.00),2.00(-2.00,7.00)],and the total SRS score and social cognition,social perception,social communication,social motivation(73.23±14.20,16.16±2.72,6.58±2.50,24.29±5.61,9.52±3.73)were significantly lower than those of the control group(95.26±15.29,19.90±2.84,12.58±2.49,31.94±6.38,13.74±4.81)(U/t=-2.38,-4.59;-5.88,-5.29,-9.47,-5.01,-3.87,P<0.05).The overall correct rate of emotional face recognition and the correc

关 键 词：孤独性障碍 心理学 社会 干预性研究 儿童 

分 类 号：R179[医药卫生—妇幼卫生保健] R748[医药卫生—公共卫生与预防医学] B844.1[哲学宗教—发展与教育心理学]