Joint attention and symbolic play in young children with autism: a randomized controlled intervention study
Joint attention and symbolic play in young children with autism: a randomized controlled intervention study
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DOI：
10.1111/j.1469-7610.2005.01567.x
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发表时间：
2006-06-01
影响因子：
7.6
通讯作者：
Paparella, T
中科院分区：
文献类型：
--
作者：
Kasari, C;Freeman, S;Paparella, T
背景：共同注意和符号游戏的延迟和缺陷是幼儿自闭症的两个重要发展问题。这些领域的缺陷已经在自闭症中得到了很好的研究，但很少成为治疗努力的重点（见Kasari， Freeman, & Paparella, 2001）。在本研究中，我们考察了联合注意和象征性游戏的针对性干预的效果。方法：研究对象为58名3 ~ 4岁的自闭症儿童（男孩46名）。儿童被随机分为联合注意力干预组、象征性游戏干预组或对照组。干预每天30分钟，持续5 - 6周。在干预前和干预后，由独立的评估人员收集了共同注意力和游戏技能以及母子互动的结构化评估。结果：结果表明，干预组和对照组在某些行为上均有显著改善。在结构化的联合注意评估中，联合注意干预组的儿童对联合注意的表现和反应显著增加；在母子互动中，儿童对联合注意的反应显著增加。游戏组儿童在与母亲的互动中表现出更多的符号游戏类型，在游戏评估和与母亲的互动中表现出更高的游戏水平。结论：本随机对照试验为联合注意和游戏干预幼儿自闭症的特异性和普遍性提供了有希望的数据。未来的研究需要检查这些早期干预对儿童发展的长期影响。
Background: Delays and deficits in joint attention and symbolic play constitute two important developmental problems in young children with autism. These areas of deficit have been well studied in autism but have rarely been the focus of treatment efforts (see Kasari, Freeman, & Paparella, 2001). In this study, we examine the efficacy of targeted interventions of joint attention and symbolic play. Methods: Participants were 58 children with autism aged 3 and 4 years ( 46 boys). Children were randomized to a joint attention intervention, a symbolic play intervention, or control group. Interventions were conducted 30 minutes daily for 5 - 6 weeks. Both structured assessments of joint attention and play skills and mother - child interactions were collected pre and post intervention by independent assessors. Results: Results indicate that both intervention groups improved significantly over the control group on certain behaviors. Children in the joint attention intervention initiated significantly more showing and responsiveness to joint attention on the structured joint attention assessment and more child-initiated joint attention in the mother - child interaction. The children in the play group showed more diverse types of symbolic play in interaction with their mothers and higher play levels on both the play assessment and in interaction with their mothers. Conclusions: This randomized controlled trial provides promising data on the specificity and generalizability of joint attention and play interventions for young children with autism. Future studies need to examine the long-term effects of these early interventions on children's development.