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孤独症儿童模仿能力对社交沟通的影响——一项早期介入丹佛 模式的干预研究
其他题名The Impact of Imitation Abilities on Social Communication in Children with Autism: An Intervention Study Using the Early Start Denver Model
肖石花
导师李晶
2023-12
摘要

模仿是儿童早期社会互动学习的基础和关键技能,而孤独症儿童的模仿能力存在明显的缺陷,这可能导致他们在社交沟通领域面临挑战。社交沟通障碍是孤独症儿童的核心缺陷之一,以往研究发现,孤独症儿童的模仿能力与社交沟通能力有一定的相关性,但模仿能力对社交沟通发展的影响程度和路径还缺乏系统性 研究和实验性证据。早期介入丹佛模式(Early Start Denver Model, ESDM)是一种综合性的自然发展行为干预方法,孤独症儿童的社交沟通是这一干预方法的主要目标领域,而对模仿能力的培养被认为是 ESDM 干预的优势之一。因此,本文旨在通过早期介入丹佛模式干预实验探讨孤独症儿童模仿能力与社交沟通能力之 间的关系,以及 ESDM 干预对孤独症儿童模仿能力和社交沟通能力的影响。

本文采用非随机对照研究,招募了 52 名 2~5 岁的孤独症儿童,其中 28 名 接受为期 12 周的早期介入丹佛模式干预,24 名接受常规干预。使用模仿能力评 估表和社交沟通能力评估表在干预前后对儿童进行测评,并采用方差分析、相关分析、回归分析等方法进行数据处理和分析,结果表明:

(1)孤独症儿童模仿能力与社交沟通能力之间存在紧密的联系和显著的相 关性,不同类型的模仿可能与社交沟通的不同领域之间存在特定的关系。如声音模仿与表达性沟通关系更密切,手势模仿可能与社交技能的关系更紧密,而驭物模仿可能与共同注意关系更密切。

(2)模仿能力对孤独症儿童社交沟通能力的改善具有显著影响,模仿因素(基线期水平和改善程度)对社交沟通改善程度的影响均有显著性,其中,模仿改善程度是最强大的预测因子。两个模仿因素能够共同在较高程度上解释和预测孤独症儿童社交沟通的改善。

(3)研究首次发现年龄对模仿能力与社交沟通能力之间的关系可能具有显著的正向调节作用,随着年龄增长,模仿能力对社交沟通能力的影响增强。以上效应在两组中保持一致,表明模仿因素对孤独症儿童社交沟通变化的影响是稳健 且具有普遍性的。

此外,本研究表明,在接受 ESDM 干预后,孤独症儿童的模仿能力和社交沟通能力均得到显著改善。在模仿领域,ESDM 干预相较于常规干预显示出显著优势,ESDM 组的模仿能力总分以及在驭物模仿、手势模仿和口面部模仿等子项目上的改善均显著超过常规干预组,而在社交沟通领域,本次研究未观察到 ESDM 相对常规干预效果的显著差异。

总体而言,本研究发现孤独症儿童的模仿能力与社交沟通能力之间具有紧密联系,模仿因素(基线期水平和改善程度)对孤独症儿童社交沟通能力的变化具有显著影响,而儿童的年龄对二者的关系具有调节效应。并且早期介入丹佛模式能够帮助孤独症儿童提高模仿能力和社交沟通能力,尤其对提高孤独症儿童的模仿能力具有显著优势。该结果揭示了模仿在孤独症儿童社交发展中的重要性,可以为孤独症儿童的早期干预提供更有效的指导和评估,从而优化干预方案和提高干预效果。

其他摘要

Imitation is a foundational and critical skill in early social interactive learning for children, yet children with autism exhibit significant deficits in imitation abilities, potentially leading to challenges in social communication. Social communication impairments are one of the core deficits in children with autism. Previous studies have identified a correlation between the imitation abilities and social communication skills in autistic children, but there is a lack of systematic research and experimental evidence on the extent and pathways of the influence of imitation abilities on social communication development. The Early Start Denver Model (ESDM) is a comprehensive natural developmental behavioral intervention, with the social communication of autistic children being a primary target area of this intervention, and the cultivation of imitation abilities is considered one of the strengths of ESDM intervention. Therefore, this paper aims to explore the relationship between imitation abilities and social communication skills in autistic children through the experimental intervention of the Early Start Denver Model, as well as the impact of ESDM intervention on these abilities.

This study employed a non-randomized controlled trial with experimental and control groups, recruiting 52 autistic children aged 2-5 years, of which 28 received 12 weeks of ESDM intervention and 24 received standard intervention. Assessment scales for imitation and social communication skills were used to evaluate the children before and after the intervention. Data were analyzed using variance analysis, correlation analysis, and regression analysis. The results showed:

(1) A close link and significant correlation exist between the imitation abilities and social communication skills in autistic children. Different types of imitation may relate specifically to different areas of social communication. For instance, vocal imitation is more closely related to expressive communication, gesture imitation to social skills, and object manipulation to joint attention.

(2) Imitation abilities significantly impact the improvement of social communication skills in autistic children. Two imitation factors—improvement in imitation abilities and baseline level of imitation—significantly influenced the improvement in social communication, with the degree of improvement in imitation being the strongest predictor. These factors collectively explain and predict improvements in the social communication of autistic children to a considerable extent.

(3) The study found for the first time that age might play a significant positive moderating role in the relationship between imitation abilities and social communication skills. With increasing age, the impact of imitation abilities on social communication skills strengthens. This effect was consistent across both groups, indicating that the impact of imitation factors on changes in social communication in autistic children is robust and universal.

(3) The study found for the first time that age might play a significant positive moderating role in the relationship between imitation abilities and social communication skills. With increasing age, the impact of imitation abilities on social communication skills strengthens. This effect was consistent across both groups, indicating that the impact of imitation factors on changes in social communication in autistic children is robust and universal.

Additionally, the results of this study indicated that the ESDM intervention significantly enhances both imitation and social communication abilities in autistic children. The ESDM group showed significant advantages over the standard intervention group in the post-intervention total imitation ability score and in the improvement of object manipulation, gesture, and facial imitation. However, in the area of social communication, no significant differences in intervention effects were found.

Overall, this study found a close link between imitation abilities and social communication skills in autistic children. Imitation factors (baseline level, improvement in imitation abilities, and baseline level of imitation) significantly influence changes in social communication skills in autistic children, with the child's age having a moderating effect. The Early Start Denver Model can help improve imitation and social communication abilities in autistic children, particularly in enhancing imitation abilities. These results reveal the importance of imitation in the social development of autistic children, offering more effective guidance and assessment for early intervention in autism, thereby optimizing intervention programs and enhancing intervention effects.

关键词孤独症 模仿能力 社交沟通 早期介入丹佛模式
学位类型继续教育硕士
语种中文
学位名称理学硕士
学位专业儿童发展与教育心理学
学位授予单位中国科学院大学
学位授予地点中国科学院心理研究所
文献类型学位论文
条目标识符http://ir.psych.ac.cn/handle/311026/48205
专题认知与发展心理学研究室
推荐引用方式
GB/T 7714
肖石花. 孤独症儿童模仿能力对社交沟通的影响——一项早期介入丹佛 模式的干预研究[D]. 中国科学院心理研究所. 中国科学院大学,2023.
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