认知与发展心理学研究室知识库

随着孤独症谱系障碍(Autism Spectrum Disorder, ASD)患病率的增加，人们对有效教育和康复治疗服务的需求也随之增加。其中应用行为分析是 ASD 儿童康 复干预中最常用的干预方式之一，它主要通过行为的 A（antecedent）B（behavior） C（consequence）塑造儿童的行为，以改善 ASD 儿童的问题行为、语言、社交 互动、认知、生活自理能力。而语言治疗对 ASD 儿童的语言及沟通能力的提升也发挥着重要的作用，语言治疗遵循儿童语言的发展，以改善 ASD 儿童语言及沟通能力。但语言治疗与应用行为分析在社交沟通、语言能力上的干预存在很多重合的部分，这会让家长在干预时长不变的情况下，选择何种康复干预方式产生困扰。另外词汇是语言的基本单位，词汇的发展和类型的丰富度、语法的发展，是评估儿童语言能力的重要指标。在 ASD 儿童的康复干预过程中是否需要进行多种词汇类型的干预、ASD 儿童词类多样性与语言能力之间的关系也是研究者们关注的方向。因此，本研究旨在考察：1.应用行为分析联合语言治疗对比单一使用应用行为分析对 ASD 儿童语言能力的干预效果；2.ASD 儿童词类多样性的发展与其语言能力之间的关系如何。

本研究选取了 60 名 36-78 个月的 ASD 儿童，分为实验组（n=30）和对照组 （n=30），对照组进行应用行为分析干预，实验组进行应用行为分析联合语言治疗干预，两组的干预时长均为3小时/天，5天/周，共干预3个月，干预前后使 用《汉语儿童语言发育迟缓评价法，简称S-S法（Sign - Significate relations）》 评估。

研究结果表明：（1）经过3个月的干预后，两组儿童在 S-S 语言理解、S-S语言表达、口语沟通能力、口语表达内容复杂度、词类理解多样性、词类表达多样性等语言能力方面均有所提升，这说明应用行为分析、语言治疗均能给 ASD 儿童带来有效的康复效果。（2）经过 3 个月的干预后，两组儿童在口语沟通能力方面的提升程度无显著差异，这说明即使在单独的应用行为分析组，ASD儿童也有足够的机会进行口语沟通的学习和锻炼。（3）经过3个月的干预后，相比于对照组儿童，实验组儿童在 S-S 语言理解阶段、S-S 语言表达阶段、口语表达内容复杂度、词类理解多样性、词类表达多样性等语言能力方面提升程度更明显，这说明在干预时间不变的情况下，相比于单一的应用行为分析干预，应用行为分析联合语言治疗能给 ASD 儿童语言能力的各个方面带来更有效的康复效果。（4）不管使用何种干预方式，不论是干预前还是干预后，词类理解多样性 与 S-S 语言理解存在正相关，词类表达多样性与 S-S 语言表达、口语沟通能力、口语表达内容复杂度之间均存在正相关，但词类多样性与大部分语言能力维度之间的logistic回归分析结果不显著，这说明词类多样性能力发展越好的ASD儿童，其语言能力也会越好，但不能单一地通过 ASD 儿童词类多样性能力的好直接预 测其语言能力一定会好，可能还跟语言的语法、语用能力有关。

本研究发现，应用行为分析联合语言治疗的干预方式对 ASD 儿童语言能力 各个方面的提升效果都会优于单一的应用行为分析的干预方式；同时词类多样性 与其语言能力之间存在正相关，但词类多样性与大部分语言能力维度之间的 logistic 回归分析结果不显著。这些研究结果将有助于减少家长在选择何种康复干预时所产生的困扰，同时对未来临床上提升 ASD 儿童语言能力的康复干预方向也具有重要的参考意义。

As the prevalence rate of autism spectrum disorders (ASD) increases, the need for effective education and rehabilitation services also increases. The applied behavior analysis is one of the most commonly used intervention in autism spectrum disorders, it mainly through the behavior of A (antecedent) B (behavior) C (consequence) shape children's behavior (including language behavior), in order to improve the problem behavior, language, social interaction, cognition, life self-care ability of children with autism spectrum disorders. Speech-language therapy also plays an important role in the improvement of the language and communication skills of children with autism spectrum disorders. Speech-language therapy follows the development of children's language, so as to improve the language and communication skills of children with autism spectrum disorders. However, there are many overlaps between the intervention of speech-language therapy and applied behavior analysis in social communication and language ability, which will make parents puzzled to choose what intervention methods when the intervention time is unchanged. In addition, vocabulary is the basic unit of language, Vocabulary diversity is the type of vocabulary, such as nouns, verbs, adjectives, pronouns and so on. The development and diversity of vocabulary and the development of grammar are important indicators to assessing children's language ability. Whether the intervention of vocabulary types diversity are needed during rehabilitation intervention in children with ASD, and the relationship between vocabulary diversity and the relationship between vocabulary diversity and language is also the direction of researchers' attention. Therefore, this study aims to observe: 1. To compare the effects of applied behavior analysis combined with speech-language therapy and single use applied behavior analysis on language ability in children with autism spectrum disorders; 2. What is the relationship between the development of vocabulary diversity and language ability of children with ASD.

Sixty children with autism spectrum disorders aged 36-78 months were selected and divided into the experimental group (n=30) and the control group (n=30). The control group was given the applied behavior analysis intervention, and the experimental group was given the applied behavior analysis combined with speech-language therapy intervention, the intervention duration in both groups was 3 hours per day, 5 days per week for a total of 3 months.

The results show that: (1) after three months of intervention, all children’s ability in S-S language comprehension stage, S-S language expression stage, oral communication ability, oral expression content complexity, comprehension of vocabulary types diversity and expression of vocabulary types diversity are improved, it shows that applied behavior analysis and speech-language therapy can bring effective rehabilitation services to children with autism spectrum disorders.(2) After 3 months of intervention, there was no significant difference in the improvement of oral communication ability in the two groups, which indicated that even in the separate applied behavior analysis group, children with autism spectrum disorders also had enough opportunities to learn and exercise oral communication.(3) After 3 months of intervention, compared with the children in the control group, the ability in the children of experimental group improved more significantly in S-S language comprehension stage, S-S language expression stage, oral expression content complexity, comprehension of vocabulary types diversity and expression of vocabulary types diversity, it shows that in the case of intervention time unchanged, compared to a single application behavior analysis intervention, applied behavior analysis combined speech-language therapy can bring more effective rehabilitation services to children with autism spectrum disorders.(4) no matter what kind of intervention, whether before intervention or after intervention, there is a positive correlation between comprehension of vocabulary types diversity and S-S language comprehension, between expression of vocabulary types diversity and S-S language expression, between expression of vocabulary types diversity and oral communication ability, between expression of vocabulary types diversity and oral content complexity, but the results of the logistic regression analysis between the vocabulary types diversity and language ability were not significant, this shows that the better the vocabulary types diversity development of children with ASD, the better their language skills will be, but their language ability cannot be directly predicted by their vocabulary types diversity, which may also be related to the grammar and pragmatic ability of language.

This study found that the effect of the intervention of application behavior analysis combined with speech-language therapy is better than the single behavior analysis. Meanwhile, there was a positive correlation between the vocabulary types diversity and language ability, but the results of logistic regression analysis between the vocabulary types diversity and language ability were not significant. These results will help to reduce the problems of parents in which intervention to choose, and also have some important reference significance for the future direction of rehabilitation intervention to improve the language ability of children with autism spectrum disorders.