亲子合作式音乐疗法对孤独症谱系障碍儿童及其母亲影响的前瞻性随机对照研究

Effect of parent-child cooperative music therapy on children with autism spectrum disorder and their mothers: a prospective randomized controlled study

摘要:

目的 探讨亲子合作式音乐疗法对孤独症谱系障碍（autism spectrum disorder，ASD）儿童的核心症状及其母亲的影响。 方法 前瞻性采用随机数字表法将112例ASD儿童及其母亲分为音乐疗法组和应用行为分析法（applied behavior analysis，ABA）组，每组各56例。ABA组采用ABA进行干预，音乐疗法组在ABA组基础上采用亲子合作式音乐疗法。2组干预时长均为8周。采用儿童孤独症评估量表（Childhood Autism Rating Scale，CARS）、儿童孤独症家长评定量表（Autism Behavior Checklist，ABC）、亲职压力简表（Parenting Stress Index-Short Form，PSI-SF）、家庭关怀度指数量表（Family APGAR Index，APGAR）和Herth希望量表（Herth Hope Index，HHI），评估干预前和干预后ASD儿童的核心症状及其母亲的亲职压力、家庭关怀度和希望水平。 结果 共100对母子参与了全程研究（每组各50对）。干预后音乐疗法组ASD儿童ABC量表总分、感觉维度、社交维度、躯体运动维度得分，以及CARS量表总分低于ABA组（P<0.05）。干预后音乐疗法组母亲的PSI-SF总分、亲子互动失调维度得分，HHI量表总分和各维度得分，以及APGAR量表总分、合作度和亲密度得分均高于ABA组（P<0.05）。 结论 在ABA的基础上，加用亲子合作式音乐疗法可改善ASD儿童的核心症状，减轻母亲的亲职压力，提升其家庭关怀度指数和希望水平。 引用格式：中国当代儿科杂志，2022，24（5）：472-481

Abstract:

Objective To study the effect of parent-child cooperative music therapy on the core symptoms of children with autism spectrum disorder (ASD) and their mothers. Methods In this prospective study, 112 children with ASD and their mothers were divided into a music therapy group and an applied behavior analysis (ABA) group using a random number table (n=56 each). The children in the ABA group were treated with ABA, and those in the music therapy group were given parent-child cooperative music therapy in addition to the ABA treatment. The duration of intervention was 8 weeks for both groups. Childhood Autism Rating Scale (CARS), Autism Behavior Checklist (ABC), Parenting Stress Index-Short form (PSI-SF), Family APGAR Index, and Herth Hope Index (HHI) were used to evaluate the core symptoms of children with ASD and the parenting stress, family APGAR index, and hope level of mothers before and after intervention. Results A total of 100 child-mother dyads completed the whole study, with 50 child-mother dyads in each group. After intervention, the children in the music therapy group had significantly lower total score of ABC scale and scores of sensation, social interaction, and somatic movement, as well as a significantly lower total score of CARS than those in the ABA group (P<0.05). After intervention, compared with the mothers in the ABA group, the mothers in the music therapy group had significantly higher total score of PSI-SF and score of parent-child dysfunctional interaction, significantly higher total score of HHI and scores of each dimension, and significantly higher total score of APGAR and scores of cooperation and intimacy (P<0.05). Conclusions Parent-child cooperative music therapy combined with ABA can alleviate the core symptoms of children with ASD, reduce the parenting stress of their mothers, and improve family APGAR index and hope level.