基于角色游戏的阶梯式同伴介入改善学前孤独症幼儿共同游戏行为的行动研究

基于应用行为分析（ABA）的干预是孤独症谱系障碍（ASD）儿童的主流干预手段之一，虽有大量循证证据支持其有效性，然而在实践中也引发了一些讨论。本文梳理了ABA在国内外ASD儿童干预领域的研究进展，重点围绕干预策略结构化程度、惩罚手段使用、技能泛化及家庭投入负荷等问题进行了澄清与探讨。文章进一步引入神经多样性视角，分析其对ABA伦理实践的启示。在此基础上，从技术优化、家庭支持、专业能力及公众信任建设等方面提出对我国ABA干预服务优化的建议。本文旨在为ASD儿童行为干预的本土化发展与科学实践提供理性讨论与思考。

为进一步探究改善自闭症儿童共情能力发展的方法,研究者采用单一被试倒返实验设计(A1-BA2),通过绘本教学的形式,对一名自闭症儿童的共情能力进行为期25天的干预.研究表明,绘本教学对自闭症儿童的“表情模仿”“表情指认”“表情指认”能力的干预效果较好,对于“情绪状态理解”能力的干预效果欠佳.绘本教学利用自闭症儿童的视觉学习优势,符合自闭症儿童的认知特点和学习兴趣,可改善自闭症儿童的共情能力,但由于教学形式单一,容易让自闭症儿童产生视觉疲劳.因此,未来可综合多种契合自闭症儿童学习特点的干预方法,让教学形式灵活多样,教学情景生动有趣.

随着数字技术的发展，数字赋能艺术治疗已成为新趋势：传统疗法与数字媒介结合，诞生了诸如数字影像治疗、数字游戏治疗、交互装置治疗等多种跨领域的解决方案。关键反应训练（PRT）作为孤独症儿童常用的治疗方法，是指治疗师将孤独症儿童置入自然生活情境，瞄准儿童核心障碍，对影响其发展的关键领域进行训练，以此来提升孤独症儿童的社会功能。本文以这种干预方法为基础，发挥虚拟空间设计的交互性、沉浸性等优势，进行了PRT介入孤独症儿童虚拟空间的干预研究和实验。根据实验结果，提出PRT介入孤独症儿童虚拟空间需遵循多元化设计、空间设计、分项干预和交互简化等原则，这为后续艺术治疗虚拟空间设计研究提供思路。

针对孤独症儿童在社会交往中普遍存在的五大社交障碍领域的干预需求，以及传统干预方法存在的机械化操作、反馈滞后及感官通道单一等局限，构建“三层响应式”干预模型。该模型以艺术疗愈为数据采集方式、以生成式人工智能与联觉理论为动态适配方式、以数字软件交互为表达方式，形成基础层、适配层、表达层三层递进的干预架构。理论分析表明，该模型能对五大社交障碍实现系统性的分层覆盖，形成从底层感知唤醒到表层行为训练的干预闭环，可为突破当前孤独症社交障碍干预瓶颈提供理论支持。

目的 探讨融合团体箱庭疗法对学龄前Asperger综合征（AS）儿童的临床效果。方法 将44例学龄前AS儿童作为研究对象，随机分成试验组和对照组，每组22例。对照组采用常规训练进行干预，试验组在常规训练的基础上，接受融合团体箱庭疗法。通过社交反应量表（SRS）、情绪识别工具和沙盘主题特征的变化评定治疗6个月后的疗效。结果 干预前试验组儿童SRS总分、各因子得分以及正立、倒置、上半面孔、下半面孔的面部表情识别正确率与对照组比较差异无统计学意义（P > 0.05）。与干预前比较，干预6个月后对照组和试验组儿童SRS总分和各因子得分均较前降低（P < 0.01）；对照组除正立位外，其余位置表情识别正确率均较前增高（P < 0.05）；试验组各位置表情识别正确率均较前增高（P < 0.05）。干预后试验组儿童SRS总分与除社交知觉因子外的其余各因子得分均低于对照组（P < 0.01）；各位置表情识别正确率均高于对照组（P < 0.01）。试验组儿童干预前与干预后沙盘主题特征个数比较差异具有统计学意义（P < 0.01）。结论 融合团体箱庭疗法可有效提高学龄前AS儿童的社交反应和情绪识别能力。

本文将基于“DIR地板时光”六个功能性里程碑内容，以小班幼儿小M为研究对象进行追踪观察。在对“DIR地板时光”组织架构与情绪内容设计下进行区域联动、地板时光游戏、统筹一日生活、延伸游戏、结合舒心课程并持续性地评估反馈实施路径下深入探索自闭症幼儿情绪互动方式多元化发展的个案研究。

… aimed at joint attention (JA) and symbolic play (SP) in preschool children with autism, with … Participants were 58 children (46 boys) with autism between 3 and 4 years of age. Children …

… and joint attention significantly improved in a group of preschool … , joint attention, and play are pivotal abilities in early development, and that intervention for young children with autism …

… children with Autism Spectrum Disorder (ASD) to experience deficits in joint attention and play skills, which are typically developed within the first 2 years of life. Joint attention skills refer …

… interventions of joint attention and symbolic play. Methods: Participants were 58 children with autism aged 3 and 4 … Joint attention skills were recently taught to 5 preschool children with …

… for preschoolers with autism. We taught 3 dyads of preschoolers with autism to follow joint activity schedules that cued both members of the pair to play a sequence of interactive …

Objective This study examines the cognitive and language outcomes of children with an autism spectrum disorder (ASD) over a five -year period after receiving targeted early interventions that focused on joint attention and play skills. Method Forty children from the original study (n = 58) had complete data at the five year follow up. Results 80% of children had achieved functional use of spoken language with baseline play level predicting spoken language at the five -year follow- up. Of children who were using spoken language at age eight years, several baseline behaviors predicted their later ability, including earlier age of entry into the study, initiating joint attention skill, play level, and assignment to either the joint attention or symbolic play intervention group. Only baseline play diversity predicted cognitive scores at age eight. Conclusions This study represents one of the only long term follow up studies of children who participated in preschool early interventions aimed at targeting core developmental difficulties. The study findings suggest that focusing on joint attention and play skills in comprehensive treatment models is important for long term spoken language outcomes.

… structured test, play with preschool teachers, and play with mothers… preschool placement, preschool hours per week, program philosophy, and preschool teacher experience with autism …

… play, declarative joint attention, social referencing and imitation of symbolic play in 3- to 6-year-old children with an autism … with ASD initiated less joint attention with their mothers when …

… Beyond these studies though, little focus has been given to teachers targeting joint attention and play within the daily activities and routines of children with autism in the preschool …

… dren with autism. In each study, nonverbal communication behaviors (… joint attention and requesting skills) and symbolic play skills were assessed in preschool-aged children with autism…

Center-based classroom community interventions create opportunities for young children with autism to connect with peers. Yet, there has been little examination of the peer interactions of toddlers with autism who experience core challenges in social communication and play skills that may create barriers to successful peer interactions. Classrooms of toddlers were randomized to an experimental social communication intervention including peers or to the standard individual (adult–child) social communication intervention. Both toddlers in peer and no peer conditions demonstrated significant gains in social communication and play. Toddlers with greater receptive language and combination and presymbolic play skills were most likely to demonstrate peer engagement. Lay Abstract Although young children may participate in education and intervention programs that take place in classrooms or groups, there is little information about how toddlers with special needs, and specifically toddlers with autism, are engaging with their peers. This study takes place in a public center-based early intervention program for toddlers with autism. Classrooms of toddlers were randomly assigned to an individual social communication intervention or the same intervention adapted to include a peer. Children in both groups made gains in social communication and play skills. Children who had the peer intervention were more engaged with peers when an adult was present, but not when the children were unsupported. This article adds information about early skills that may be important for children to master so that they have more success when trying to interact with their peers. These skills include understanding language (referred to as “receptive language” at 12 months or more) and play skills including building and stacking (referred to as “combination play”—for example, building with blocks or completing a puzzle) and extending familiar actions to themselves, others, and figures (referred to as “presymbolic play”—for example, putting a bottle to the doll or to themselves). Understanding which skills to target can help practitioners focus their instruction to build children’s skills toward connecting with peers through play.

… Across two studies, 58 and 41 preschool children with autism, respectively, were randomly assigned to one of two intervention groups, joint attention or play skills, and taught the …

… with autism, the … —joint attention, imitation, and toy play—were simultaneously examined as predictors of current language ability in a large sample of preschool age children with autism…

… are grouped with peers who demonstrate appropriate social skills, when there is minimal adult–child interaction, when play and joint attention are the target behaviors, and when the …

… Thirty-five children diagnosed with autism were randomly assigned to either a joint attention or a symbolic play … This preschool program did not emphasize joint attention or symbolic …

… It is joint play with others that makes play varied and flexible, thus helping to explain the narrow repetitive forms of pretend play that occur in autism (… and play skills (at preschool level) …

… play promoted joint attention better than play with toys. The researcher provided planned and sequential, but informal guidance on the four phases of intervention. To promote focusing …

… that many preschool children with autism can be interested in a variety of play materials and … Previous research has shown that play behavior of children with autism can be modified …

Play helps to develop social skills. Children with autism show deviances in their play behavior that may be associated with delays in their social development. In this study, we investigated manipulative, functional and symbolic play behavior of toddlers with and without autism (mean age: 26.45, SD 5.63). The results showed that the quality of interaction between the child and the caregiver was related to the development of play behavior. In particular, security of attachment was related to better play behavior. When the developmental level of the child is taken into account, the attachment relationship of the child with the caregiver at this young age is a better predictor of the level of play behavior than the child's disorder.

Early development marks a period of rapid learning facilitated by children’s natural curiosity about the people around them. In children with typical development, these early social attentional preferences set the foundation for learning about and from the surrounding world of people. Much of this learning happens using joint attention, the ability to coordinate attention between people and objects of mutual interest. It is well documented that decreased gaze use is commonly observed in individuals with autism and individuals with fragile X syndrome (FXS). Despite the growing body of research comparing phenotypic similarities between individuals with autism and individuals with FXS, no studies have directly compared joint attention performance between these groups. In the present study, we considered the similarities and differences in joint attention between preschool-aged boys with autism or FXS, and the relation between joint attention, language, and other phenotypic characteristics known to differ between boys with autism and boys with FXS. Although joint attention appeared similar, between-group differences emerged when controlling for the influence of age, non-verbal IQ, and autism symptom severity. Differences were also observed when considering how joint attention performance related to other aspects of the phenotype. For example, strong positive associations were observed between joint attention and language performance in boys with autism but not boys with FXS, even after controlling for non-verbal IQ. In contrast, the negative association between joint attention and anxiety symptom severity was significant and stronger in boys with FXS than in autism. These data offer preliminary insights into the similarities and differences between the autism and FXS phenotypes.

… Prior to intervention, both participants engaged in few conversational exchanges with a peer; during intervention an increase was seen in both scripted phrases and unscripted phrases. …

Students with autism spectrum disorder (ASD) are often taught within inclusive classrooms, which provide opportunities to develop social communication and peer interaction skills. Pivotal response training (PRT) and peer‐mediated intervention (PMI) are evidence‐based practices that promote social skill development. We used a concurrent multiple probe across peers design to evaluate the effects of training three third‐grade peers to use PRT as a PMI to promote the social communication and play behaviors of a classmate with ASD during recess. Generalization measures were conducted in the classroom during free play. Results indicated a functional relationship between training peers on PRT and increased use of PRT and between peers' use of PRT and the target child's communication to peers, confirmed by Tau‐U and visual analysis. A functional relation between peers' use of PRT and the target child's play with peers was not demonstrated. Similar effects were observed in the generalization environment.

… intervention sessions involving video modelling, therapist- and peer-mediation and free play. … Play interventions involving peer modelling build social interactions and reinforce targeted …

… and started eating, the group leader then stepped away from the group, monitoring from the side of the classroom and providing support when necessary. While eating lunch, the girls …

Abstract Background Little is known about the extent to which embodied digital mediation may support social engagement between children with or without autism (ASD) in free play settings. This study draws on Affordance theory and Constructionism to investigate social play behaviours associated with use of a Tangible User Interface (TUI) during free play. Method The study used a detailed observational and descriptive design. Two groups of children with ASD and two groups of typically developing (TD) children were filmed during a 20-minute play session with either a passive toy, or a digital toy with a TUI. Behaviours were coded according to a scheme based on Parten’s Play States. Data were described in terms of duration, frequency and the likelihood of transition to another state, given the current state. Results For TD children, Parallel and Associative were the most frequently observed Play States across both conditions. For those with ASD, Parallel Play and Non-Play-Related Conversation were the most frequent states in the passive condition, while Parallel and Associative Play were the most common in the TUI condition. This group demonstrated a longer duration of co-operative play with the TUI toy compared to TD children. Both groups showed higher frequencies of social play in the TUI condition. Conclusions Social play states can be effectively mediated by TUIs for both TD and ASD groups. For the ASD group, repetitive behaviour with a TUI may not be inhibitory to social engagement. Practitioners may consider making TUI enabled toys available during free play opportunities.

Advocating for inclusive literacy teaching pedagogies, to support 3–5-year-old children’s multimodal and multilingual storying, is fundamental in diverse nations. In Australia, for example, there are over 26% of 5-year-old children connecting with language backgrounds other than English, 7% are Aboriginal, and over 5% are diagnosed with special needs (AEDC, 2021). Arguably, children draw from their own cultural, linguistic, and neuro diverse ways of expressing; hence, visual, gestural, spatial, auditory, and touch-type modes of expression, deserve greater recognition in literacy. Our critical participatory action research advocates for an expanded view of literacy focusing on children’s assets to communicate stories beyond vocal or written versions of story’telling’ in English, by incorporating translanguaging. We consider ‘storying’ to be a more inclusive term that incorporates multiple and multilingual modes in story creation. Our research on Kaurna country (the Adelaide Plains), involved 66 three to five-year-old culturally, linguistically and neuro diverse preschoolers, and their families. They interacted and translanguaged with 10 educators to explore multilingual, Aboriginal, and autistic children’s storying. The 6-month research project questioned: ‘How do diverse children communicate stories and how can children’s storying be encouraged with culturally responsive community involvement?.’ Observation, interview, questionnaire, artefact and reflective journaling data identified diverse children’s storying capabilities, highlighting touch, embodied expression and movement of props, as children expressed imagined stories. Thematic analysis led to the emergence of the concept, ‘communicative capital,’ a component nestled within Bourdieu’s (1991) ‘cultural capital,’ highlighting multiple modes of expression beyond named languages (as per the concept of ‘linguistic capital’). We argue that children’s communicative funds of knowledge and semiotic systems for meaning-making deserve increased value in inclusive literacy education, curriculum development, teacher education, pedagogy, practice and policy, so to embrace and expand the storying strengths of children with autism, First Nations children, multilingual children, and all children worldwide.

Abstract Despite the growing acceptance of inclusive education policy, effective inclusion of children with autism spectrum disorder (ASD) in mainstream settings has not been ensured. Moreover, the research-to-practice gap in the field of autism spectrum disorder ( Bolte, 2019 ) is a wake-up call for researchers to rethink inclusion. Grounded in cultural-historical theory, this paper examines the inclusive practices of one child with ASD from the child's perspective. Toby (pseudonym) aged 3 years 5 months was observed in the naturalistic setting of a preschool over 8 weeks. A total of 8 h of digital video data were recorded to understand the practices that support or mitigate the process of both primary and secondary development of a child with ASD in a play-based setting. The dynamic relationship between the child's motive and the institutional demands of preschool (Hedegaard, 2019) were analysed in relation to the inclusive practices for Toby's development. The findings show how the child's persistent negotiations, the educators' understanding of the child's motive, and the practice setting created conditions that supported Toby's development and pushed against reported ‘secondary disability’ (Vygotsky, 1993). The findings suggest a different approach to children with ASD which has potential possibilities to support their inclusion in play-based settings.

… in research projects examining the efficacy of the Project DATA model with toddlers and preschoolers with autism. … as the celebration of diversity put into action. She is proud of what she …

Abstract Background Children on the autism spectrum may receive Early Intensive Behavioural Intervention (EIBI) in Sweden to support development by providing learning opportunities. However, research suggests a need to improve the quality of their learning environment. Aim This pre-registered study (#NCT03634761) aimed to evaluate the Swedish Autism Program Environment Rating Scale (APERS-P-SE) as a means to promote the quality of the pre-school learning environment for children on the autism spectrum, along with outcomes for these children, and their pre-school staff. Material and methods In a quasi-experimental study, pre-school staff (n = 35) conducted either EIBI supported by in-service training and on-site coaching based on APERS-P-SE assessment (at k = 9 preschools) or EIBI only (k = 8), during an 8-months period. Results The quality of the immediate learning environment (primary outcome) increased significantly in the EIBI/APERS-P-SE preschools. However, changes in child and pre-school staff measures were not significant. Conclusions and significance In-service training and on-site coaching based on APERS-P-SE assessments can increase the quality of the learning environment in Swedish pre-school. Studies of longer duration and larger sample size are required to determine if using the APERS-P-SE can also achieve desired behavioural change for children-, and impact pre-school staff applying EIBI.

… Only 3/14 of the younger preschool group and 19/33 of the autistic group were … older preschooler group. Chi-squared analyses showed: (i) a significant difference between the autistic …

… preschoolers with autism using materials during sensory bin activities. We posted the following research … Will preschoolers with autism readily imitate actions seen through point-of-view …

The current study describes the design, implementation, and analysis of a professional development programme using a Lesson Study model to enhance awareness in preschool professionals regarding inclusive education for children with autism spectrum disorder. The mixed method approach included pre- and post-intervention questionnaires, audio-recordings of group seminars, and an interview. The results indicated an increase in autism awareness among the professionals, suggesting that professionals changed their practice as a result of the programme. This was particularly clear regarding making adjustments to the learning environment and taking measures to prevent challenging situations. In addition to describing the implementation of a professional development programme in a preschool, this paper emphasises the importance of appropriate conditions for such initiatives.

This study examined executive control (EC) in preschoolers with and without autism spectrum disorders (ASD) using the Behavior Rating Inventory of Executive Functions-Preschool Version (BRIEF-P). ASD participants were a clinically referred sample of preschoolers; the typically developing control group was selected from the BRIEF-P standardization sample. The ASD group was rated significantly worse on all BRIEF-P scores, and these impairments did not correlate with ASD symptoms. These findings document impairments in real world EC in preschoolers with ASD, and have implications for assessing preschoolers suspected of having an ASD. Furthermore, the findings also converge with BRIEF studies of school-aged children with ASD.

… Recent research shows that even preschool children have an impressive and spontaneous grasp of this mental source of action. The acquisition of the knowledge and skills necessary …

Individuals with autism spectrum disorders (ASD) have shown impaired performance in canonical and nonsocial working memory (WM). However, no study has investigated social WM and its early development. Using biological motion stimuli, our study assessed the development of social and nonsocial WM capacity among children with or without ASD across the age span between 4 and 6 (N = 150). While typically developing (TD) children show a rapid development from age 5 to 6, children with ASD showed a delayed development for both social and nonsocial WM capacity, reaching a significant group difference at age 6. Furthermore, we found a negative correlation between social (but not nonsocial) WM capacity and the severity of autistic symptoms among children with ASD. In contrast, there is a positive correlation between both types of WM capacity and intelligence among TD children but not among children with ASD. Our findings thus indicate that individuals with ASD miss the rapid development of WM capacity in early childhood and, particularly, their delayed social WM development might contribute to core symptoms that critically depend on social information processing.

Background Autism Spectrum Disorder (ASD) is a lifelong condition that affects children and early intervention to provide an appropriate education for ASD children is necessary. Objective This study aimed to assess the awareness of ASD among preschool teachers in Qassim region, Saudi Arabia. Methods A cross-sectional study was carried out from December 2021 to February 2022 among preschool teachers in the Qassim region of Saudi Arabia. A random sampling technique was applied to select teachers through the Ministry of Education website. Results A total of 164 preschool teachers took part in the questionnaire. The most common age group was 30 - 40 years (58.5%). The total mean score of AKQ was 15.0 (SD 4.97). Nearly three-quarters (74.4%) of the teachers were classified as having a poor level of awareness while 25.6% had a good awareness level. Factors associated with a good awareness level include being a teacher (p=0.034) and having direct contact with autistic children (p=0.016). It is important to note that having more years of experience was significantly associated with knowledge regarding the correct pattern to diagnose children with autism (p=0.049). Conclusion The awareness of preschool teachers regarding ASD was deficient. Teachers who are in contact with autistic students demonstrated better knowledge than the rest of the preschool teachers. Preschool teachers are expected to maintain high standards in their work to meet the children's abnormal development and to identify them from an early stage, then refer them to diagnosis services.