关键词: 孤独症谱系障碍, 共同注意, 同伴介入

Abstract: Objective To compare and analyze the effect of joint attention(JA)and peer-mediated intervention(PMI)on the treatment of children with autism spectrum disorders(ASD),in order to provide evidence for optimizing intervention programs. Methods Totally 60 ASD children who have typically developed siblings in Henan Children′s Hospital from January 2019 to June 2020 were recruited in this study,and were divided into JA group(n=30)and PMI group(n=30)according to their performance intellectual quotient.Childhood Autism Rating Scale(CARS),Early Social-Communication Scale(ESCS)and Infant-Junior Middle School Social Adaptive Capacity Scale(SM) were used to evaluate children′s performance before intervention,after intervention and 4 weeks in intervention.The differences in scores before and after intervention were compared. Results The differential value of the score in indication follow,fixation follow and eye change before and after intervention between JA group and PMI group were significantly different(t=2.25,2.12,2.33,P＜0.05),which was not significant in terms of finger indication and active display(P>0.05).In terms of the differential value of CARS score before and after treatment,there was no significant difference between the JA group and PMI group(P>0.05).In 4 weeks after intervention,there were no significant differences in indication follow,fixation follow and eye change before and after intervention between JA group and PMI group(P>0.05).At the end of intervention and 4 weeks after the intervention,the score difference of SM scale in PMI group was higher than that in JA group,and the difference was significant(t=2.56,2.29,P<0.05). Conclusions Both JA and PMI have positive effects on children with ASD.Compared with PMI,JA has a good immediate effect on the improvement of response joint attention ability,but the maintenance effect of the two methods is similar.However,PMI is superior than JA in improving social adaptation ability.

Key words: autism spectrum disorder, joint attention, peer-mediated