Abstract: Objective To explore the effectiveness of caregiver skill training in improving the symptoms of children with autism spectrum disorder (ASD) and parental psychological defense mechanism, so as to provide evidence for clinical intervention of autistic children. Methods A total of 120 ASD children and their parents who have seen a doctor in a tertiary care children′s hospital in Chongqing from May to November 2021 were selected as the study subjects and were divided into the control group and the intervention group according to the voluntary principle. The control group received conventional intervention, while children and parents in the intervention group received caregiver skills training for 6 weeks, of which online theoretical training lasted for 4 weeks with a frequency of 5 times/week, and offline practical skills training lasted for 2 week with a frequency of 1.5 hours/time, 5 times/week. Before the intervention, at the end of the intervention, and one month after the end of the intervention, the defense ability of parents in the two groups was assessed using the Defense Mechanism Questionnaire (DSQ), the intervention effect of the children in the two groups was evaluated using the Autism Behavior Checklist (ABC) and the infant-junior middle school social adaptive capacity scale(SM). Results At the end of the intervention, the score of immature defense mechanism of parents in the intervention group was 3.79 ± 1.29, which was significantly lower than that in the control group (4.28 ± 1.14) (t＝-2.281, P <0.05). One month after the end of the intervention, the scores of immature defense mechanism and intermediate defense mechanism of parents in the intervention group were significantly lower than those in the control group (t=-2.490, -2.196, P <0.05). The score of autism behavior checklist in the intervention group was 55.25±8.89, significantly lower than that in the control group (60.32±9.61) (t =-2.997, P<0.05), and the time effect was significant (F=73.54, P <0.05).At the end of the intervention and one month after the end of the intervention, compared with the control group, the number of children with moderate and severe abnormalities in social life ability in the intervention group was significantly reduced (Z＝-2.119,-3.164, P<0.05). Conclusion Caregiver skill training can effectively improve the immature defense mechanism of parents and reduce the symptoms of ASD children.

Key words: autism, psychological defense mechanisms, caregiver skills training

摘要： 目的 探究照顾者技能培训对改善孤独症患儿症状及父母心理防御机制的有效性,为孤独症患儿临床干预提供依据。方法 选取2021年5—11月在重庆某三甲儿童医院就诊并确诊的120名孤独症谱系障碍的患儿及父母作为研究对象,按自愿原则分为对照组和干预组。对照组患儿使用常规干预方法。干预组患儿及父母接受持续6周的照顾者技能培训。线上进行理论培训,每周5节课,持续4周;线下进行实践技能培训,每周5次,每次1.5 h,持续2周。在干预前、干预结束时及干预结束后一个月,使用防御机制问卷(DSQ)对两组患儿父母的防御能力进行评估;使用孤独症行为量表(ABC)和婴儿-初中生社会生活能力量表(SM)对两组患儿的干预效果进行评价。结果 干预结束时,干预组患儿父母不成熟防御机制得分(3.79±1.29)分,低于对照组(4.28±1.14)分,差异具有统计学意义(t＝-2.281,P<0.05)。干预结束后一个月,干预组父母不成熟防御机制与中间型防御机制得分均低于对照组(t＝-2.490、-2.196,P<0.05);干预组患儿孤独症行为量表得分(55.25±8.89)分,低于对照组(60.32±9.61)分,差异有统计学意义(t=-2.997,P<0.05),且时间效应有统计学意义(F=73.54,P<0.05)。干预结束时及干预结束后一个月,相比较对照组,干预组社会生活能力重、中度异常的患儿例数明显减少,差异具有统计学意义(Z＝-2.119、-3.164,P<0.05)。结论 照顾者技能培训可有效改善父母不成熟的心理防御机制,从而可帮助缓解孤独症患儿症状。

关键词: 孤独症, 心理防御机制, 照顾者技能培训