孤独症谱系障碍儿童感觉统合治疗的疗效：一项非随机前后干预研究

文献信息

中文摘要

背景： 感觉加工异常与孤独症症状相关。感觉统合治疗（SIT）影响孤独症症状严重程度、感觉特征及相关社会人口学/临床变量。
方法： 2023年5月至2025年1月期间，从开罗艾因夏姆斯大学Okasha精神病学研究所儿童与青少年精神病学系SIT门诊招募30例符合孤独症谱系障碍（ASD）病例定义、年龄3至10岁的患者，采用社会人口学/临床问卷、阿拉伯语版学龄儿童情感障碍与精神分裂症量表现况与终生版、斯坦福-比奈智力量表第五版、儿童孤独症评定量表（CARS）及感觉特征照护者问卷进行评估。参与者接受为期12周的SIT方案（每周一次30分钟会谈），随后使用CARS和感觉特征问卷进行干预后复评。
结果： 最常见年龄为3-5岁（46.66%），男性占80%。大多数参与者（73.33%）IQ评分为60-64。CARS平均分从33.9 ± 3.42降至31.95 ± 3.4，轻度孤独症增至76.67%，中度降至10%，重度病例无变化。受影响最多的领域为前庭加工、情绪/社会反应、感觉加工的行为结局及精细运动/知觉。干预后改善最多的为前庭加工、情绪/社会反应、情绪反应性、注意力不集中/易分心（p值 < 0.001）、听觉加工、影响活动水平的身体位置与运动调节（p值 0.001）。改善最少的是与耐力/肌张力相关的感觉加工及低耐力/肌张力。
结论： SIT有效降低了孤独症严重程度，并改善了感觉加工的关键感觉和行为领域，尤其在轻至中度病例中。
试验注册： ClinicalTrials.gov NCT06882642，2025年3月注册（回顾性注册）。

英文摘要

BACKGROUND: Sensory processing abnormalities have been linked to autism symptoms. Sensory integration therapy (SIT) affects autism symptom severity, sensory profile and related socio-demographic/clinical variables.
METHODS: Thirty patients, aged 3 to 10 years, meeting autism spectrum disorder (ASD) case definition were recruited from SIT clinic, Child and Adolescent Psychiatry Department, Okasha Institute of Psychiatry, Ain Shams University, Cairo, between May 2023 and January 2025, assessed by socio-demographic/clinical questionnaire, Arabic versions of Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version, Stanford-Binet Intelligence Scale Fifth Edition, Childhood Autism Rating Scale (CARS), and Sensory Profile Caregiver Questionnaire. Participants received a 12-week SIT program (one 30-minute session weekly), then post-intervention reassessment using CARS and Sensory Profile.
RESULTS: The most common age was 3-5 years (46.66%), with males comprising 80%. Most participants (73.33%) IQ scores were 60-64. Mean CARS scores decreased from 33.9 ± 3.42 to 31.95 ± 3.4, mild autism increasing to 76.67%, moderate decreasing to 10% and unchanged severe cases. Mostly affected domains were vestibular processing, emotional/social responses, behavioural outcomes of sensory processing and fine motor/perceptual. Post-intervention, the most improved were vestibular processing, emotional/social response, emotionally reactive, inattention/distractibility (p-value < 0.001), auditory processing, modulation of body position and movement affecting activity level (p-value 0.001). The least were sensory processing related to endurance/tone and low endurance/tone.
CONCLUSION: SIT effectively reduced autism severity and improved key sensory and behavioural domains of sensory processing, particularly in mild to moderate cases.
TRIAL REGISTRATION: ClinicalTrials.gov NCT06882642, registered March 2025 (retrospectively registered).