标题：屏幕暴露对孤独症谱系障碍儿童训练疗效及情绪行为的影响

      作者：施慧玲，刘颖，周洁    海口市妇幼保健院儿保科，海南 海口 571100

      卷次： 2023年34卷12期

      【摘要】 目的 分析屏幕暴露对孤独症谱系障碍儿童训练疗效以及情绪行为的影响。方法 选取海口市妇幼保健院儿童发育行为门诊2020—2022年连续接受6个月结构化治疗的120例3~6岁孤独症儿童为研究对象，根据治疗期间电子屏幕暴露情况分为屏幕暴露组(>1 h/d) 68例和非屏幕暴露组(≤1 h/d) 52例，使用自闭症儿童心理教育评核第三版(PEP-3)及长处与困难问卷(SDQ)评价两组儿童的训练疗效与情绪行为情况。结果 68例屏幕暴露儿童中3岁13例(56.52%)、4岁24例(54.55%)、5岁21 例(65.63％)、6岁10例(47.62%)，不同年龄的屏幕暴露儿童比较差异无统计学意义(P>0.05 )；屏幕暴露儿童中男童组 58例(58%)，女童组 10例(50%)，差异无统计学意义(P>0.05)；使用率最高的电子产品前三位分别是手机(41.67%)、电视(30.83％)、平板电脑(23.33%)；干预6个月后，屏幕暴露组儿童PEP-3的认知、语言表达、语言理解、小肌肉、大肌肉、模仿、生活自理、适应行为8个维度的发育百分比级数明显低于非暴露组儿童，差异均有统计学意义(P<0.05)；屏幕暴露组儿童SDQ量表的情绪症状、品行问题、多动、同伴交往问题、亲社会行为、困难总分、影响因子等7个维度的异常检出率明显高于非暴露组儿童，差异均有统计学意义(P<0.05)。结论 孤独症儿童屏幕暴露现象较严重，屏幕暴露对训练疗效及情绪行为问题均有影响。需要减少孤独症儿童及家长的屏幕使用时间，增加亲子互动，才能促进情绪与行为健康发展，提高训练疗效。
      【关键词】 孤独症谱系障碍；儿童；屏幕暴露；疗效；情绪行为
      【中图分类号】 R729 【文献标识码】 A 【文章编号】 1003—6350（2023）12—1741—04

Effect of screen exposure on training efficacy and emotional behavior in children with autism spectrum disorders.SHI Hui-ling, LIU Ying, ZHOU Jie.
Department of Pediatric Care, Haikou Maternal and Child Health Hospital, Haikou571100, Hainan, CHINA
【Abstract】 Objective To analyze the effects of screen exposure on training efficacy and emotional behavior inchildren with autism spectrum disorders. Methods A total of 120 autistic children aged 3-6 years who had completedstructured teaching training from 2020 to 2022 were selected, which were divided into screen exposure group (>1 h/d,68 cases) and non-screen exposure group (≤1 h/d, 52 cases) according to the electronic screen exposure. Training effica-cy and emotional behavior were evaluated using the Psycho-educational Profile: Third Edition (PEP-3) and the Strengthand Difficulty Questionnaire (SDQ) scale before and after training. Results Among the 68 children in screen exposuregroup, there were 13 (56.52%) cases of 3 years old, 24 cases (54.55%) of 4 years old, 21 cases (65.63%) of 5 years old,and 10 cases (47.62%) of 6 years old. There was no significant difference in screen exposure among children of differentages in the screen exposure group (P>0.05). In the screen exposure group, 58 (58%) were boys and 10 (50%) were girls,with no statistically significant difference (P>0.05). The top three electronic products with the highest usage rate weremobile phone (41.67%), TV (30.83%), and tablet computer (23.33%). After 6 months of intervention, the developmentalpercentages of cognition, language expression, language understanding, small muscle, large muscle, imitation, self-care,and adaptive behavior of PEP-3 in screen exposure group were significantly lower than those of children in non-screenexposure group (P<0.05). The abnormal detection rates of emotional symptoms, conduct problems, hyperactivity, peercommunication problems, prosocial behavior, total difficulty score, and influence factor of the SDQ Scale in screen expo-sure group were significantly higher than those in the non-screen exposure group (P<0.05). Conclusion Screen expo-sure is more severe in autistic children, which will effect on training efficacy and emotional behavior problems. It is nec-essary to reduce the screen use time of autistic children and their parents, and increase the parent-child interaction, in or-der to promote the healthy development of emotion and behavior, and improve the efficacy of training.
      【Key words】 Autism spectrum disorder; Children; Screen exposure; Efficacy; Emotional behavior