Curative effect of progressively integrated sandplay therapy on core symptoms and sleep management in preschool children with mild-to-moderate autism spectrum disorder / 中国当代儿科杂志

OBJECTIVE@#To explore the curative effect of progressively integrated sandplay therapy on core symptoms and sleep management in preschool children with mild-to-moderate autism spectrum disorder (ASD).@*METHODS@#A total of 50 mild-to-moderate ASD preschool children were randomly divided into an experimental group (n=25) and a control group (n=25). The control group was treated with structured teaching and auditory integration training (AIT). Based on these, the experimental group was treated with progressively integrated sandplay therapy. The Autism Behavior Checklist (ABC), Children Autism Rating Scale (CARS), Social Responsiveness Scale (SRS), Children's Sleep Habit Questionnaire (CSHQ) and emotion recognition tools were used to evaluate the overall curative effect before treatment and 3 months after treatment.@*RESULTS@#The experimental group had significantly lower scores of feeling, social interaction, somatic motor, language factor, total ABC and total CARS than the control group (P<0.05). The experimental group had also significantly lower scores of social cognition, social communication, social motivation, autistic behavior factor and total SRS than the control group (P<0.05). The experimental group had a significantly higher accurate rate of recognition of the upper facial expression and lower facial expression than the control group (P<0.05). The experimental group had significantly lower scores of bedtime resistance, sleep onset, sleep duration, night waking, daytime sleepiness, and total CSHQ than the control group (P<0.05). The experimental group had significantly reduced themes of wounding and significantly increased themes of healing after sandplay therapy (P<0.05).@*CONCLUSIONS@#Progressively integrated sandplay therapy can effectively improve the core symptoms and sleep quality of preschool children with mild-to-moderate ASD, which can be used as an early rehabilitation measure.

Clinical effect of integrated sandplay therapy in children with Asperger syndrome / 中国当代儿科杂志

OBJECTIVE@#To study the clinical effect of integrated sandplay therapy in preschool children with Asperger syndrome (AS).@*METHODS@#A total of 44 preschool children with AS were randomly divided into an experimental group and a control group, with 22 children in each group. The children in the control group were given routine training, and those in the experimental group were given integrated sandplay therapy in addition to the routine training. The treatment response was assess by the Social Responsiveness Scale (SRS), emotional recognition tools and changes in sandplay theme characteristics after 6 months of treatment.@*RESULTS@#Before intervention, there were no significant differences between the two groups in the total score of SRS, the score of each factor of SRS, and correct rates of facial expression recognition of the upright position, inverted position, upper face and lower face (P>0.05). After 6 months of intervention, both groups had significant reductions in the total score of SRS and the score of each factor of SRS (P<0.01); the control group had significant increases in the correct rates of facial expression recognition of all positions except the upright position (P<0.05), while the experimental group had significant increases in the correct rates of facial expression recognition of all positions (P<0.05). Compared with the control group after intervention, the experimental group had significantly lower total score of SRS and scores of all factors of SRS except social perception (P<0.01) and significantly higher correct rates of facial expression recognition of all positions (P<0.01). The experimental group had a significant change in the number of sandplay theme characteristics after intervention (P<0.01).@*CONCLUSIONS@#Integrated sandplay therapy can improve social responsiveness and emotion recognition ability in preschool children with AS.

Clinical efficacy of interactive group sandplay versus individual sandplay in the treatment of preschool children with autism spectrum disorder / 中国当代儿科杂志

OBJECTIVE@#To study the clinical efficacy of interactive group sandplay versus individual sandplay in the treatment of preschool children with autism spectrum disorder (ASD).@*METHODS@#A total of 80 ASD children, aged 4-6 years, were enrolled and randomly divided into experimental and control groups, with 40 children in each group. The children in the experimental group joined group sandplay with normal children at a ratio of 1: 3, and those in the control group were treated with individual sandplay. The Aberrant Behavior Checklist (ABC) and Autism Treatment Evaluation Checklist (ATEC) were used to evaluate the treatment outcome after three months of intervention.@*RESULTS@#There were 33 children in the experimental group and 28 in the control group. After three months of intervention, the experimental group had significant reductions in the scores of irritability, social withdrawal, and stereotypic behavior and the total score of the ABC scale (P<0.05), and the control group had significant reductions in the scores of behavior and inappropriate speech and the total score of the ABC scale (P<0.05). Compared with the control group, the experimental group had significantly greater improvements in the score of social withdrawal and the total score of the ABC scale after three months of intervention (P<0.05). After three months of intervention, the experimental group had significant reductions in the scores of sociability, sensory and cognitive awareness, and physical/health behavior and the total score of the ATEC scale (P<0.05), and the control group had significant reductions in the scores of speech, sociability, and physical/health behavior and the total score of the ATEC scale (P<0.05). Compared with the control group, the experimental group had significantly greater improvements in the scores of speech, sociability, and sensory and cognitive awareness and the total score of the ATEC scale after intervention (P<0.01). Compared with the control group, the experimental group also had significantly greater improvements in eye contact and sand stereotyped arrangement (P<0.05).@*CONCLUSIONS@#Both interactive group sandplay and individual sandplay are effective in the treatment of ASD in preschool children. Interactive group sandplay is better than individual sandplay in the treatment of ASD, with significant improvements in sociability, emotion and stereotypic behavior.

Analysis of the correlation between intelligence and social mood for children with expressive language disorder / 中华行为医学与脑科学杂志

ObjectiveTo explore the characteristics and correlation of intelligence development and socioemotional development in 1~3 years old children with expressive language disorder,and provide a basis for early intervention.Methods125 cases with expressive language disorder(language disorder group) and 126 normal children (normal group) are evaluated in two parts (intelligence and social mood) with 0~6 years old neuropsychological development diagnosis scale and Chinese version of urban infant-toddler social and emotional assessment.Results (1)The scores in language disorder group were lower than normal group in the area of free movements (81.60±10.40 vs 89.62±7.94),adaptability (81.48±10.95 vs 91.25±8.89),language (67.46±7.20 vs 89.13±8.24),social behavior (76.61±9.73 vs 90.12±8.13) and total developmental quotient (80.17±6.39 vs 91.15±6.05) (P<0.05).(2) There were significant differences between language disorder group and normal group in the area of externalizing behavior(56.28±10.15 vs 53.57±7.91),deregulation (56.45±10.61 vs 51.11±9.32) and capabilities(46.79±9.08 vs 51.25±7.47) (P<0.05).The boys' scores in internalizing behavior were lower than the girls' (49.19±10.76 vs 54.71±9.90) (P<0.05).(3) The scores of gross motor had positive correlation with externalizing behavior (r=0.220,P<0.05).The scores of language had negative correlation with externalizing behavior and deregulation(r=-0.650,P<0.05;r=-0.470,P<0.05).The scores of social behavior had negative correlation with externalizing behavior (r=-0.208,P<0.05).There was also a negative correlation between total development and deregulation (r=-0.184,P<0.05).(4) Multiple stepwise linear regression results showed that the externalizing behavior domain and mothers' education could predict 44.1% of variances in the language area.ConclusionThe children with expressive language disorder not only show backward in level of language development,but also in the development of other areas,and also bad social behavior and emotional problems.Individualized parenting interventions should be adopted to promote these children's intelligent development in an all-round way.

Curative effect of Sandplay therapy on attention deficit hyperactivity disorder in preschool children co - mor-bid sleep disorder / 中华实用儿科临床杂志

Objective To investigate the curative effect of Sandplay therapy on attention deficit hyperactivity disorder (ADHD)preschool children co - morbid sleep disorder. Methods According to the random number generated by EXCEL software's RAND function,a total of 62 ADHD children co - morbid sleep disorder were randomly divi-ded into experimental group(n = 31)and control group (n = 31). The control group was treated with family behavior therapy and the experimental group was treated with sandplay therapy based on the family behavior therapy. With the Achenbach Child Behavior Check List (CBCL),Conners Parent Symptom Questionnaire (PSQ),Conner Concise Questionnaire (Conners Abbreviated Symptom Questionnaire,ASQ)and Children′s Sleep Habit Questionnaire(CSHQ),the overall curative effect was evaluated before and after treatment by their scores. Results The results of independent - samples t test showed that the scores of PSQ′s all factors,ASQ′s and CBCL′s total score,CSHQ′s total score and all factors had no significant difference between the two groups before the intervention (t conduct problem = - 0. 847,t learning problems =0. 504,t psychosomatic disorder = - 1. 008,t hyperactivity/ impulsion = - 0. 331,t anxiety = 0. 690,t hyperactivity index = 0. 757,t CBCL′s total score =- 0. 532,t ASQ′s total score = 0. 514,t CSHQ′s total score = 1. 132,t sleep impedance = - 0. 767,t sleep latency = - 0. 634,t sleep duration = 0. 150, tsleep anxiety = 0. 149,t sleep wake = 0. 417,t sleep disorder = 0. 709,t sleep apnea = 0. 950,t daytime sleepiness = 1. 530,all P > 0. 05). The scores of PSQ′s all factors,ASQ′s and CBCL′s total score,sleep impedance,sleep latency,sleep duration,sleep wake, daytime sleepiness and CSHQ′s total score all had significant differences between the two groups after the intervention(t conduct problem = - 3. 982,t learning problems = - 2. 258,t psychosomatic disorder = - 2. 470,t hyperactivity/ impulsion = - 4. 377,t anxiety =- 2. 684,t hyperactivity index = - 4. 249,t CBCL′s total score = - 3. 982,t ASQ′s total score = - 5. 576,t sleep impedance = - 3. 712,t sleep latency =- 2. 947,t sleep duration = - 2. 332,t sleep wake = - 6. 031,t daytime sleepiness = - 6. 256,t CSHQ′s total score = - 6. 706,all P < 0. 05). The results of analysis of variance of repeated measurement showed that PSQ behaviour problem,psychosomatic disor-der,hyperactivity and hyperactivity index scores of the main effects of intervention had significant difference (F conduct problem = 4. 966,F psychosomatic disorder = 5. 176,F hyperactivity/ impulsion = 4. 949,F hyperactivity index = 4. 926,all P < 0. 05);the main intervention effects of ASQ and CBCL′s total score had statistical difference (F CBCL = 4. 398,F ASQ = 4. 814,all P < 0. 05);the main intervention effects of sleep impedance,sleep duration,sleep wake and CSHQ′s total score had statistical difference (F sleep impedance = 5. 697,F sleep duration = 4. 467,F sleep wake = 6. 610,F CSHQ′s total score = 6. 016,all P <0. 05). There were significant differences in the characteristics of the initial sand table and the final sand table in the experimental group [traumatic subject:(4. 48 ± 1. 55)cases vs. (1. 23 ± 0. 81)cases,t = 8. 247;curing subject:(1. 77 ± 1. 09)cases vs. (4. 55 ± 1. 46)cases,t = 11. 274,all P < 0. 05]. Conclusion Sandplay therapy can effectively improve the core symptoms of preschool ADHD children co - morbid sleep disorders,which can be used as an early in-tervention.

Influence of home nurture environment on language development and social emotion in children with developmental language disorder / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the influence of home nurture environment on language development and social emotion in children with developmental language disorder (DLD).</p><p><b>METHODS</b>The 1-3 Years Child Home Nurture Environment Scale, Gesell Developmental Scale, and Infant-Toddler Social and Emotional Assessment Scale were used for the evaluation of 125 children with DLD. A total of 130 children with normal language development matched for age and sex were enrolled as control group.</p><p><b>RESULTS</b>Compared with the control group, the DLD group had a significantly higher proportion of children in a bad home nurture environment and significantly lower scores of all domains of home nurture environment (P<0.05). In children with DLD, the home nurture environment score was positively correlated with the level of language development (r=0.536, P<0.01) and the score of ability domain in social emotion (r=0.397, P<0.01) and was negatively correlated with the scores of the domains of explicit behavior, covert behavior, and imbalance in social emotion (r=-0.455, -0.438, and -0.390 respectively, P<0.01). Home nurture environment had direct influence on language development in children with DLD and affected their language development via the mediating effect of social emotion.</p><p><b>CONCLUSIONS</b>Home nurture environment influences language development and social emotion in children with DLD, and social emotion has a partial mediating effect between home nurture environment and language development.</p>

Comparison in physical and neurological development between two types of children born small for gesta-tional age / 国际儿科学杂志

Almost 3% of newborns are diagnosed as small for gestational age(SGA)worldwide.Born SGA is one of the important causes of perinatal morbidity and mortality,and is also associated with metabolic diseases in adulthood.Low birth weight by itself is insufficient to characterize growth restriction,as it does not include information about the neonate’s body proportionality.Depending on the origin,timing and severity of in-sult,small for gestational age infants are classified into two types:proportionate or symmetric growth restriction (SGR)and disproportionate or asymmetric growth restriction(AGR).There may be differences in physical and neurological development of these two types.This study compares three classification indexes,and to find differ-ences in postnatal growth of these two types.

Distribution characteristics of overweight and obesity in 0-5 years old children born small for gestational age in Shanghai city / 中华实用儿科临床杂志

Objective To understand the distribution of overweight and obesity in 0-5 years old children who were born small for gestational age ( SGA) in Shanghai through a cross-sectional investigation. Methods All resident children aged 0-5 years were included, covering all 18 districts in Shanghai. Health-check cards were prepared for SGA children. The check-up included weight,length/height and head circumference. Body mass index ( BMI) was used to evaluate the overweight and obesity according to the standard of World Health Organization ( WHO) . Results This study investigated 728 602 children aged 0-5 years in Shanghai,and ultimately 23 871 of them were defined as SGA,a-mong whom 9 805(41. 4%) were boys and 14 066(58. 9%) were girls. The BMI of SGA children were higher than that of appropriate for gestational age( AGA) from 4 to 18 months,while for the rest of the time,they were basically the same. There was no difference in changing tendency of BMI between SGA children and those AGA children. The distri-bution of overweight and obesity according to the standard of WHO in SGA boys among different ages was 7. 7% to 20. 7%, and 15. 7% in average;the distribution of SGA girls among different ages was 5. 9% to 18. 3%,and 12. 9% in average. The proportion of overweight at the age of 4-18 months was significantly higher than that of other ages. There was no correlation between overweight at 0-2 years old and overweight at the age of 5(P>0. 05). Conclusions Com-pared with SGA girls,overweight and obesity in SGA boys were more serious. The age of 4-18 months were the period of high incidence of overweight. There was no correlation between overweight at 0-2 years old and overweight at the age of 5.

Preventive Effect and Safety of Fluconazol on Fungal Infection in Pediatric Intensive Care Unit / 实用儿科临床杂志

Objective To study the preventive effect of small-dose fluconazol adiministered in low frequency on nosocomial fungal infectoin.Methods The condition of nosocomial fungal infection among 200 patients in pediatric intensive care unit (PICU)were observed,who were suffered with serious infection or basic diseases and underwent broad-spectrum or ultra-broad spectrum antibiotic and steroid hormones treatment.These patients were divided imto treatment and control group.And the patients in treatment group received fluconazol[5 mg/(kg?time)once every 2 days,total 3 times,after that,twice 1 week till improved] to prevent fungal infection .The control group were treated with fluconazol [6-10 mg/(kg?time),once everyday for 10-14 days] after fungal infection.Results The incidence rate of nosocomial fungal infectoin of control group was 58.3%(56 out of 96 cases,which were 44 cases of mouth,5 cases of respiratory tract ,5 cases of digestive tract and 2 cases of urethra ) and that of treatment group was 1.9%(2 out of 104 cases, which were 2 cases of mouth).In control group,37 cases were cured,17 cases improved and 2 cases were not effective.Mouth fungal infection in treatment group was gently and cured with 1 or 2 times of local treatment .The treatment group didn′t occured liver function damage or aggravation.Conclusion For PICU patients, adiministration of small-dose flucomazol in low frequency is an effective and relatively safety method to prevent against nosocomial fungal infectoin.