Effects of step-by-step fusion sandplay therapy on clinical symptoms, emotional cognition and quality of life in children with autism spectrum disorder / 中华行为医学与脑科学杂志

ABSTRACT

Objective:To explore the effect of step-by-step fusion sandplay therapy on clinical symptoms, emotional cognition and quality of life in children with autism spectrum disorder(ASD).Methods:Eighty children with ASD who were admitted in Zhumadian Central Hospital and the Third Affiliated Hospital of Zhengzhou University from January 2019 to January 2021 were selected as the research objects, and they were divided into the study group( n=45) and the control group ( n=35) according to the random number table method.The children in control group were given structured education combined with auditory system training intervention, while the children in study group were given step-by-step fusion sandplay therapy combined with pretend play training on the basis of the control group.Children in the two groups were intervened for 6 months.Autism behavior checklist (ABC), childhood autism rating scale (CARS), social responsiveness scale (SRS), emotion recognition tools and pediatric quality of life (PedsQL) were applied before and after 6 months of intervention.The scores of ABC, SRS, CARS, emotion recognition and PedsQL were compared between the two groups, and Pearson correlation analysis was used to analyze the relationships between the scores of ABC, SRS, CARS, emotion cognition and PedsQL. Results:Compared with pre-intervention, the two groups of children after 6 months of intervention, the sensation, social interaction, body movement, language, self, ABC total score, social perception, social cognition, social communication, social motivation, autistic behavior, SRS total score and CARS scores decreased ( tstudy group= 5.182, 7.200, 6.778, 7.302, 5.140, 36.178, 3.955, 15.294, 9.014, 11.063, 9.723, 45.354, 25.827, all P<0.05, tcontrol group= 1.971, 2.612, 1.665, 2.294, 2.129, 10.809, 2.305, 5.544, 2.650, 2.955, 2.849, 16.485, 5.910, all P<0.05), upright, inverted, upper half face, lower half face emotion discrimination rate, physiological function, emotional function, social function, school function and PedsQL total scores all increased ( tstudy group= 16.723, 31.037, 10.951, 7.234, 7.572, 7.393, 9.036, 7.236, 6.223, all P<0.05. tcontrol group= 5.458, 14.008, 4.196, 2.653, 3.260, 3.566, 3.298, 2.766, 3.876, all P<0.05). After 6 months of intervention, the ABC total score and the scores of sensation, social interaction, body movement, language, and self-care of children in the study group were all lower than those in the control group (ABC total score difference the study group (21.9±2.8) points, the control group (7.5±2.6) points), t=23.537, P<0.05). The scores of social perception, social cognition, social communication, social motivation, autistic behavior and SRS total score were all lower than those in the control group (SRS total score difference study group (18.7±0.7) points, control group (8.1±0.6) points, t=71.448, P<0.05). The CARS score of study group was lower than that in control group (CARS score difference study group (7.7±1.1) points, control group (2.2±0.8) points, t=24.887, P<0.05), while the scores of upright, inverted, upper and lower face emotion discrimination rate, physiological function, emotional function, social function, school function and the PedsQL total score were all higher than those in the control group (PedsQL total score difference study group (8.4±1.2) points, control group (0.7±0.9) points, t=31.648, P<0.05). Correlation analysis showed that the ABC total score, SRS total score, and CARS score of children with ASD were negatively correlated with physiological function, emotional function, social function, school function and PedsQL total score ( rABC total score=-0.387, -0.334, -0.324, -0.289, -0.349, all P<0.05. rSRS total score = -0.390, -0.343, -0.299, -0.283, -0.378, all P<0.05. rCARS score = -0.321, -0.298, -0.293, -0.235, -0.319, all P<0.05). Upright, inverted, upper and lower faces were positively correlated with physiological function, emotional function, social function, school function and PedsQL total score ( rupright=0.837, 0.650, 0.669, 0.710, 0.680, all P<0.05. rinversion=0.688, 0.611, 0.615, 0.602, 0.647, all P<0.05. rupper half face=0.755, 0.669, 0.638, 0.740, 0.629, all P<0.05. rlower half face=0.738, 0.724, 0.553, 0.568, 0.560, all P<0.05). Conclusion:The step-by-step fusion sandplay therapy can effectively alleviate the clinical symptoms of children with ASD, improve their social responsiveness, and improve their emotional cognitive function and quality of life.