刘奇,武文杰,刘丽莹,等.一对一与小组叙事干预对发展性语言障碍风险儿童指称表达能力的影响[J].中华物理医学与康复杂志,2026,48(4):323-328
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| 一对一与小组叙事干预对发展性语言障碍风险儿童指称表达能力的影响 |
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| DOI：10.3760/cma.j.cn421666-20250516-00420 |
| 中文关键词: 发展性语言障碍 早期干预 (教育) 指称表达 |
| 英文关键词: Language development Language disorders Early intervention(education) Referring expressions |
| 基金项目:中国残疾人联合会课题 (2023CDPFHS-05)；中南大学湘雅二医院国家临床重点专科院级科研专项 (YWH202500001)；河北省研究生创业创新项目 (CXZZBS2025005)；河北大学文学院学生科研创新项目 (24WXYD007) |
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| 中文摘要: |
| 目的 初步探讨一对一叙事干预及小组叙事干预对发展性语言障碍风险儿童指称表达能力的影响。 方法 采用随机对照研究设计，将28例发展性语言障碍风险儿童随机分为一对一干预组（9例）、小组干预组（9例）及控制等候组（10例）。使用STEPS-STORY叙事疗法进行为期1个月的叙事干预，经干预3个月后进行随访评估。其中一对一干预组由言语治疗师单独施教，小组干预组以每2人为一小组，由言语治疗师统一施教。于训练前、后采用多语言叙事评估工具（MAIN）对各组儿童的叙事能力进行评估，并对其中的指称表达变化情况进行全面分析。 结果 基线时期时3组儿童的指称表达能力组间差异均无统计学意义（均P>0.05）。与干预前组内比较，干预后一对一干预组和小组干预组其定指评分均存在显著差异（均P＜0.05），随访时定指评分无显著差异（P＞0.05）；但2组干预后及随访时的定指评分均表现出大效应量的实际差异（均Hedges′g＞0.80），提示叙事干预对2组发展性语言障碍风险儿童的定指表达能力具有实际干预效果。组间比较显示，干预后及随访时两个干预组的定指评分均无显著差异（均P＞0.05），但一对一干预组的定指评分呈现出中等效应（干预后Hedges′g=0.643）至大效应（随访时Hedges′g=1.380）的实际优势，提示一对一干预对发展性语言障碍风险儿童定指表达能力的提升效果更优。 结论 早期叙事干预对促进发展性语言障碍风险儿童定指指称表达能力的发展具有积极作用，且以一对一干预模式的提升效果更显著。 |
| 英文摘要: |
| Objective To compare the effects of one-on-one intervention(OI) with those of group intervention(GI) in improving the referring expression abilities of children at risk of developmental language disorder(DLD). Methods This was a randomized and controlled trial. Twenty-eight children at risk of developing a DLD were randomly assigned to an OI group(n=9), a GI group(n=9) or a control group(n=10). All followed the STEPS-STORY narrative therapy program for one month, with follow-up assessments conducted three months later. Those in the OI group received individual instruction from a speech-language pathologist, whereas the GI group members received instruction in pairs. Narrative ability, specifically referring expression, were assessed before and after the intervention using the Multilingual Assessment Instrument for Narratives(MAIN). Results There was no significant difference in average referring expression among the three groups before the experiment. Both the OI and GI groups showed significant improvement in their average definite refering scores(all Hedges' g>0.80), but there was no significant difference between those two groups at follow-up. So the narrative intervention effectively enhanced the children's definite referring expression. There was a medium-to-large effect size(post-test Hledges' g=0.643: follow-up Hedges' g=1.380) in the Ol group, suggesting more efective improvement in definite referning expression than the GI treatment. Conclusions Early narrative intervention can promote the development of definite referring expression ability among children at risk of a developmental language disorder. One-on-one intervention appears to be more effective than group intervention. |
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