The Survey Research Of The Situation Of Rehabilitation For Children With Autism And Intervention Experimental Research In Tianjin

Objective: The aim of the survey research was to describe the current situation of rehabilitation and education for children with autism and analysis the problems of autism-related rehabilitative services in Tianjin; The aim of the prospective study was to compare outcome for pre-school children with autism receiving Early Intensive Behavioural Interventions (EIBI) or autism-specific nursery provision; The other two studies were to evaluate the validity of the EIBI for pre-school children with autism and examine the effect of the education of special school for school age children with autism.Methods: (1) To investigate the rehabilitation and educational agencies for children with autism in Tianjin, all children in these agencies were screened by Clancy Autism Behavior Scale (CABS), children who were suspected of having autism(CABS>14) were diagnosed by clinicians. Self-designed questionnaires were used to investigate administrators of the 11 agencies which enrolled children with autism. (2) Forty children with autism (20 in EIBI programmes, 20 in autism-specific nursery) to compare the outcome for pre-school children with autism receiving the two kinds of interventions. Children in the two groups was identified on the basis of parents preference, they were matched 1:1 by gender and age. All EIBI children received EIBI programmes, nursery children received education as usual and had not received EIBI programmes before. At follows, 1.5 years later, assessing by Revised-Chinese Version of Psycho-Educational Profile (C-PEP) and Autism Behavior Checklist (ABC). (3) 8 children with autism (chronological age 35～43 months) to examine the validity of the Early Intensive Behavioural Intervention. After be assessed using C-PEP, individual teaching plans were made for each child, the EIBI pattern was applied in training. After one year, they were re-assessed using C-PEP. (4) Forty children with autism of school age were selected in the research to examine the effect of the education of special school, they were assessed at each end of the semester using ABC and Wechsler Preschool and Primary Scale of Intelligence (WPPSI) in one year. (5) Self-designed questionnaires were used to investigate 80 children with autism came from these agencies were selected in the research. Using t test, chi-square test, pearson linear correlation and multiple linear regression to analyze these data.Results: (1) There were 4 agencies for preschool children and 7 special schools for school age children have autism-related education in Tianjin. There were statistically significant differences were observed in gender, educational background and specialty domain of teachers within the pre-school group and the school age group(P<0.05). (2) Children were formally diagnosed as autism at an average of 4(SD=1.86) and had chosen 3.62(SD=1.61) rehabilitation agencies for treatment before. (3) Prospective assessment was undertaken before, Groups did not differ on assessments of the severity of autism at baseline. After different interventions in 1.5 years, there were significant differences between the two groups in mean scores of social communication, daily living skills and the total score assessing by ABC, the scores of the EIBI group is lower than the nursery group in these items. Differences were also observed on measures of mean scores of fine activities, eye-hand coordination, expressional recognition and the development score assessing by C-PEP, the scores of the EIBI group is higher than the nursery group in these items. (4) Having taken EIBI for one year, there were statistically significant differences of mean scores in each profile of the C-PEP scale in the pre-school group(n=8) (P<0.05)and children had more significant progress than before. (5) Forty children of autism having taken special school's education half of one year, at follow-up, there was no significant progress in autism behavior or IQ.Conclusion: The current autism-related rehabilitative and educational services couldn't be satisfied with the demands in Tianjin. For pre-school children with autism, the Early Intensive Behavioural Intervention is an effective training strategy. Special school is not fit for children with autism at school age. Home-based EIBI should be developed in our country in the mordern time. These findings must be taken into account in policy making to provide better and more specific policy and finance supports for this group of diseases.