孤独症谱系障碍儿童自我意识的发展特征及其机制探讨

顾丽慧; 沈敏

doi:10.3969/j.issn.1672-4933.2026.04.004

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孤独症谱系障碍儿童自我意识的发展特征及其机制探讨

孤独症行为干预与康复 | 更新时间：2026-09-22

- 孤独症谱系障碍儿童自我意识的发展特征及其机制探讨
- Exploring the Developmental Characteristics and Mechanisms of Self-Awareness in Children with Autism Spectrum Disorder
- 中国听力语言康复科学杂志 2026年24卷第4期页码：350-355
- 作者机构：
  
  1.上海市特殊儿童康复中心上海 200127
  2.上海交通大学医学院附属上海儿童医学中心上海 200127
- 作者简介：
  
  顾丽慧本科副主任康复治疗师/中级心理治疗师；研究方向：情绪行为问题干预
  沈敏，E-mail：minshen223@vip.163.com
- 基金信息：
  
  2023年上海市残疾人联合会康复政策研究专项立项项目“孤独症儿童主要照护者心理问题现状及政策需求研究”(2023ZC1006)
- DOI：10.3969/j.issn.1672-4933.2026.04.004
  中图分类号： R494
- 收稿：2026-03-12，
  
  修回：2026-05-13，
  
  录用：2026-06-30，
  
  纸质出版：2026-07-15
- 稿件说明：
移动端阅览
顾丽慧,沈敏.孤独症谱系障碍儿童自我意识的发展特征及其机制探讨[J].中国听力语言康复科学杂志,2026,24(04):350-355.

GU Li-hui,SHEN min.Exploring the Developmental Characteristics and Mechanisms of Self-Awareness in Children with Autism Spectrum Disorder[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2026,24(04):350-355.
顾丽慧,沈敏.孤独症谱系障碍儿童自我意识的发展特征及其机制探讨[J].中国听力语言康复科学杂志,2026,24(04):350-355. DOI： 10.3969/j.issn.1672-4933.2026.04.004.

GU Li-hui,SHEN min.Exploring the Developmental Characteristics and Mechanisms of Self-Awareness in Children with Autism Spectrum Disorder[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2026,24(04):350-355. DOI： 10.3969/j.issn.1672-4933.2026.04.004.

摘要

目的

探讨和分析孤独症谱系障碍（ASD）儿童自我意识的发展特征及其内在机制，为ASD儿童的康复干预提供理论依据。

方法

基于自我意识的生理自我、社会自我、心理自我3个层面，阐述普通儿童早期自我意识的发展轨迹与ASD儿童的发展偏差，并从神经机制、认知加工、社会互动的角度分析ASD儿童自我意识发展特征及内在机制，提出相应干预策略。

结果

ASD儿童自我意识发展在3个层面均存在显著滞后。在生理自我层面表现为身体表征模糊、感知觉整合失调，其机制与感觉运动环路异常等相关；在社会自我层面表现为心理理论缺损、角色定位困难、群体归属感缺失，女童倾向采用更多社交补偿策略，其机制与社会脑网络连接异常等相关。在心理自我层面表现为内感受与元认知能力缺损、自尊水平偏低，其机制与默认模式网络功能异常等相关。3个层面相互关联、彼此影响。基于上述特征与机制，提出认知建构、身体感知、身心整合、社会互动及生态支持的干预策略。

结论

ASD儿童自我意识发展呈现多层面、多系统的协同障碍，针对生理、社会、心理3个层面的协同干预可有效促进其综合功能提升。

Abstract

Objective

To explore and analyze the developmental characteristics and underlying mechanisms of self-awareness in children with autism spectrum disorder (ASD)

and to provide a theoretical basis for rehabilitation interventions.

Methods

Based on the three dimensions of self-awareness (physical self

social self

psychological self)

this paper described the early developmental trajectory of self-awareness in typically developing children and the developmental deviations in children with ASD. The developmental characteristics and mechanisms of self-awareness in ASD were analyzed from the perspectives of neural mechanisms

cognitive processing

and social interaction

and corresponding intervention strategies were proposed.

Results

Children with ASD showed significant developmental delays across all three dimensions. In the physical self dimension

they exhibited blurred body representation and sensory integration deficits

with mechanisms related to abnormalities in sensorimotor circuits

among others. In the social self dimension

they demonstrated theory of mind deficits

difficulties in role positioning

and lack of group belonging

with female children tending to adopt more social compensation strategies; the mechanisms were associated with abnormalities in social brain network connectivity

among others. In the psychological self dimension

they showed deficits in interoception and metacognition

as well as low self-esteem

with mechanisms related to default mode network dysfunction

among others. The three dimensions were interrelated and influenced each other. Based on the above characteristics and mechanisms

intervention strategies including cognitive construction

body perception

mind-body integration

social interaction

and ecological support were proposed.

Conclusion

The development of self-awareness in children with ASD involves multi-dimensional and multi-system synergistic impairments. Coordinated interventions targeting the physical

social

and psychological dimensions can effectively promote the overall functional development of these children.

关键词

Keywords

references

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