医教融合联合低强度聚焦超声干预孤独症谱系障碍儿童个案分析

陈伟民; 赵艳嫔; 葛佳乐; 涂顺顺; 朱国丽; 严朝珊

doi:null

您当前的位置：

首页 >

文章列表页 >

医教融合联合低强度聚焦超声干预孤独症谱系障碍儿童个案分析

更新时间：2026-10-19

- 医教融合联合低强度聚焦超声干预孤独症谱系障碍儿童个案分析
- A Case Study of Integrated Medical-Educational Intervention Combined with Low-Intensity Focused Ultrasound in a Child with Autism Spectrum Disorder
- 中国听力语言康复科学杂志 2026年页码：1-8
- 作者机构：
  
  同济大学附属养志康复医院上海 201619
- 作者简介：
  
  陈伟民硕士主管治疗师；研究方向：孤独症儿童早期康复教育
  严朝珊，E-mail：765341109@qq.com
- 基金信息：
  
  国家临床重点专科建设项目(Z155080000004);上海市重中之重康复医学研究中心(2023ZZ02027);上海市级医院示范性研究型病房项目“上海市养志康复医院示范性研究型病房（培育）项目”(SHDC2023CRW018B);上海市级医院诊疗技术推广及优化管理项目“上海市级医院康复医学科专科联盟”(SHDC22023304-A)
- DOI：
  中图分类号： G762
- 收稿：2025-05-09，
  
  修回：2026-02-17，
  
  录用：2026-03-12，
  
  网络首发：2026-10-17，
- 稿件说明：
移动端阅览
陈伟民,赵艳嫔,葛佳乐等.医教融合联合低强度聚焦超声干预孤独症谱系障碍儿童个案分析[J].中国听力语言康复科学杂志,

CHEN Wei-min,ZHAO Yan-pin,GE Jia-le,et al.A Case Study of Integrated Medical-Educational Intervention Combined with Low-Intensity Focused Ultrasound in a Child with Autism Spectrum Disorder[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,
陈伟民,赵艳嫔,葛佳乐等.医教融合联合低强度聚焦超声干预孤独症谱系障碍儿童个案分析[J].中国听力语言康复科学杂志, DOI：10.3969/j.issn.1672-4933...001.

CHEN Wei-min,ZHAO Yan-pin,GE Jia-le,et al.A Case Study of Integrated Medical-Educational Intervention Combined with Low-Intensity Focused Ultrasound in a Child with Autism Spectrum Disorder[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation, DOI：10.3969/j.issn.1672-4933...001.

摘要

目的

报告1例学龄前轻度孤独症谱系障碍（ASD）儿童接受医教融合课程联合低强度聚焦超声（low-intensity focused ultrasound，LIFUS）干预及其行为、脑功能连接和社会适应变化。

方法

采用无平行对照的探索性单例前后测设计，对1例4岁9个月男童在持续医教融合训练基础上，加用4周左侧背外侧前额叶LIFUS干预共20次，同期开展12次医教融合课程。干预前、LIFUS结束时及结束后12周，结合行为量表、静息态功能性近红外光谱成像与生态观察进行描述性评估。

结果

与干预前相比，孤独症行为量表和孤独症治疗评估量表总分在干预结束时下降，随访时进一步下降。社交反应量表第二版T分及重复行为量表修订版总分在干预结束时下降，随访时均回升，前者接近基线，后者仍低于基线。双侧前额叶之间及左侧前额叶与双侧感觉运动区之间的功能连接指标在干预结束时升高，随访时仍高于基线。自编幼儿园适应行为量表评分升高，课堂参与增加。患儿完成全部LIFUS疗程，初期出现短暂抗拒和焦虑，未发生导致干预中断的不良事件。

结论

本例为联合干预的实施可行性提供了初步资料。患儿部分行为及适应指标呈改善趋势，伴脑功能连接变化，但随访期不同指标的变化不一。LIFUS的附加作用及联合干预的有效性与安全性仍需进一步验证。

Abstract

Objective

To report the implementation of an integrated medical-educational program combined with low-intensity focused ultrasound (LIFUS) in a preschool child with mild autism spectrum disorder (ASD)

and to describe changes in behavior

functional brain connectivity

and social adaptation.

Methods

An exploratory single-case pre-post design without a parallel control group was used. A boy aged 4 years and 9 months received 20 sessions of LIFUS targeting the left dorsolateral prefrontal cortex over 4 weeks as an adjunct to ongoing integrated medical-educational training

with 12 program sessions delivered during the same period. Descriptive assessments were conducted at baseline

immediately after completion of LIFUS

and at the 12-week follow-up using behavioral rating scales

resting-state functional near-infrared spectroscopy

and naturalistic observations.

Results

Autism Behavior Checklist and Autism Treatment Evaluation Checklist total scores decreased at intervention completion and further at follow-up. The Social Responsiveness Scale

Second Edition total T-score and Repetitive Behavior Scale- Revised total score decreased initially

then increased at follow-up; the former approached baseline

while the latter remained below baseline. Connectivity between bilateral prefrontal regions and between the left prefrontal and bilateral sensorimotor regions increased at intervention completion and remained above baseline at follow-up. Scores on the study-developed Kindergarten Adaptive Behavior Scale increased

as did classroom participation. The child completed all LIFUS sessions

with brief initial resistance and anxiety but no adverse events leading to intervention discontinuation.

Conclusion

Conclusion This case provides preliminary evidence on the feasibility of implementing the combined intervention. Some behavioral and adaptive measures showed favorable trends alongside changes in functional brain connectivity

but follow-up trajectories varied across measures. The added benefit of LIFUS and the efficacy and safety of the combined intervention require further evaluation.

关键词

Keywords

references

Lord C , Elsabbagh M , Baird G , et al . Autism spectrum disorder [J ] . The Lancet , 2018 , 392 ( 10146 ): 508 - 520 .

Hai Y , Bai S , Qiao H , et al . A Review of Therapeutic Approaches for Autism Spectrum Disorder [J ] . Brain Sciences , 2025 , 15 ( 12 ): 1280 - 1280 .

Lord C , Charman T , Havdahl A , et al . The Lancet Commission on the future of care and clinical research in autism [J ] . The Lancet , 2022 , 399 ( 10321 ): 271 - 334 .

Mazzone L , Dooling SW , Volpe E , et al . Precision microbial intervention improves social behavior but not autism severity:A pilot double-blind randomized placebo-controlled trial [J ] . Cell Host & Microbe , 2024 , 32 ( 1 ): 106 - 116.e6 .

王吉 , 刘兆清 , 房舒 , 等 . 医教结合模式在孤独症谱系障碍儿童干预中的疗效分析 [J ] . 兰州大学学报(医学版) , 2024 , 50 ( 4 ): 8 - 11,19 .

Segal L , Green J , Twizeyemariya A , et al . Estimated Therapy Costs and Downstream Cost Consequences of iBASIS-Video Interaction to Promote Positive Parenting Intervention vs Usual Care Among Children Displaying Early Behavioral Signs of Autism in Australia [J ] . JAMA Network Open , 2023 , 6 ( 4 ): e235847 .

Green J , Leadbitter K , Ainsworth J , et al . An integrated early care pathway for autism [J ] . The Lancet.Child & Adolescent Health , 2022 , 6 ( 5 ): 335 - 344 .

Selimbeyoglu A , Kim CK , Inoue M , et al . Modulation of prefrontal cortex excitation/inhibition balance rescues social behavior in CNTNAP2-deficient mice [J ] . Science Translational Medicine , 2017 , 9 ( 401 ): eaah6733 .

Larson C , Thomas HR , Crutcher J , et al . Language Networks in Autism Spectrum Disorder: A systematic review of connectivity-based fMRI studies [J ] . Review Journal of Autism and Developmental Disorders , 2025 , 12 ( 1 ): 110 - 137 .

罗凯旋 , 冯湘君 , 陈茉弦 , 等 . 低强度聚焦超声对神经调控作用研究进展 [J ] . 中国现代医学杂志 , 2021 , 31 ( 7 ): 41 - 44 .

白杨 . 低强度聚焦超声对社会击败应激小鼠的社交回避改善作用及调控机制研究 [D ] . 天津大学 , 2021 .

Casanova MF , Shaban M , Ghazal M , et al . Ringing Decay of Gamma Oscillations and Transcranial Magnetic Stimulation Therapy in Autism Spectrum Disorder [J ] . Applied Psychophysiology and Biofeedback , 2021 , 46 ( 2 ): 161 - 173 .

Jeong H , Kim D , Na S , et al . Repeated neuromodulation with low-intensity focused ultrasound in patients with Alzheimer's disease . Journal of Alzheimer's Disease , 2025 , 105 ( 3 ): 955 - 965 .

Cheng S , Xu X , Yan CS , et al . Case Report:Low-intensity transcranial focused ultrasound stimulation improves social interaction and stereotyped behavior in a boy with autism spectrum disorder [J ] . Frontiers in Psychiatry , 2025 , 16 : 1606300 .

Rihan LS , Youssef AM , Abdelaziz AW , et al . Assessment of the Validity and Reliability of an Arabic Version of Autism Behavior Checklist:One Center Study [J ] . QJM:An International Journal of Medicine , 2024 , 117 ( Supplement_1 ):hcae070.512.

Ji SI , Park H , Yoon SA , et al . A validation study of the CARS-2 compared with the ADOS-2 in the diagnosis of autism spectrum disorder: a suggestion for cutoff scores [J ] . Journal of the Korean Academy of Child and Adolescent Psychiatry , 2023 , 34 ( 1 ): 45 - 50 .

Tehrani-Doost M , Shahrivar Z , Torabi N , et al . Cross-cultural validation and normative data of the social responsiveness scale in a group of Iranian general child population [J ] . Journal of autism and developmental disorders , 2020 , 50 : 2389 - 2396 .

Martínez-González AE , Piqueras JA . Standard scores of the Repetitive Behavior Scale-Revised for people with autism and intellectual disability in Spain [J ] . Actas espanolas de psiquiatria , 2019 , 47 ( 6 ): 209 - 217 .

Mai G , Jiang Z , Wang X , et al . Neuroplasticity of speech-in-noise processing in older adults assessed by functional near-infrared spectroscopy(fNIRS) [J ] . Brain Topography , 2024 , 37 ( 6 ): 1139 - 1157 .

Hou X , Zhang Z , Zhao C , et al . NIRS-KIT:a MATLAB toolbox for both resting-state and task fNIRS data analysis [J ] . Neurophotonics , 2021 , 8 ( 1 ): 010802 - 010802 .

Abu-Dahab SMN , Alwawi DA , Alkhamra HA . Do Occupational Therapy Goals for Children with Autism Spectrum Disorder Reflect Participation? A Mapping to the ICF-CY and ICF Core Sets Study [J ] . Journal of Autism and Developmental Disorders , 2026 , 56 : 773 - 783 .

Halford E , Jakubiszak S , Krug K , et al . What is Task-Oriented Training? A Scoping Review [J ] . Student Journal of Occupational Therapy , 2024 , 4 ( 1 ): 1 - 23 .

Zhang T , Pan N , Wang Y , et al . Transcranial focused ultrasound neuromodulation: a review of the excitatory and inhibitory effects on brain activity in human and animals [J ] . Frontiers in human neuroscience , 2021 , 15 : 749162 .

Mir-Moghtadaei A , Caballero R , Fried P , et al . Concordance between BeamF3 and MRI-neuronavigated target sites for repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex [J ] . Brain stimulation , 2015 , 8 ( 5 ): 965 - 973 .

Howley M . Structured teaching and eclectic classroom practice for children with autism in special schools:a case of mindful blending [D ] . University of Northampton , 2015 .

Taylor C . Multisensory Integration in Early Toddlerhood: Interrelationships with Context,SES and Expressive Vocabulary [D ] . Virginia Tech , 2021 .

Fage C , Consel CY , Balland E , et al . Tablet apps to support first school inclusion of children with autism spectrum disorders (ASD)in mainstream classrooms: A pilot study [J ] . Frontiers in psychology , 2018 , 9 : 2020 .

Yamoah O , Balser S , Ogland-Hand C , et al . A win-win for all of us: COVID-19 sheds light on the essentialness of child care as key infrastructure [J ] . Early childhood research quarterly , 2023 , 63 : 113 - 120 .

国务院办公厅 . 关于转发教育部等部门"十四五"特殊教育发展提升行动计划的通知(国办发〔2021〕60号)[EB/OL ] . https://www.gov.cn/zhengce/content/2022-01/25/content_5670341.htm. 2021-12-31 https://www.gov.cn/zhengce/content/2022-01/25/content_5670341.htm.2021-12-31 .

法国教育部 . Inclusive education: International perspectives [EB/OL ] . https://www.education.gouv.fr/international-perspectives-inclusive-education-9734.2019-02-12 https://www.education.gouv.fr/international-perspectives-inclusive-education-9734.2019-02-12 .

Damyanov K . International Classification of Functioning, Disability, and Health for Children and Youth (ICF-CY) as a Framework for Early Intervention Planning in Inclusive Education [J ] . Open Journal of Social Sciences , 2024 , 12 ( 11 ): 85 - 98 .

Xie S , Gong C , Lu J , et al . Enhancing Chinese preschoolers'executive function via mindfulness training: An fNIRS study [J ] . Frontiers in Behavioral Neuroscience , 2022 , 16 : 961797 .

Chen M , Zhao G , Peng L . Transcranial Magnetic Stimulation Applications in the Study of Executive Functions:A Review [J ] . Brain and Behavior , 2024 , 14 ( 11 ): e70099 .

Ohtani T , Matsuo K , Sutoh C , et al . Reduced brain activation in response to social cognition tasks in autism spectrum disorder with and without depression [J ] . Neuropsychiatric Disease and Treatment , 2021 , 17 : 3015 - 3024 .

Wan L , LI Y , Zhu G , et al . Multimodal investigation of dynamic brain network alterations in autism spectrum disorder: Linking connectivity dynamics to symptoms and developmental trajectories [J ] . NeuroImage , 2024 , 302 : 120895 .

Hull JV , Dokovna LB , Jacokes ZJ , et al . Resting-State Functional Connectivity in Autism Spectrum Disorders:A Review [J ] . Frontiers in Psychiatry , 2017 , 7 : 205 - 205 .

Hertrich I , Dietrich S , Blum C , et al . The Role of the Dorsolateral Prefrontal Cortex for Speech and Language Processing [J ] . Frontiers in Human Neuroscience , 2021 , 15 : 645209 .

Xie H , Liang J , Luo Y , et al . Targeting the dorsolateral prefrontal cortex to enhance memory control: divergent effects on social and non-social memories [J ] . Social Cognitive And Affective Neuroscience , 2025 , 20 ( 1 ): nsaf052 .

Kildahl AN , Hellerud JMA , Halvorsen MB , et al . The Aberrant Behavior Checklist in a Clinical Sample of Autistic Individuals with Intellectual Disabilities and Co-Occurring Mental Health Problems: Psychometric Properties, Factor Structure, and Longitudinal Measurement Invariance [J/OL ] . Journal of Autism and Developmental Disorders , 2025 , https://link.springer.com/10.1007/s10803-024-06697-5.2026-02-17 https://link.springer.com/10.1007/s10803-024-06697-5.2026-02-17 .

Munzer TG , Miller AL , Brophy-Herb HE , et al . Characteristics Associated With Parent-Teacher Concordance on Child Behavior Problem Ratings in Low-Income Preschoolers [J ] . Academic Pediatrics , 2018 , 18 ( 4 ): 452 - 459 .

Salazar J , Moustgaard H , Bracchiglione J , et al . Empirical evidence of observer bias in randomized clinical trials: updated and expanded analysis of trials with both blinded and non-blinded outcome assessors [J ] . Journal of Clinical Epidemiology , 2025 , 183 : 111787 .

Kock F , Berbekova A , Assaf AG . Understanding and managing the threat of common method bias:Detection,prevention and control [J ] . Tourism Management , 2021 , 86 : 104330 .

Chen Y , Tang J , Chen Y , et al . Amplitude of fNIRS resting-state global signal is related to EEG vigilance measures:A simultaneous fNIRS and EEG study [J ] . Frontiers in Neuroscience , 2020 , 14 : 560878 .

Loh WW , Ren D . The Unfulfilled Promise of Longitudinal Designs for Causal Inference [J ] . Collabra:Psychology , 2023 , 9 ( 1 ): 89142 .

Zheng S , Zheng L , Qiao X , et al . Intensive longitudinal data analysis: Models and application [J ] . Advances in Psychological Science , 2021 , 29 ( 11 ): 1948 - 1969 .

Kong XJ , Liu J , Liu K , et al . Probiotic and oxytocin combination therapy in patients with autism spectrum disorder:a randomized,double-blinded,placebo-controlled pilot trial [J ] . Nutrients , 2021 , 13 ( 5 ): 1552 .

Xie Y , Sun J , Man W , et al . Personalized estimates of brain cortical structural variability in individuals with Autism spectrum disorder: the predictor of brain age and neurobiology relevance [J ] . Molecular Autism , 2023 , 14 ( 1 ): 27 - 27 .

Penagos-Corzo JC , Cosio van-Hasselt M , Escobar D , et al . Mirror neurons and empathy-related regions in psychopathy:Systematic review,meta-analysis,and a working model [J ] . Social Neuroscience , 2022 , 17 ( 5 ): 462 - 479 .

Lee W , Weisholtz DS , Strangman GE , et al . Safety review and perspectives of transcranial focused ultrasound brain stimulation [J ] . Brain & NeuroRehabilitation , 2021 , 14 ( 1 ): e4 .

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

自然情境教学促进孤独症谱系障碍儿童主动口语沟通的个案研究

基于多主体协同视角的人工智能支持孤独症谱系障碍儿童教育干预的实践挑战与优化路径

基于社会故事法改善孤独症谱系障碍儿童同伴交往主动性个案研究

宁夏回族自治区孤独症谱系障碍儿童家庭养护现状及支持资源需求调查研究

基于协同学序参量的孤独症谱系障碍学生融合教育课堂协同机制实证研究