显性运动动作学习对自闭症儿童运动、社交和认知能力的影响

Autism Spectrum Disorders (ASD) is a neurodevelopmental disorder characterized by social and communication impairments as well as a wide range of behavior deficits. For years, motor disturbance reported in ASD has not been treated as a major core deficit because of the overwhelming problems in sociability and communication. Recent studies, however, reveal that motor deficits are fundamental and contribute to the core symptoms of ASD. Furthermore, it is claimed that compromised motor skill acquisition plays a critical role on the clumsiness and poor fundamental motor skills in ASD. Untreated motor problems can persist well into adolescence and adulthood, which result in long-term physical, psychological, and behavioral issues in individuals with ASD. Thus, the ability to understand and address the overall picture of a child with ASD, and especially motor dysfunction, has become a critical need for developing effective intervention programs. However, most existing intervention programs do not directly target motor deficits in ASD. Even though a few programs include modules of motor skills, little is known about how those methods, developed by researchers and tested in lab-based studies, are being used or translated to education programs. Our objectives in this application are to identify key factors that affect motor dysfunctions of ASD (i.e., implicit and explicit motor learning), and to develop and validate a school-based physical activity program. Aim 1 will evaluate implicit motor learning and its relationship to motor, social, and cognitive functioning in children with and without ASD. Aim 2 will evaluate explicit motor learning when learning strategies are provided for lab-based tasks in children with ASD. Aim 3 will integrate what we learned from the lab-based research to develop an instruction-enriched physical activity program and evaluate the efficacy of explicit instructions in school settings. Although instruction-enriched interventions have been commonly used in social and linguistic domains, utilizing such techniques in the motor domain, especially in a school-based physical activity setting, is novel. It is hypothesized that children with ASD will demonstrate impaired motor learning, but possess the ability to utilize explicit processes during learning. The instruction-enriched physical activity program will greatly enhance not only motor but also social and cognitive functioning. The long-term goal of our research is to understand the mechanisms underlying motor deficits in ASD, and identify best practices for improving symptomology in Chinese children with ASD. .This novel project will translate the carefully controlled lab-based research and clinical assessments into the environment-enriched school-based programs. Success in this endeavor could significantly advance our understanding of motor dysfunctions and their relationship to core impairments in ASD. It will offer a fundamental framework for developing, evaluating, and implementing effective intervention strategies for ASD.

自闭症儿童具有社会交往，沟通障碍和刻板或重复的行为模式。 最近一些研究显示运动功能障碍也是自闭症的基本症状，并且和自闭症的核心症状密切相关。同时，动作学习障碍被认为是导致运动功能障碍的根本原因。因此，提高动作学习从而减缓运动障碍至关重要。然而，大多数现有的干预方案并未针对动作学习。 此外，很少有研究去测试如何把实验室环境下的研究结果联系到能实际操作的干预方案。所以，此项目将主要针对自闭症儿童隐性和显性动作学习。开发和评估有针对性的，系统的，渐进性的特殊体育干预项目。具体包括在实验环境下，评估和测试显性和隐性动作学习（目标1和2）；和在学校环境下，开发和评估能激发显性动作学习的体育干预项目（目标3）。 我们这个项目的长期研究目标是要了解运动障碍在自闭症的诊断和治疗中的作用，确定能在学校中应用的最佳干预策略。并希望，为中国的自闭症儿童提供有效的特殊教育方案。让这些儿童能成功地过渡到普通的生活中。

自闭症儿童临床上所表现出的运动动作障碍是自闭症的基本症状，并且和自闭症的核心症状（社交，沟通障碍）紧密相关。然而，自闭儿童在基本动作能力上所显现出来的多种临床表现往往被忽视而得不到适当的干预和治疗。有研究表明未经治疗的运动动作障碍可以持续地进入青春期和成年期，并导致长期的身体、心理和行为问题。因此，提高运动动作学习从而减缓运动障碍至关重要。目前，我们对自闭儿童的运动动作学习能力和发展情况并不十分了解，大多数现有的治疗和干预方案并没有特别地针对运动动作学习。迄今为止，关于自闭症儿童运动动作学习的研究项目非常少。此项研究为国内为数很少的直接针对自闭儿童基本动作学习的项目，旨在实验室和学校环境下，运用体育干预的手段提高自闭症儿童的基本运动能力。研究内容包括在实验室和特殊教育环境下自闭儿童运动动作学习能力的评估；开发和研究在特殊教育环境下针对自闭症儿童运动动作学习障碍的体育干预项目。同时验证体育干预在提高自闭儿童的运动，社交和认知能力方面的效果。主要结果显示即使是低功能的自闭儿童依然具有一定的动作学习能力，关键在于提供与个体功能相匹配的干预指令和任务。目前结果显示在CPRT框架下发展的干预计划效果是显著的（无论功能高低）。儿童的社交功能会对动作干预效果起到非常重要的影响。为了进一步提高干预的长期效果，特别是相对复杂的动作操作能力，长时间的干预，及对家长的教育可能至关重要。同样重要的是对个体特性的评估分析。临床/教育工作者需要了解儿童个体，家长，及相关人员的诉求，制定出与个体功能，环境相对应的干预计划，从而达到干预效果的最优化。总之，发展并推进我国自闭症儿童运动动作学习研究，以及运动能力同社交和认知能力的关系研究具有深刻意义。本研究成果应用前景广阔，研发出的自然环境下的动作技能干预方案及结构化的教学模式，可普遍运用自闭症康复中心，改善儿童动作发展障碍现状，促进认知及社交能力提升. 此项研究不仅可以为我国的自闭症儿童特殊教育改革和发展提供理论和实践依据，而且有助于制定有效和易行的干预方法，从而降低公共卫生及医疗费用。

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