目的 探索蒙特梭利教学法在脑瘫儿童认知训练中的应用效果.方法 选取2013年7月至2016年7月间咸阳彩虹医院儿童保健康复科收治的30～36月龄脑瘫患儿116例,将其随机分为两组.对照组(n=57)进行常规认知教学,干预组(n=59)以蒙特梭利教学法进行认知教学.教学持续12个月,分别于第6、9、12个月时各进行1次评估,记录并进行统计分析.结果 ① 在训练第9、12个月后,干预组患儿的颜色匹配测试完成率优于对照组(χ2值分别为5.098、5.954,均P<0.05).② 在训练6个月后,颜色和物品的匹配 、颜色和形状的表达注意4项,干预组患儿的速度均优于对照组(t值分别为2.041、3.037、2.155、2.468,均P<0.05);在训练9个月后,干预组患儿的颜色 、形状 、物品3个维度的匹配速度和表达注意速度均优于对照组(t值分别为2.856、3.454、5.509、5.837、8.424、4.923,均P<0.05);在训练12个月后,干预组患儿的颜色 、形状 、物品3个维度的匹配速度和表达注意速度均持续优于对照组患儿(t值分别为2.888、3.273、6.672、6.672、3.567、4.290,均P<0.05).③ 训练第9和第12个月后的颜色匹配 、训练第12个月后的颜色表达的错误数,干预组患儿均少于对照组(t值分别为2.713、2.846、2.467,均P<0.05).结论 蒙特梭利教学法有助于促进脑瘫儿童认知的发展.%Objective To explore the application effect of Montessori teaching method on cognitive training of children with cerebral palsy (CP) .Methods A total of 116 children with CP aged 30 - 36 months old who were admitted to the department of children healthcare and rehabilitation in Xianyang Caihong Hospital during July 2013 to July 2016 were selected and divided into two groups randomly .The children in control group (n = 57) were given conventional cognitive teaching ,while the children in intervention group (n = 59) adopted the Montessori teaching method to carry out cognitive teaching .The teaching lasted for 12 months ,and each assessment was conducted ,recorded and analyzed statistically at the 6th ,9th ,and 12th month respectively .Results After training for 9 and 12 months ,the completion rate of the children in color matching test in the intervention group was better than that in the control group (χ2 value was 5 .098 and 5 .954 ,respectively ,both P < 0 .05) .After training for 6 months ,in 4 items such as color matching ,item matching ,color expression ,and shape expression ,the speed of children in the intervention group was higher than that in the control group (t value was 2 .041 ,3 .037 ,2 .155 and 2 .468 ,respectively ,all P < 0 .05) .After training for 9 months ,the matching speed and expression attention speed of 3 dimensions including color ,shape and item of children in the intervention group were all higher than those in the control group (t value was 2 .856 ,3 .454 ,5 .509 ,5 .837 ,8 .424 and 4 .923 , respectively ,all P < 0 .05) .After training for 12 months ,the matching speed and expression attention speed of the 3 dimensions including color ,shape and item of children in the intervention group were all higher than those in the control group (t value was 2 .888 ,3 .273 ,6 .672 ,6 .672 ,3 .567 and 4 .290 ,respectively ,all P < 0 .05) .For the errors number in the color matching test after training for 9 and 12 months ,and the errors number in the color expression test after training for 12 month ,the children in the intervention group were less than those in the control group (t value was 2 .713 ,2 .846 and 2 .467 ,respectively ,all P < 0 .05) . Conclusion The Montessori teaching method can promote the cognitive development of children with CP .
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