Research And Discussion Of Sandplay Therapy In The Rehabilitation Of Children With Global Development Delay

Objective:This research studied the clinical data of children with global development delay(GDD)to investigate the related factors affecting the incidence of GDD.The psychological and behavioral characteristics of children with GDD were explored through family interviews and scale evaluation.The effects of sandplay therapy on the rehabilitation of children with GDD was analyzed through randomized controlled experiments,so as to guide clinical treatment.Method:55 children with GDD who met the inclusion criteria in the Rehabilitation Department of Children’s Hospital Affiliated to Soochow University from January 1,2018 to September 30,2018 were selected as subjects.(1)Normal children of the same age group(normal group,n=88)randomly matched with each subject were retrospectively analyzed.(2)Comparing and analyzing the basic data of mothers age of pregnancy,threatened abortion,parents’educational level,premature delivery,major postnatal diseases and early separation between the two groups.(3)Family interviews and scales were conducted in the GDD group,and the results were compared with those of the national norm ini 978.(4)The GDD group was randomly divided into the experimental group and the control group.The experimental group received eight consecutive chamber treatments on the basis of routine rehabilitation treatment,once a week,30 minutes a time.The control group only received routine rehabilitation treatment.Parents of the children were interviewed before and after treatment,and their daily life and learning performance were recorded.Children in the two groups were assessed with the Neuropsychological Examination Scale(2016),and Infant-junior Middle School student Social-life Ability Scale(SM).And the Conners Parents Symptom Questionnaire(PSQ)should be added for children>3 years old.To observe and compare the psychological and behavioral characteristics,motor level,cognition,language,social behavior and life ability of the two groups before and after treatment,so as to explore the effect of sandplay therapy on the rehabilitation of children with GDD.Results:First,the related factors affecting the incidence of GDD:(1)There were 40 males(72.73%)and 15 females(27.27%)in the GDD group.The ratio of males to females was 2.67:1.There vas a significant gender difference in the prevalence of GDD.(2)There was no significant difference between GDD group and non-GDD group in mothers age at pregnancy(≥35 years old)and parents’ educational level(P>0.05).(3)The proportion of threatened abortion among mothers in GDD group was significantly higher than that in non-GDD group(P<0,05);the proportion of premature delivery(gestational age<37 weeks),major neonatal diseases and early separation in GDD group was significantly higher than that in non-GDD group(P<0.05).Second,the psychological and behavioral characteristics of children with GDD:The results of family interviews suggest that children with GDD have emotional,behavioral and social problems.Before treatment,there are 39 children(32 males and 7 females)with GDD in the 3～5 years old group,and had significantly higher scores in PSQ’s conduct problems(male:0.91±0.27,female:0.81±0.24)and learning problems(male:0.98±0.27,female:1.07±0.47)than those of boys and girls in norm group(conduct problems:male:0.53±0.39,female:0.49±0.35;learning problems:male:0.50±0.33,Female:0.62±0.57)(P<0.05).Third,the effects of sandplay therapy on the rehabilitation of children with GDD:After treatment,the scores of social ability in Neuropsychological Examination Scale(75.26±11.51)and SM(9.07±0.73)of the experimental group were higher than those of the control group(social ability in Neuropsychologicd Examination Scale:73.00(11.00);SM:8.46±0.74)(P<0.05).After treatment,the experimental group’s scores of learning problems(0.75(0.50)),impulse-hyperactivity(0.50(0.25))and hyperactivity index(0.56±0.19)in PSQ were lower than control group,s(learning problems:1.00(0.25),impulse-hyperactivity:0.88±0.36,hyperactivity index:0.83±0.27 in PSQ)(P<0.05).After treatment,the experimental group’s scores of gross motor(80.11±15.31),fine motor(82.00(19.00)),adaptability(82.00(15.00)),language(75.26±17.91)in Neuropsychological Examination Scale and conduct problems(0.58(0.42)),physical and mental disorders(0.00(0.20)),anxiety(0.50(0.50))in PSQ were compared with those in the control group(gross motor:87.00(16.25),fine motor:83.00(13.00),adaptability:78.50(10.75),language:1.50(17.50)in Neuropsychological Examination Scale,behavioral problems:0.88±0.30,physical and mental disorders:0.00(0.20),anxiety;0.53±0.36 in PSQ)(P>0.05).Conclusion:(1)There are significant gender differences in the prevalence of GDD.Early segregation,threatened abortion,premature delivery(gestational age<37 weeks)and major postnatal diseases are the related factors affecting the incidence of GDD.(2)Compared with normal children nearly the same age,children with GDD are more likely to have psychological problems.(3)Sandplay therapy can not only effectively treat the psychological problems of children with GDD,but also promote the development of social behavior and life ability.It can be used as an effective means to treat children with GDD.