Real-scenarios Observation And Application Of Social Communication Behaviors In Children With Autism (3-8 Years Old)

Objective: Social communication disorders are one of the core deficits in autism.In recent years,it has been suggested that the intervention of children in autism should focus on improving their social ability,in which accurate and effective social ability assessment is the basis of effective intervention.There are many problems in domestic social ability evaluation,such as fewer tools,separation of evaluation results from training,high professional requirements for evaluation personnel,and so on.Therefore,this study developed a tool called Real-Scenarios Observation of Social Communication Behaviors(ROSCB)for children with autism aged 3-8 years and applied it in intermittent Theta Burst Stimulation(iTBS).Methods:(1)Our team selected ASD social behavior indicators from previous literature,autism screening scale and interviews,designed corresponding social behavior assessment scenarios,compiled assessment manuals,and then established ROSCB.(2)The children with ASD were tested with the developed ROSCB tool,and the results were analyzed by exploratory factor analysis(N = 33)and confirmatory factor analysis(N = 62).Social response scale,autistic behavior checklist and childhood autism rating scale were used as calibration validity tools.The ROSCB was used to test typical developmental children.(3)Fourteen ASD children were given iTBS intervention twice a day for 14 days and the interval between the two interventions was at least 50 minutes.ROSCB assessment and ASD Behavioral symptom scale assessment were performed before and after the intervention to explore whether ROSCB can test the intervention effect of iTBS on the social behavior of ASD children.Results: ROSCB is a validated assessment tool that include play-based observation,a coding scheme for children’s social behavior,and an assessment manual.Study 1:(1)Findings suggested that items from the ROSCB could be further separated into four subdomains of social-communication impairments,namely “Basic Social Communication Behaviors”,“Social Attention Coordination Behaviors”,“Close Physical Contact”,and “Interaction Quality”.The four-factor structure fited well with both the exploration and validation samples.(2)The total score of ROSCB and the scores of each factor in typical developmental children were significantly lower than those in the ASD group.In addition,there was a significant correlation between ROSCB score and social response scale and autism behavior checklist score.Study 2: After intervention,the total score of ROSCB in ASD group decreased significantly(p = 0.03),and the score of basic social behavior factors also decreased significantly(p = 0.059).There was no significant difference in the score of “Close Physical Contact” between the ASD treatment group and the control group.Except for the factor of “Close Physical Contact”,the total score of ROSCB and the scores of other three factors in the ASD group were significantly higher than those in the TD group(p < 0.001).In addition,there was a significant positive correlation between the difference value of social response scale and the difference of ROSCB score.Conclusion:(1)the reliability and validity of the developed ROSCB are good,and the results of factor analysis show that ROSCB includes four dimensions: “Basic Social Communication Behaviors”,“Social Attention Coordination Behaviors”,“Close Physical Contact”,and “Interaction Quality”.(2)ROSCB could effectively distinguish the level of social behavior between autistic children and typical developmental children.(3)ROSCB could test the intervention effect of iTBS on social behavior of ASD children.