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自闭症干预的ＳＣＥＲＴＳ模式

作者：杨广学

　　关于在自然的生活环境（例如家庭）中进行心理-教育干预的潜能，在此仅提出一个观点：在儿童的实际活动中随时随地地把握时机，促进契机式学习（incidental learning），特别值得我们注意。这种思路与处方式学习（prescriptive learning）预定内容和程序的做法大相径庭。许多干预方案理论上似乎头头是道，但是一旦接触自闭症儿童的实际情况，便大打折扣，原因在于脱离了临床实践和生活实际中儿童的个人需要，脱离了社会互动的情境意义和具体的生活功能。举例来说，社会故事干预^[15]是一个很有创意的干预方案，但是实际应用过程中并不可能完全根据预设的语法逻辑来展开，比如固定的句型比例就显得学究气十足，不切实际。从儿童的意义完形或经验的现象场（phenomenal field）作为干预的切入点，是我们从心理治疗临床实践中积累的一个基本经验。教育干预也应该充分注意在互动的语境中提供身体或情感的意义表达的框架性支持，否则提高人际交流和社会交往能力的优先的地位就无法落实。
　　总之，SCERTS模式为直接处理自闭症儿童的主要问题提供了一个具有综合性的框架，针对自闭症患者的核心缺陷，重点关注儿童意义感受和表达能力的发展，注重运用象征手段实现家庭中的人际交流，促进儿童的自我调节和互动能力。该模式广泛吸收了当代自闭症干预研究的成果，提供了个别化干预的新动向和新策略，值得进一步追踪。
　　
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