Abstract: Background As an emerging comprehensive therapeutic approach, music therapy has been increasingly applied and valued in the rehabilitation of children with autism. However, studies on the intervention effects of music therapy on the psychological functions of children with autism remain insufficient. Objective To analyze the intervention efficacy of music therapy on core psychological symptoms in children with autism spectrum disorder (ASD). Methods A total of 66 children with ASD who received rehabilitation training at Qihong Special Children Training and Education Center in Jiang’an District, Wuhan, from March to July 2025 were enrolled as research subjects. They were randomly divided into the control group and the observation group using the random number table method, with 33 cases in each group. The control group received routine rehabilitation treatment intervention, while the observation group received additional music therapy on the basis of routine rehabilitation training. The intervention duration for both groups was 16 weeks. Before intervention, 8 weeks and 16 weeks after intervention, the therapeutic effects of the two groups were evaluated and compared using the Autism Treatment Evaluation Checklist (ATEC) and Childhood Autism Rating Scale (CARS). Results All 66 children with ASD completed the study without dropout. There were no significant differences in gender and age between the two groups (P>0.05). Repeated-measures analysis of variance showed significant interactive effects of group and time on CARS and ATEC scores (P Interaction<0.05). Both group and time exerted significant main effects on CARS and ATEC scores (P Group<0.05, P Time<0.05). After 16 weeks of intervention, the CARS and ATEC scores of children in the observation group were significantly lower than those in the control group (P<0.05). Intra-group comparison revealed that in the observation group, the CARS and ATEC scores at 8 weeks of intervention were lower than those before intervention, and the scores at 16 weeks of intervention were further lower than those before intervention and at 8 weeks of intervention (all P<0.05). In the control group, the CARS and ATEC scores at 8 weeks and 16 weeks of intervention were significantly lower than those before intervention, and the scores at 16 weeks of intervention were lower than those before intervention and at 8 weeks of intervention (all P<0.05). Interactive effects of group and time were observed on the subscores of ATEC including language, social interaction, behavior and cognition (P Group<0.05). The main effects of group on ATEC language, social interaction and behavior subscores were significant (P Interaction<0.05), whereas no significant main effect of group was found on cognitive subscores (P Group>0.05). Time showed significant main effects on all ATEC subscores (language, social interaction, behavior and cognition) (P Time<0.05). After 16 weeks of intervention, the ATEC subscores of language, social interaction, behavior and cognition in the observation group were all lower than those in the control group (all P<0.05). Intra-group comparison indicated that in the observation group, all ATEC subscores at 8 weeks of intervention were lower than baseline, and further decreased at 16 weeks of intervention (all P<0.05). In the control group, only the ATEC language and social interaction subscores at 8 weeks and 16 weeks of intervention were significantly lower than baseline, and the scores at 16 weeks were superior to those at 8 weeks (all P<0.05). The clinical total effective rate of the observation group was significantly higher than that of the control group [93.9% (31/33) vs 54.5% (18/33)] (χ2 =5.356,P<0.05). Conclusion Compared with routine rehabilitation therapy, music therapy can better improve the language ability, social interaction, behavioral performance and cognitive function of children with ASD.

Key words: Autism spectrum disorder, Children, Psychological function, Music therapy, Intervention effect

摘要： 背景 音乐治疗作为新兴的综合性的治疗方法，在孤独症谱系障碍（ASD）儿童的康复治疗中逐渐兴起，且日益得到重视。但音乐治疗对ASD儿童心理功能的干预研究尚少。目的 分析音乐治疗对ASD儿童核心心理症状的干预效果。方法 选取2025年3—7月于武汉市江岸区启弘特殊儿童培训教育中心接受康复训练的66例ASD儿童为研究对象，采用随机数字表法将ASD儿童分为对照组33例和观察组33例，对照组施以常规康复治疗干预，观察组在常规康复训练的基础上接受音乐治疗干预。两组均干预16周。干预前、干预8周后和干预16周后，通过孤独症治疗评估量表（ATEC）和儿童孤独症评定量表（CARS）比较治疗效果。结果 66例ASD儿童均顺利完成本研究，无脱落。两组 ASD 儿童性别、年龄比较，差异无统计学意义（P>0.05）。重复测量方差分析结果显示，组别与时间对CARS、ATEC评分均存在交互作用（P交互<0.05），组别对CARS、ATEC评分主效应均显著（P组别<0.05），时间对CARS、ATEC评分主效应均显著（P时间<0.05）。干预16周后，观察组ASD儿童CARS、ATEC评分均低于对照组（P<0.05）。组内比较显示，观察组ASD儿童干预8周CARS、ATEC评分均低于干预前，干预16周后各项评分均低于干预前及干预8周（P<0.05；P<0.05）；对照组ASD儿童干预8周及16周后CARS、ATEC评分均低于干预前，干预16周后各项评分均低于干预前及干预8周（P<0.05）。组别与时间对 ATEC 语言、社交、行为、认知评分均存在交互作用（P交互<0.05）；组别对ATEC语言、社交、行为评分主效应均显著（P组别<0.05），但对认知评分主效应不显著（P组别 >0.05）；时间对ATEC语言、社交、行为、认知评分主效应均显著（P 时间<0.05）。干预16周后，观察组ASD儿童ATEC语言、社交、行为、认知评分均低于对照组（P<0.05）。组内比较显示，观察组干预8周ATEC语言、社交、行为、认知评分均低于干预前，干预16周后各项评分均低于干预前及干预8周（P<0.05）；对照组ASD儿童干预8周ATEC语言、社交评分均低于干预前，干预16周后两项评分均低于干预前及干预8周（P<0.05）。观察组ASD儿童临床总有效率高于对照组［93.9％（31/33）和54.5％（18/33）］（χ2 =5.356，P<0.05）。结论 与常规康复治疗模式相比，音乐治疗能够更好地改善 ASD 儿童语言、社交、行为和认知能力。

关键词: 孤独症谱系障碍, 儿童, 心理功能, 音乐治疗, 干预效果