自然情境教学在孤独症谱系障碍儿童护理中的应用研究进展

Research Progress on the Application of Natural Environment Teaching in Nursing of Children with Autism Spectrum Disorder

摘要: 目的：系统梳理自然情境教学(NET)在孤独症谱系障碍(ASD)儿童护理中的理论基础、实践应用及现存问题，为建立本土化、标准化的ASD儿童护理干预路径提供参考。方法：全面回顾NET的理论起源与核心操作要素，比较NET与传统结构化教学的差异，总结其在医院、康复机构及家庭场景中的护理实践模式，并分析临床应用效果与循证证据，探讨当前推广面临的困境及解决对策。结果：NET基于应用行为分析(ABA)原理，通过跟随儿童动机、自然强化和情境嵌入等策略，在提升ASD儿童社交沟通能力、减少问题行为及促进技能泛化方面成效显著，其有效性已得到国际权威机构认可。但国内临床应用中存在专业人才短缺、干预方案标准化不足、家庭实施难度大等问题。结论：需通过构建本土化标准护理流程、加强专业培训、深化家庭赋能及推进多场景技术融合，以推动NET在ASD儿童护理中的规范化、精准化应用，提高患儿康复效果与生活质量。

Abstract: Objective: To systematically review the theoretical basis, practical application, and existing problems of Natural Environment Teaching (NET) in the nursing of children with Autism Spectrum Disorder (ASD), and to provide reference for establishing a localized and standardized ASD nursing intervention path. Methods: The theoretical origin and core operational elements of NET were comprehensively reviewed, the differences between NET and traditional structured teaching were compared, the nursing practice models in hospital, rehabilitation institution, and family scenarios were summarized, and the clinical application effects and evidence-based evidence were analyzed to explore the current promotion difficulties and solutions. Results: Based on the principles of Applied Behavior Analysis (ABA), NET has achieved significant results in improving social communication skills, reducing problem behaviors, and promoting skill generalization in ASD children through strategies, such as following children’s motivation, natural reinforcement, and situational embedding, and its effectiveness has been recognized by international authoritative institutions. However, there are problems, such as shortage of professional talents, insufficient standardization of intervention programs, and difficulty in family implementation in domestic clinical application. Conclusion: It is necessary to promote the standardized and precise application of NET in ASD children’s nursing by constructing localized standard nursing procedures, strengthening professional training, deepening family empowerment, and promoting multi-scenario technology integration, so as to improve the rehabilitation effect and quality of life of children.