Đánh giá khả năng phát triển của kẻ tự kỷ ở một số trường chuyên biệt tại thành phố hồ chí minh thông qua trắc nghiệm PEP3

DANH GIA KHA NANG PHAT TRIEN CUA TRE TL/ KY MOT SO TRUONG CHUYEN BIET TAI THANH PHO HO CHI MINH THONG QUA TRAC NGHIEM PEP TS Ngd Xuan eiep Tnrdng Dgi hgc Khoa hpc xd hoi vd Nhdn vdn, Dgi hgc Qudc gia thdnh Ho Chi Minh TOM TAT Trdc nghiem PEP dugc phdi triin di ddnh gid su khdng ding diu vi hgc igpva cac yeu^ kem dgc Irung cig tri phi lu ky vd Iri cd rdi hgn phdt triin khdc PEP cung cgp nhiing chi bdo ve khd ndng phdt Iriin ky ndng vd cdc Ihdng lln hOu i^cho VI fc chdn dodn, cing nhu xdc dinh mtic nghiim uong cua uieu chung Cdng viic ddnh gid nhdm Ihu thdp nhiing Ihdng lin lir hai nguin (bi sung) quan Irong: Diu lien, thang la mpt cdng cu lieu chudn hda dugc thiit ki di ddnh gid suphdt triin cac ky nang giao Ilip vgn dpng vd hdnh vl kem Ihich nghi cia tri lu ky nghl ngd bl IV ky vd tre co rdt logn phdt uiin Ign Ida khdc (PDD) Thd hai, thang Id mpt phuang phdp chmh Ihuc dugc si dung de Idy Ihdng tin hiiu ich lu cha me hogc ngudi chdm soc ire Trong nghien cim ching tdi nghiin cim trin 32 Iri lu ky, kit qud cho Ihiy hdu het Iretukyd mic thiiu h,t In^ng binh ki din Id thiiu hgt ndng vd Ihliu hul nhe Rdi It ire phdi triln binh thudng Tir khda: Rii logn phi tu ky: Cdng cu ddnh gid: PEP Ngdy nhdn bdi: 11/8/2016; Ngdy duyil dang bdi: 25/9/2016 l.Oatvinde Theo Hidp hpi Sde khde Tfim thin qudc tl: Rdi loan tu ky (Autism Specttum Disorder-ASD), dupe hieu nhu Rdi lojn phfit ttiln Ian tda (Pervasive Developmental Disorder-PDDs), nguydn nhfin bdi su suy gifim trim vfi bao phu sv suy nghT, cfim giic, ngdn ngtt vfi khfi nfing quan he vdi ngudi khfic Nhttng roi lojn dd ttidng ttiudng dupc chfin dofin thdi tho iu, ggi lfi rdi lojn lu k^, tidp ttieo la Rdi loan phit ttiln Ian tda khdng dfic hieu va ed nhilu djng nhe han nhu Hdi chdng Asperger va hai rdi lojn hilm gfip khac la Hdi Chung Rett va Rdi lojn tan rfittidittioau (Chantal Sicile - Kira, 2004) Hgi Chung tir ky lfi mgt hgi chdng da khuylt tfiL bidu hidn su rdi loan phat mentixinghfinh vi nhjn Uiuc, ngdn ngtt va quan he xa hdi Tre tir ky muin TAPCHfTAMLynoCSd 10(211), 10-2016 ddng kin Uil gidi ridng cda minh, khdng quan tam ddn ttid gidi xung quanh, khdng mudn giao tilp lien Ijc vdi ngudi khfic Do do, ttd tir ky rat han che ttong vide hilu bilt mdi ttudng xung quanh, cac chuin muc xa hdi ndi chung vfi nhflng quy tic, ky nfing dng xu qua Iai gifl-a eon ngudi (Ngd Xuan Diep, 2009) Dd xic dinh nfing phit tiiln cda tid tii ky, eung nhu gidp cic n h i chuydn mdn xfiy dpng chuong trinh can ttiiep, ttiang dfinh gifi PEP dupc cho la cdng cp hftu hidu cho vige ttipc hidn hai nhiem vu D I xfic djnh kha nfing phfit Oiln cua tie tu ky, ttong bii vidt niy, ehdng tdi dfi tiln hanh nghien cdu tten 32 tte tv ky tai mgt sd midng chuydn bigt tren dja bin Uiinh phd Hd Chi Minh nhfim nhjn nhttng vin d l tixing linh vvc phit triln cua tie tv ky Nghidn edu nfiy gidp cfic nhfi chuyen mdn, cfic chuydn vidn ean Uiiep ed efich nhin cu till ban vl nfing phit tridn cda ti-e ky Tren co sd dd |idp eho cfie ea sd giio due ung dvng each thdc can thigp phd hgp, hiju qui nhfim nang cao nfing cho tte tv ky Tong quan cfic nghidn cihi v l kha nfing phfit t r i l n eiia trd t p k^ Cfie nghidn cdu v l khfi nfing phat ttiln cda tre tv ky chi rfing, tre tv ky khae bj nhihig khidm khuylt vl phfit tridn khfic va didu inh hudng trpc tilp din hojt ddng edj tre Trudc het, hojt dgng tti tug chju inh hudng true tilp tu nfing gific quan eda trd Theo TS Stephen M Edelson, hfiu hdt tte ky bi suy gifim d mgt hojc nhidu gific quan: thinh giic, thj giac, xdc gific, vj gific, khuu gific, tidn dinh v i cfic gific quan nhjn cfim Cfic co quan cfim giic niy ed the qufi nhjy cfim hojc ttiiiu nhjy cfim Dilu nfiy gjy cho ngudi til k^ khd khfin ttong vide xd Iy Uidng tin tu mdi tnidng (Cau Ijc bd Gia dinh cd trd tv k^, Tmng lam Dfio tjo v i Phfit niln gifio dpc djc bijt, Vidn Nhi Qudc gia, 2003) Nhftng nhfi n ^ i d n cuu dua gifi Uiuyit lfi nfio cda tte dudng nhu khdng thi tjo dugc sp can bfing cho nhttng cfim gifie (Vd Nguydn Tinh Vfin, 2002), cd nhttng ti-d khdng bao gid ttiich dugc dm i p nen tid rit hjn cbl ttong eim nhjn giic quan (mjc giic) vi phit ttiln xdc cim - tinh cam (Howlin P., Baron - Cohen S v i Hadwin J., 1999) Mdt so tid khic tiiich quan sit nhiing ehuyin dOng quay ttdn vfi nhttng phin nhd cda dd vjt mfi khdng quan tfim din nhttng sv kign dang dien xung quanh tte, dieu nfiy eung din ddn nhttng hjn che vl nhjn ttiuc Uil gidi Do dd, ttong tii l i ^ ttd tir ky, ngudi ta cflng quan tfim nhilu din ttj liju gific quan (sensory Uierapy) Lidn quan din cfie tinh hudng giao tilp, theo Les Roberts, trd hf ki gifi khd khfin tixing vide hidu biet cfic tinh hudng lidn quan din quan hd xfi hgi nhu: khdng giao tiep bfing mfit, hinh thdc giao tilp nghdo nin, khd khfin ttong vije hieu cic ttjng thfii tam Iy eua ngudi khfic, khd khfin ttong vigc dofin bilt nhttng nhu cau, y mudn vfi tiifii dd eda ngudi khfic; khdng hilu nhttng trang tiifii tinh cfim phuc tap nhu hfinh dijn, tv hfio, ngugng ngjp; khdng hilu nhOng diln biln 32 TAPCHfTAM L y n o c s a ID (211), 10 - 2016 logicttxmgqua ttinh giao tilp xfi hdi ndi chung va giao tilp vdi ngudi khic ndi ridng (Vd Nguydn Tinh Vfin, 2002) Theo nhung nhi nghidn cuu Uiugc Hidp hgi Sue khde Tam tiian qudc tl, da sd tte tti ky cd khd khan Idn vl hgc cich Uiam gia vao cic boat dpng tiiong tfic xa hgi vdi ngudi hing ngiy (Poweis M.D., Tre tv ky cflng gap nhung khd khan nhfit dinh lidn quan din tiidng hiong Theo TS Vd Nguyen Tinh Vfin (2002), tie tu ky cd mgt sd vin dd vl nhjn thdc nhu: tid khdng nhjn bidt dupc nhttng tinh hudng vui dda, gia vd, chai tiidng tugng, chai ddng vai Loma Wing (1998) cho ring, ttd tii ky khdng phit ttiln ttd Choi gia vd va cic boat dgng mdng mgng gidng nhu ttd bmhttiudng.Nhttng tte hom cdttidcd nhung boat ddng mdng mgng nhung quan sit kittiinhttng hgjt dgng niy cung Ijp di Ifip Iai, ca n« bidt chai cung tte khfie Uii hoat dpng hidng mpng cflng chdng til nghT vfi bit tte khfic Iam di lim Iai boat dgng dd, chd chdng hiu nhu khdng lim tiieo su mdng mang cua ngudi khic (Wing L., 1998) Nhu vjy, ttd gap nhttng khilm khuylt khfi'nghidm ttong ttong ^ n tilde ly tinh, dfic bidt Ifi choi mdng mgng, choi ddng vai, gifi vd Tre hiu ^M gfip khd khfin ttong lien kit gittattiuctai vi mdng mpng Lidn quan din tir phuc vp ci nhfin, tiieo Powcis, trd m ky khdng quan tfim den vigc hgc hdi nhung ky nfing sdng Cdng vdi cfie vfin dl ngdn ngtt vi giao tidp ttd til ky Uiudng gfip khd khfin ttong vide hilu cac ky nfing gidp bfinttifin.Mgt cdng vigc don gifin Ifi hgc cich su dung nhi vd sinh cd Id cflng Ii tta ngji Idn ddi vdi nhidu ttd tu ky (Wing L., 1998) Do do, giao dpc ti^ tit ky, ttudc het phii giio dpc nfing ttr phuc vp vi vd sinh ci nhfin, dfiy Ii ndi dung can dugc quan tam hing dfiu (Lovaas O.I., 1981) Nhidu tte bj rdi lojn hi k} tilp nhjn nhflngtfidngtin bing eich nbd miy mdc Nhflng tte niy nhd tat nhidu Uidng tin nhu so vi chu chdng chua din tudi di hge vi chdng eg till kl Iji nhflng ciu chuydn chinh xac tung txi hofic cd kha nfing nhd tdng ttie hoan chinh mgt cfich ehinh xac vl ngdn ngtt, nhu nhd nguyen vfin cfiu ndi cda ngudi khie Khdng nhu nhflng ttd binh ttiudng hgc ndi li ttd bfit dau ndi tung m mdt rdi tiln din hai tit vi cfiu ngfin, mgt sd nd ky hgc not bfit diu Ifi nhfic Iji nguyen cfiu cda ngudi khic, ddng Uidi ttd cd xu hudng nho mgi didu lien quan den tinh hudng (Sussman F 1999) Cd nhttng tre tu ky hgc tdt qua quan sit (visual), nhttng tid tiiich xem sich, bfio vfi ti vi Theo iihttng nha nghidn cdu vd tu ky, hiu hit nhttng ttd cd khd khfin vl ngdn ngtt hgc tfiong qua quan sfit dd vjt tdt ban hgctfidngqua nghe, vi vdi tre nfiy tiij gific lfi giac quan nhay cim nhat Ngofii ra, hpc ttidng qua thao tfic cflng la dilm mjnh cua mgt sd ttd tii ky, dje didm ndi bjt d nhttngtt*niy Ifittiichnhin cac nut bim dong mo cda sfip xep nhttng dd choi Uianh hang, ndi chung, tte hgc tdt hati Uidng qua dpng chjm cac vjt (Sussman F., 1999) TAP CHlTAMLynOCSd-10 (211), 10-2016 Hdi chdng m ky la mdt djng rdi loan phit tiidn, mdc dg, djc dilm vfi tinh chfit nhjn tilde cda tte tit khic (Slater A vi Bremner G., 2003) Trong hiu hit cic ttd bj chjm phit tiiln m' md cd cic ky nfing ngdn ngtt vi giaotiepxfi hdi phu hop vdi kha nang m' me cda tte thi ttd ky Iji cd nhttng ky nfing giao tilp xa hdi vfi ngdn ngtt d dudi mde nhttng kha nfing khic ttxmg phfit ttiln (Poweis M.D., 2000) Theo Robert, nhflng khilm khuylt Iam cho ttd ky khdng hilu dupc ddi sdng xdc cam,tinhcfim cda ngudi khac Tuy nhien, mgt sd ttd tu ky Iji cd khfi nfing nhd ky dieu mgt sd ITnh vuc ttd ydu thich Do dd raa bin chit nhjn thdc eda ttd tu ky cd tinh chit khic bigt Vi vay, dilu quan ttgng li phai nhan ttiuc sp khic bidt cda mdi ca nhan tri qua trinh hgc tap, tilp tiiu (Cfiu lac bd Gia dtoh cd tre tir ky, Trang tam Dfio tao vi Phit ttidn giio dpc djc bidt, Vidn Nhi Qudc gia, 2003) Theo tic gifi Bryna Siegel, mditiTidnghpp tv ky till hijn mgt khia cjnh khac vd Idifi nfing hgc tjp vfi nhflng bit lpc ttong bgc tjp Mdi khfi nfing hgc tjp vfi mdi bit Ivc hgc tap cd thi anh hudng din ttd tv ky ttieo cfich dfic bidt (Volkmar F.R., Paul R„ Klin A Cohen D., 2005) VSn dl djt lfi hgi chdng tv ky inh hudng ddn nhttng ttd khac theo nhftng efich thdc khic nhu the nao: Mdt sd tte cd khfi nang thdng minh trang binh hojc ttdn trang binh, ttong nhttng tie khfic Iai cd nhttng mdc dd khfic vl chjm phfit trien m' mj Cd nhflng trd ky rdt lui va ttinh giao tilp, nhflng tre khic hgc ttidng qua giao tilp xfi hOi nhilu hem Didu nfiy giii thieh cho tfit ci nhthig ylu td cd the inh hudng din sp phit triln liu dii eda tie (Powers M.D., 2000) Mgt nhjn xdt khfic Ifi trd ky nhu Ifi su mit nfing hgc tjp, vdi mgi ttiju chdng khfie sS bao gdm mOt nhdm sp ylu kdm hgc tjp c6 lidn quan xuit hijn hay "mat nfing hgc tap chuydn bigt cda chdng k^" De Uivc hidn mgt chuong trinh giao due: Budc diu ein kiim tra cu thd sp mfit nfing hgc tjp cua mdt dda ttd lp ky Budc ttid hai cin khio sat nhttng chiln lupc dilu ttj, nhflng chuong ttinh dilu tti hidn tji va nhttng gi cd thi dua cich tilde day chi tilt cho sv mat nfing hgc tjp dfic trung d cfi nhan ttd m ky xfic djnh (Siegel B., 2003) Hiu hit, ttd tv ky cd nhttng rdi lojn vide cim nhjn giac quan, tre cd the thieu nhjy cfim hay qufi nhay cam ddi vdi mdt gific quan hay nhilu gific quan, ngudng cfim giic cda tri ed thi lfi qufi eao hay qui tiiip khiin cho tre khdng ttld tri gific chinh xic su vjt, hijn tugng xung quanh hofic tri giic qufi khic thudng Trd tv ky khdng thieh giao tilp cflng nhu trii nghidm cic tinh hudng xfi hdi, tre ttiich choi mgt minh hon li choi vdi ban cdng Ilia Chinh vi Iy dd mfi tre khdng bao gid quan tam din vijc hge cic chuin mpc xfi hOi eung nhu nhttng ky nfing dng xd vdi ngudi khfie, dilu nfiy lira cho nfing nhjn thuc efic tinh hudng xfi hgi eda tte rfit ban cbl Hfiu hit trd k* gfip khd khfin hidu vfi bieu djt ngdn ngtt Khfi nfing choi mdng tugng hay gifi vd Ifi mgt van dd khd khfin ddi vdi trd tv ky Khfi nfing cda tu nhu phfin tich '" TAPCHlTAMLynOCSd 10(211), 10-2016 tdng hgp truu tupng hda vfi khai quit hda it duac sd dpng ttong khim phi vfi nhjn biet the gidi cua tte ky Do ttd tv ky khdng quan tam din giao tilp vfi quan he xa hgi ndn trd gjp khd khan ttong vide hilu vfi bidu djt xuc cam, tinh cim, cimg nhu cic ky nang sdng va tv phpc vu ban than Tu nhttng djc dilm trdn, chdng ta thiy tid tu ky cd nhttng khic bidt nhit dinh vd nang tilp nhjn thdng tin, ITnh hdi thdng tin va xu Iy thdng tin so vdi trd binh tbudng Nhu vjy Ifi tre tu ky co khfic bidt vl cac lihh vuc phit tiiln 3, Phuomg phap nghien ciru 3.1 Thang cong cu ludng PEP Tiae ngbiein PEP Ii ttic nghidm dugc xay dpng tidn nin tang Iy thuyit •'vung phfit tridn gin" cda L.S Vugdtidd Ly thuyit la mdt ttong nhttng quan diem chd dao ve Iy lujn hpc tap dugc fip dpng dua ttdn ba vung nhjn tilde cua ttd Ba vdng phit triln dugc khii quit la: Vdng Uid nhit: vung hr lap (ttrong dng vdi tidu chi ludn ludn Ifim dugc = dilmttxmgPEP 3), ttd em dfi cd nfing ^ mdt minh, hgc mdt minh, khdng cin sp gidp dd hofic khich Id cda mgt ngudi ^ J V u n g ttld ba: vimg xa lg (tuang dng vdi tidu chi cliua bao gid Iam dupe = didm ttong PEP 3), tid em khdng cd khfi nfing ddng nhan tiiuc vin dl, eho dd CO su giup dd vfi khich Id tdi da eda mdt ngudi Idn; Vdng did bai, nim d gitta hai vung ttdn, vimg hpc tap hay vung phdt Iriin gin (mong dng vdi tidu chi ldc Ifim dupc ldc khdng = I didm ttong PEP 3), ttd em cd till lam chd kiln ttidc chua bidt vdi sp hudng dan cua mpt ngudi Idn (Nguydn Vfin Thfinh, 2006) Cho ddn nay, PEP vin Ifi edng cu tdt nhit tiang vide dfinh gifi sp phfit tiidn eda tre tii ky, cung nhu vide tim cac hfinh vi kem ttiich nghi ttong nhdm ttd k^ (Eric Scholcr, Margaret D Lansing, Robert J Reichler, Lee M Marcus, 2005) De dua cfic dtt lieu khoa hgc ttong ndi dung nghien cdu nay, chdng tdi dS sd dpng bg cdng ep PEP muc phfit tiiln PEP dupc ttiiit kl dl ho ttg cie nhi giio dpc ttong vide Ijp kl hojch xay dpng chuong ninh can ttiidp vfi dfinh gifi ttd ni ky hay ttd cd rii lojn phfit ttidn Ian tda khfie PEP bao gdm hai phfin chinli Phin tiipc hfinh dng dvng dinh gifi vfi quan sfit tiuc tilp ti* Phin nfiy bao gdm 10 tiiu test, ttong cd tidu test kha nfing phfit ttiln va tidu test muc dp kemfliichnghi cda ttd Phan dinh gii cda ngudi chfim sdc cd tiiu test vdi muc dieh ghi Iji cfic phfin dng hfinh vi cda ttd cflng nhu mpt sd ky nfing ttidng thudng ttd djt duge thdng qua phin tti Idi cda cha me hay ngudi nudi dudng n* (Eric Scholer, Margaret D Lansing, Robert J Reichler, Lee M Marcus, 2005) Phfin cac tiiu test vl phit tiiln gdm: Tiiu les, 1: Nhjn thuc cd Idi/tiudc Idi, cd 34 bfii tjp tnmg vfio nhjn tilde vfi tti nhd m Cac item khfi nfing TAPCHfTAM Ly HOC, Sfi' 10 (211), 10 - 2016 35 giii qu;lt vin dl, gpi tdn, sfip xep va phdi hgp tti gific van ddng Tiiu test 2: Ngdn ngtt didn djL cd 25 bfii, ludng khfi nfing vide the hign Idi ndi hofic cd chi cda tte Tiiu test 3: Tidp ttiu ngdn ngtt, cd 19 bfii, nhim ludng khfi nang hilu ngdn ngfl ndi cda tte Tiiu test 4: Vjn ddng tinh, cd 20 bii, nhim danh gifi muc dp cda tte ttong viec phdi hpp cac bd phjn khac tten CO the Tliu test 5: Van dgng thd, cd 15 bii, nhfim dinh gii kha nfing cda tid ttong vide kiim sofit cfic phan khic cda co thd Tiiu lest 6: Lidn kit tay mfit, cd 10 bii, nhim danh gia khfi nfing bfit chudc cda tre ttong vide phdi hgp thj giac vi vjn dgng Phan cfic tidu test ve hfinh vi kem thich nghi gdm: 77ew les, 7: Diln dat cfim xdc, CO 11 bfii nham ludng mdc tre the hidn phan dng tinh cam ttiich hpp, bao gdm sd dung net mjt hofic hs till co thi Tiiu tes, 8: Tuong tic xa hji, cd 12 bii, nhfim ludng khfi nang tutmg tfic xfi hgi cda tie vdi ngudi khfic Tiiu ,est 9: Nhttng hinh vi van dgng dfic tiung, cd 1S bii, nhfim ludng nhttng hanh vi xdc giac vfi cam gific diln hinh eda tie tu ky Tiiu test 10: Nhflng hinh vi loi ndi djc tiung, cd 11 bai, nhfim ludng nfing ndi mgt each thich hpp vdi sp Ijp Iji tdi thilu hofic bjp bg eda tie Phfin dfinh gifi cda ngudi chfim sdc gdm: Tiiu test 11: Cfic vin dl vl hinh vi ed 10 bai, nhfim tim hidu nhttng hanh vi, ngdn ngtt, giao tilp, quan hd xfi hji bat thudng d Ire Tiiu test 12: Tinh tu ljp cd 13 bfii, nhfim tim hilu cic ky nfing phuc vp cda tie nhu cic ky nfingfinudng, ngd, di vd sinh, mfic quinfio,tfim Tliu tes, 13: Hfinh vi thich dng cd 15 bii, nhfim Hm hilu nfing ung phd eua vdi nhidu linh hudng da djng ttong cugc sdng 3.2 Cdch thuc hipn trie nghipm PEP Trfic nghijm PEP dupe irdn ttd Id 30 din 72 thing tuoi tji mgt so tradng chuyen bigi tten tiifinh phd Hd Chi Minh Cic tre niy dang duoe can Uiigp tji cic ttudng chuyen bijt vi da dugc xic djnh la tre tu ky bdi kit qua chfin doin cua cie bie sy Iji mdt sd bgnh vijn: Bjnh vien Nhi Ddng 1, Bjnh vien Nhl Dong 2, Bdnh vijn Tam than thinh phd Hd Chi Minh < ^f" '^''' ^"""^ ' ^ """"g y c' hiiu ching tu ky, NXB Bamboo, Austtalia, 2002 Cfiu lae bd Gia dinh ed tre ky, Trung tam Dao tao va Phfit triln giao dpc djc biet, Vien Nlii Qudc gia, Vi tuang lai Iri lu ky H i Ngi, 2003 CJiantal Sieile - Kira, Auhsm Spectrum Disorders - The Complete Guide to Understanding Autism, Asperger Sydrome Pervasive Developmental Disorder and Other ASDs, The Berkley Publishing Group A division of Penguin Group, New York, USA 2004 Eiic Scholer, Margaret D Lansing, Robert J Reichler and Lee M Maieus Psychoeducallonal Profile - Third Edition, Pro - Ed, Inc, America, 2005 Howlin P., Baron - Cohen S and Hadwin J., Teaching Children wiih Autism to Mind- Read, John Wiley and Sons Publishing, USA, 1999 Lovaas 0.1., The Me Book, Pro.ed An Intemational Publisher, USA, 1981 Powers M.D., Children mih Autism, Woodbine House, USA, 2000 10 Siegel B., Helping Children With Autism Learn, Oxford University Press, USA, 2003 11 Slater A and Bremner G., An Imroduclion lo Developmental Psychology, 2003 12 Sussman F., More than Wgrds, The Hanen Centte, Canada, 1999 13 Blackwell Publishing, UK 14 Volkmar F.R., Paul R Klin A and Cohen D., Handbook of Autism and Pervasive Developmenlal Disorders, Vol Two, Published by John Wiley & Sons, Inc., USA, 2005 15 Wing L., The Autistic Spectrum, Constable and Company Limited, London, 1998 TAP CHfTAM Ly HOC, S6 10 (211), 10 - 2016 ... khd khfin vl ngdn ngtt hgc tfiong qua quan sfit dd vjt tdt ban hgctfidngqua nghe, vi vdi tre nfiy tiij gific lfi giac quan nhay cim nhat Ngofii ra, hpc ttidng qua thao tfic cflng la dilm mjnh... din ttj liju gific quan (sensory Uierapy) Lidn quan din cfie tinh hudng giao tilp, theo Les Roberts, trd hf ki gifi khd khfin tixing vide hidu biet cfic tinh hudng lidn quan din quan hd xfi hgi... gidi ridng cda minh, khdng quan tam ddn ttid gidi xung quanh, khdng mudn giao tilp lien Ijc vdi ngudi khfic Do do, ttd tir ky rat han che ttong vide hilu bilt mdi ttudng xung quanh, cac chuin