Thực hiện chương trình can thiệp sớm cho trẻ chậm phát triển trí tuệ

THUC NGHIEM CHUONG TRINH
CAN THIEP SOM CHO TRE
C H A M P H A T TRIEN TRI TUE
TS. NguySn OCfc San
Trudng khoa Khoa Tdm ly - Gido diic, Trudng Dgi hgc Sifpham Hd Nr'ii.
I
TOM TAT
Bdi bdo tap trung phdn rich cdc ket qua cua nghien cdu thuc nghiem ve
chuang trinh can thiep sdm cho tre chdm phdl tnen tri tue - Chuang Irinh Portage
(ket qud cua 6 thdng ddu thifc nghiem). ti'f do ddnh gid vd dUa ra cdc kien nghi cho
viec thie't ke vd trien khai tiep theo cdc chuang irinh can thiep sdm cho ire. Ke'l qud
nghien cifii cho thdy: nhom thuc nghiem co sU tie'n bd cd y nghTa ve chi sd hdnh vi
thich I'nig tdng hap, mpt sd ITnh vi/c phdl trien co su cdi thien ro ret (co sukhdc biet):
giao tiep. xd hpi hoa. mol sd ITnh vUc khdc il co sif cdi thien: ky ndng sinh hoat thudng
ngdy, van dgng. Chuang trinh can thiep co hieu qud.
Tit khoa: Thuc nghiem; Can thiep; Tie'chgm phdt trien tri tue; Hdnh vi thich Ttng.
Ngdy nhdn bdi: 8/6/2012; Ngdy duyet ddng bdi: 25/12/2012.
1. D a t v a n d e
Hien nay cd nhilu chuong trinh can thiep sdm cho tre cham phat tnen tri
tue duoc thuc hien d nudc ngoai va trong nudc. Cac nha nghien ciiu tam ly hpc
phat triln lien tue thiet ke' cac chuong trinh can thiep va tien hanh thuc nghiem
d l danh gia miic dp hieu qua cua cac chuong trinh khac nhau. tir dd cd dupc
cac CO sd d l dilu chinh, thie't ke mdi hoac dua ra cac khuye'n cao lira chpn cho
cac nha thuc hanh. Viec tie'n hanh thuc nghiem - danh gia chuong trinh cung
dupc tie'n hanh cho cac chuong trinh trong cac mdi trudng van hda khac nhau.
0 Viet Nam da cd nhilu chuong trinh dupc nhap khau va thuc hien tai
cac trung tam giao due dac biet. Ket qua ciia cac chuong trinh chu yeu dupc
danh gia bang each tdng ke't kinh nghiem, viec tie'n hanh cac thuc nghiem de
danh gia hieu qua cua chuong trinh can thiep cdn rat it.
Nghien cuu nay tien hanh thuc nghiem danh gia hieu qua chuong tiinh
Portage - chuong trinh hudng dan hd tip su phat trien ciia tie nhd ( 0 - 6 tudi) -

TAP CHf TAM LV HOC, Sd 1 (166), 1 - 2 0 1 3

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trong viec can thiep cho tre chdm phat trifo trf tue tai Ha Ndi. Thuc nghi^i^
dupc tidn hanh trong vdng 12 thdng. Bai bdo ndy tdp trung phdn tfch kdt qua 6
thdng ddu cia thuc nghidm.
2. Gidi thieu ve thtrc nghiem
2.1. Muc dich cua thuc nghiem
Ddnh gid hidu qua cia chuong trinh can thiep sdm cho tre chdm phdt
trien tri tud, th^ hidn d chi sd hanh vi thfch ing tdng hap cia tre (Adaptive
behavior composite), cti th^;
- Chuong trinh can thidp cd dem lai hidu qua hay khdng trong didu kidn
Viet Nam? Ddu la nhing did'm cdn Iuu y?
- Hieu qua cia chuang trinh can thidp cd duoc duy tri theo thdi gian va
dn dinh hay khdng?
2.2. Md hinh thuc nghiem
+ Thuc nghidm dupc thie't ke vdi rad hinh thuc nghiem td hap: ddnh gid
giua cac nhdm dd'i tUdng (Between subject design) va ndi nhdm (Within subject
design) vdi cdc phep do lidn tue tai cdc thdi diem khdc nhau trpng qua trinh
thuc nghiem.
Thuc nghiem dupc tid'n hdnh tren 2 nhdm tre: nhdm thuc nghiem va
nhdm dd'i ching. Nhdm thuc nghiem se nhan dupc chucmg trinh can thiep trong
6 thdng ddu. Nhdm dd'i ching nhdn dupc su can thidp trong 6 thang sau.
Ddnh gid ke't qua cdc ITnh vuc phdt tridn duoc thuc hien 5 Idn, tai 5 thdi
diem trong qua trinh thuc nghiem vdi ca hai nhdm (thang 0 - trudc thuc
nghiem, dung de xac djnh tre cd ddp ing ydu cau d^ tham gia vao thtrc nghiem
hay khdng vd san mdu thuc nghidm, thdng thi 3, thang t h i 6, 9 va thang 12).

- Viec danh gid hieu qud cua thuc nghiem dupc tien hanh bang cac kiem
djnh gitta cdc nhdm dd'i tupng (Between subjects) tai cdc thdi di^m ddnh gia:
ki^m djnh su khdc biet giia cdc chi sd hanh vi cua hai nhdm thuc nghidm va
dd'i ching. Ddnh gid su khdc biet trong todn bd thdi gian thuc nghidm.
- Danh gia ndi nhdm ddi tui^ng (Within subject) cung dupc tie'n hanh
dua trdn cac chi sd danh gid dupc tai 5 thdi didm khdc nhau vdi mtic dfch:
1. Chi ra xu hudng bie'n ddi cua ting nhdm vd kiem tra hieu qua cua
chuang trinh.
2. Xdc djnh tfnh dn djnh cua cdc ket qua da dat duprc sau khi duac can
thiep (ndi dung nay se duac trinh bay a mpt cdng bd khac).
+ Cac bie'n sd dupc xdc dinh nhu sau:

TAP CHITAM L^f HOC, So 1 (166), 1 - 2013


- Bie'n ddc lap: Chuong trinh Portage - hudng ddn hd trp phat tridn tre
nhd 0 - 6 tudi.
- Bid'n phu thudc: Ket qua cia cdc ITnh vuc phdt trie'n tam ly (dupc the
hien bdng cac chi so) bao gdm: giao tie'p, ky nang sinh hoat thudng ngay, tuong
tac xa hdi, vin ddng va hanh vi thich ing tdng hdp.
- Cac bie'n kidm soat: Hieu qua cudi cung cua chuong trinh chu yd'u
dupc ddnh gid tren chi sd hdnh vi thich ing tdng hpp (Adaptive behavior
composite - xem thdm (2) - day la didm chung cua cdc thuc nghiem ddnh gid
chuong trinh. Cac chuang trinh dang hd trp phdt tnen khdng duac coi la
chuang trinh trj lieu ndn khdng tap trung vdo chi mdt hoac hai ITnh vuc phat
trien (vf du: trj lidu ngdn ngu hay trj lieu tang ddng giam chu y - ADHD), Cac
bie'n ddi cia cdc ITnh vyc va tieu ITnh vuc dupc xem xet chi nhdm lam ro chi sd
hdnh vi thich ing tdng hop dupc cdi thien do sy tie'n bd cua ITnh vuc nao va
chuang trinh cd tac ddng td't de'n ITnh vyc nao. Do vay, chi sd cua ITnh vuc cu
the hoac cac tieu ITnh vyc khdng coi la bie'n kie'm sodt. Bie'n kiem soat cua thuc

nghiem la: cdc chuong trinh can thiep khdc ma tre ddng thdi tham gia, mic dp
cham phdt trien cua tre thudc hai nhdm thyc nghiem - dd'i ching, gidi tinh, dp tudi.
- Cdng cu do nghiem: Ke't qua dupc do bdng cdng cii Vineland II thd'ng
nha't cho cd hai nhdm. Vineland 11 dupc thid't ke bdi: Sara S. Sparrow, Domenic
V. Cicchetti, David A. Balla, dupc chuan hda tren mdu 3.000 khdch the, duoc
xudt ban bdi nhd xudt ban Peasron (My), lit phidn ban tai bdn ldn 2 da cd chinh
sua. Day la thang do dupc s i dung khd phd bien tai cdc co sd thyc hanh va
nghien ciu tat My. Thang do nay cd the dupc s i dung vdi cdc muc dfch sau: I)
Chan dodn: chdm phat trien trf tue, cdc rdi nhidu gien, khuyet tdt, cham phat
trien, rdi nhidu hdnh vi; 2) Ddnh gid phdt trien: ddnh gid mic dp phdt trien cia
tre, xac djnh su cdn thie't can thiep; 3) Dieu chinh qud trinh: ddnh gia sy tie'n bd
trong viec hpc cac hanh vi, ky nang mdi; 4) Lap ke' hoach can thiep; va 5)
Nghidn ciu (5).
- Thang do dupc thie't ke vdi 5 ITnh vyc ddnh gid chfnh (domain): giao
tie'p, ky nang sinh boat thudng ngay, xa hdi hda, ky nang van ddng va cdc hdnh
vi kem thfch ing. Mdi ITnh vuc ddnh gid chfnh bao gdm nhieu tieu ITnh vyc
(subdomain), mdi tieu ITnh vyc dupc danh gid bdng mdt thang do. Ke't qua cua
cdc thang do dd'i vdi tieu ITnh vyc duoc gpi la diem cua ting thang (v-Scale
score), ke't qua cua mdt ITnh vyc (domain) dupc gpi la diem chuan (standard
score) (5).
2.3. Mdu thuc nghiem
- Cac nghiem the nghien ciu dupc Id'y t i cdc danh sach tre cham phat
trien trf tud tai cac trudng mam non tren dja ban cac qudn ndi thdnh thdnh phd

TAP CHiTAM L? HOC, Sd 1 (166), 1 - 2013

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Ha Ndi. Ngudi nghidn ciu lidn he vdi phu huynh tre, gidi thidu va dd nghj tham

gia chuang trinh. Phu huynh ddng y se ky vao thu ddng y. Tre dupc danh gia
Idn ddu bang trie nghidm Vineland II di xac djnh mic dd dap ing cac tieu chf
cham phdt tridn trf tud. Kd't qua ddnh gid cung duoc coi la ca .sd dd san nhdm
thyc nghiem va ddi ching. Nhttng tre duoe coi la cham phat tridn trf tud cdn
ddp ing tidu chf sau: Mdt trong sd cdc ITnh vuc cd chi sd < 70 (tic la nhd hem 2
dp lech chudn) hoac c<5 2 trong sd cac ITnh vuc cd chi sd < 77 (1,5 dd Idch
chudn) theo thang do Vineland II (xem them 2).
- Nhdm thyc nghiem 40 tre, nhdm dd'i ching 40 tre. Cac bie'n sd ^idm
sodt duoc xdc djnh bdng cdc kidm djnh. Sau mdt khoang thdi gian can thidp,
mdt sd tre khdng tie'p tue tham gia, sd tre cdn lai d ca 2 nhdm hd't thang thi 6 la
69 tre. Kd't qua duoc phdn tich tren 69 tre Iham gia de'n hd't thang t h i sau. Cdu
true cia mdu nhu sau:
Bdng 1: Bdng phdn bd nghiem the
Nhom thuc nghiem

Nhom ddi ching

1

Sfi luong (n)

37

32

2

Nam

28

24

3

Nu
Tham gia chuong trinh khac
(trung lam giao due dac biet)

9

8

3

3

STT

4

Cac bien sd

Cdc kiem djnh ve gidi vd tudi cho thd'y, khdng cd su khdc bidt. Phdn Idn
tre cd mic dd cham phdt tridn trf tue d mic nhe (low - theo thang do).
2.4. Quy trinh vd ndi dung thuc nghiem
+ Quy trinh: Thyc nghiem tie'n hanh 12 thang.
Budc 1. Chudn bj: Danh sdch tre chdm phat trien trf tud 6 cac trudng
mdm non thudc cdc quan: Hai Bd Trung, Cdu Gid'y, Hodn Kidm, IJa Dlnh, Ddng
Da, Thanh Xudn dupc tap hop. Cac gia dinh tre dupc lien he vd dd nghj tham

gia chupng trinh. Gia dinh nap tham gia dupc dd nghi ky vao thu ddng y thdm
gia (consent letter).
- Tdp huan ve viec su dyng Vineland II cho ddi ngu ddnh gid. Dpi ngii
danh gia vidn ddc lap vdi nhdm thyc hien can thiep va khdng dupc biet ve sU
phan bd ctia tre trong nhdm thyc nghidm va dd'i ching. Ddi ngu nay cung dupc
luan chuydn trong cdc lan ddnh gid tre.

50

TAPCHl'TAMLfHOCSd' 1 (166), 1 -2013


- Tren CO sd cac gia dinh ddng y tham gia, tre dupc danh gia iSn d^u
(thang 0) dl san nhdm thuc nghiem va ddi chiing. Cdng cu danh gia dupc sir
dung la thang do hanh vi thich utig Vineland II.
Budc 2. Tie'n hanh:
Giai doan 1: 6 thang d^u. Nhdm thuc nghiem dupc nhan .sir can thiep
trong vdng 6 thang d^u, trong khi nhdm ddi chiing khdng nhan dupc su can
thiep nao. Cac tre thudc nhdm ddi chiing va ihuc nghiem deu dupc theo doi de
dam bao tre khdng tham gia vao cac chuong trinh khac. Nhiing tre tham gia vao
cac chuang trinh khac se dupe tach rieng va xir ly ket qua rieng.
Giai doan 2: 6 thang cud'i. Nhdm ddi chiing bat dau dupc can thiep,
nhdm thuc nghidm dupc theo ddi trong giai doan cud'i.
Budc 3. Xir Iy du" lieu va rut ra ket luan; sir dung phan mim hd trP ciia
Vineland II va SPSS.
+ Ndi dung:
- Tap huan vl thuc hien can thiep cho tre cham phat trien theo chuong
trinh Portage va cung cap cho dpi ngu can thiep vien nhdng kien thiic ve tre
cham phat triln tri tue. Tap huan vl md hinh ABA tir chuyen gia nudc ngoai.
- Dpi ngu can thiep tie'n hanh viec nhan cac tre dl can thidp. Mdi can

thiep vien chju trdch nhiem can thiep cho 2 tre.
- Thdi gian can thiep: Mdi tu^n mdt l^n. Mdi lan 1 gid. Keo dai trong 6 thang.
- Ndi dung can thiep:
Dua tren chuong trinh Portage, can thiep vien nhan biet ve ITnh vuc
cham phat triln cua tre, tii dd dl xua't cac nhiem vu va thie't ke cac hoat ddng de
lam viec vdi tre.
Chuong trinh Portage ia chuong trinh hudng dan can thiep vien lam viec
vdi tre tir 0 tuoi de'n 6 tudi. Chuong trinh tap trung vao cac ITnh vuc phat tnen
tupng tu nhu Vineland II: giao tiep, ky nang sinh hoat thudng ngay, xa hdi hda,
van ddng. Cau triic ciia chucmg trinh gdm 2 ndi dung chinh: mdt la cac hanh vi
- da'u md'c phat triln va y nghTa ciia hanh vi dd d tirng ITnh vuc; hai la cac hoat
ddng cd the cd de giiip tre phat triln trong tiing ITnh vuc dd. Cac ndi dung nay
dupc trinh bay chi tiet, cu thi theo tirng dp tudi: 3 - 4 tudi, 4 - 5 tudi, 5 - 6 tudi
theo ca'u triic thd'ng nhat, giiip can thiep vien cd the dl dang xac dinh va td chiic
hoat ddng cho tiing ITnh vuc d mdi dp tudi. Vi du: vdi ITnh vuc giao tiep d tre 3 4 tudi, ndi dung 1: giao tiep ciia tre 3 - 4 tuoi cd mdt trong cac hanh vi: sir dung
ngdn ngii de thda thuan, thd'ng nha't trong khi choi vdi ban khac - day dupc coi
la da'u md'c phat triln; ndi dung 2: cac hoat ddng giiip phat triln: choi vdi tre,

TAPCHITAMLyHOCSdl (166), 1 -2013

51


day tre su dung cac cdu trong giao tid'p: "Dd'n lupt cd", "Dd'n luat chau", "Bdy
gid de'n luot ai?"... Cdc tdc ddng chu yd'u duoc thyc hidn dudi hinh thic cung
choi vdi trd vi du: dung the chu dd giup tre nhdn phdt am, ding dd choi dd giip
tre thyc hien viec ddng vai (4).
Tidn hanh can thidp: Nguyen tdc chung nha't cia Pprtage Id can thidp
vidn dua tren cac goi y ve boat ddng dd td chic cdc boat ddng chai vdi tre. Sau
khi can thidp vidn gap vd ldm viec vdi trd, can thidp vidn xac djnh ITnh vyc cdn

tac ddng vd ldn kd hoach tdc ddng dua trdn khung chuong trinh Portage theo
thdi lupng chung cia nghidn ciu (1 h/l Idn/I tudn) vdi mdi ire. Can thiep_yien
xay dyng kc hoach boat ddng ca nhdn (lEP - individual education plan) cho tie
cd sy tham khao y kid'n cia gidm sat (supervisor). Hang thang cac can thiep
vien tham gia cudc hpp, thap luan vd cdc iirdng hop va cdc hudng tdc ddng tiep theo.
Nhu vay, cac ITnh vyc dupc tac ddng cung chtnh la cdc ITnh vyc phat
tridn dupc do bdng Vineland II (ITnh vyc - Domains: giao tid'p, ky nang sinh
boat, xa hdi hda, van ddng). De giup trd cd duoc hanh vi thfch ing tdng hop td't
hon, cdc tac ddng can thidp dupc tidn hanh thdng qua ting ITnh vuc phat tridn.
Tdc ddng de'n ting ITnh vyc phdt tridn chinh la thao tdc hda, quy trinh hda tac
ddng can thiep nhdm dat tdi muc tidu cud'i cung la nang cao hanh vi thfch ing
cua tre.
3. Ke't qua thtrc nghiem
- Theo thang do Vineland II didm chuan cia mpt ITnh vyc (domain) dupc
gpi Id standard scpre. Ndn khi sp sdnh didm TB cua cdc ITnh vyc se ding diem nay.
- Diem chuan cua mdt tidu ITnh vyc (vf du; tie'p nhdn) dyoc gpi la VScale score. Ndn khi so sdnh cdc tieu ITnh vuc se ding didm chuan ndy.
3.1. Ke't qud ve Unh vile giao tiep giOa nhom thuc nghiem vd ddi chiJtng
LTnh vyc giao tiep bao gdm 3 tidu ITnh vuc: tid'p nhdn, bidu dat va chfi
vid't. Tie'n hdnh phan tfch ldn luot ke't qua cua ting tieu ITnh vyc.
- Tieu ITnh vuc tie'p nhdn:
Bdng 2: Ke'l qud ddnh gid lieu ITnh vuc tie'p nhdn
^~"~----..Thii diem
^~'~"^--,..,._
Nhom
Thuc nghiem
Do'i ching
T-test (p)

Thang 0
(Diem TB)

11.48
11,33
0,862

Thang 3
(Diem TB)
13,54
11,88
0,06

Thang 6
(Diem TB)
14,59
13;77
0,39

G^ii clui (Diem TB): die'm TB nia lieu ITnh vuc (V - scale score, xem muc 2.2)

52

TAP CHI TAM LV HOC, Sd' 1 (166), 1 - 2013


Quan sat tdng qudt ket qua cd thd thdy, t i didm khdi ddu la tuong ddng
(kidm djnh T-test vdi mdu ddc lap tai thdi didm 0, p = 0,862, khdng cd sy khac
bidt) chi sd' cua ca 2 nhdm ddu cd sy bien ddi theo chidu hutting tang len, trong
dd chi sd cia nhdm thyc nghidm tang cap hpn so vdi nhdm ddi ching. Tuy vay,
kdt qua tai thdng thi 3 chua cd su khdc biet gitta nhdm thuc nghiem va ddi
ching vdi ket qua kidm djnh p = 0,06. Tai thang thi 6, kd't qua cung khdng
khdc biet (p = 0,39). Nhu vay, bidu qua cia can thiep la chua rd rang. Cd thd cd

mdt sd gid thuydt vd hien tupng ndy nhu sau: I) Ban thdn nhdm ddi ching cd sy
cai thien do tre vdn dupc tdi trudng nhd dd kha nang tie'p nhan cia tre dupc
nang cao; 2) Tac ddng cia can thiep khdng tdp trung vao ITnh vyc tie'p nhan dp
vay khdng tap dupc nhttng tid'n bd Idn cd thd tao ra sy khdc biet va 3) Cdc tdc
ddng chua phi hop. Dd kiem djnh cdc gid thuye't nay cdn cd nghien ciu tap
trung hon. Bie'n ddi cua cdc chi sd thudc ITnh vyc tidp nhdn dUdc thd hien d bidu
dd sau:
CHl si5 Tiep NHAN

— B6I chi>ng

Bieu do 1: Cht sd tie'p nhdn giiia nhom Ihuc nghiem vd ddi chi'fng
- Tieu ITnh vtxc bieu dpi:
Ke't qua dupc the hidn d bang sau:
Bdng 3: Kei qud ddnh gid lieu ITnh vuc bieu dpi
~~——~____Th&i diem
Nhom
~~~~-—....._
Thuc nghiem
Ddi ching
T-test (p)

Thang 0
(Diem TB)
10,51
9,81
0,29

Thang 3
(Diem TB)

11,72
10,4
0,04

Thang 6
(fliem TB)
11,7
10.33
0,01

Ghi chli (Diem TB): diem TB ciia lieu ITnh vuc (V - scale score, xem muc 2.2)

TAPCHi TAM L? HOC, Sd 1 (166), 1 - 2013

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Ket qua tidu ITnh vuc bidu dat thd hidn xu hudmg cai thidn ro rdt. Dieu
nay khdc bidt vdi kd't qua tidu ITnh vyc tid'p nhdn dupc phdn tfch 6 phdn trdn.
Cdc chi sd cho thd'y, cing didm xud't phdt khdng khac bidt (p = 0,29), nhom
thuc nghidm cd chi sd tang cao ban so vdi nhdm dd'i ching vd co sy khac bidt
giia 2 nhdm tai thdi didm thdng thi 3 vd thdng thi 6. Bidu dd dudi day md ta
su bidn ddi cia 2 nhdm.

CHlS(:>BieUDAT
12
115

'

11

—•— Thirc nghi$m

10 5

—•— D6I churng

10
9,5
g
85
0 IhSng

3 IhSng

6 Ihang

Bieu do 2: Chi sd bie'u dpi giSa nhom ihuc nghiem vd ddi chdng
Nhu vay, can thidp cd hieu qua dd'i vdi vide nang cao chi sd tie'p nhdn 6
tre. Ddng luu y la hidu qud tdc ddng d 3 thdng ddu thd hidn ro net hon 3 thang
tie'p theo.
- LTnh vuc chil viel: Kdt qud duoc thd hien 6 bang sau:
Bdng 4: Ke'l qud ddnh gid lieu ITnh vuc chi'f vie't
Thang 0
(Diem TB)

Thang 3
(Diem TB)

Thang 6
(Diem TB)

Thuc nghiem

10.27

11.13

11,13

Doi ching

10.22

10,4

10,18

T-test(p)

0,93

0,21

0,08

~~~~-—....^Thdi diem
Nhom
"—-—-__

Ghi chli (Diem TB): diem TB ciia lieu ITnh vuc (V - scale score, xem muc 2.2)

54

TAP CHI'TAM Lt HOC, Sd 1 (166), 1 - 2013


Chi sd cua nhdm thuc nghiem cd sy tang ddn va cao hon nhdm dd'i
ching. Nhdm dd'i ching ft bid'n ddi. Tuy nhien, kiem djnh khdng cho thd'y sy
khdc biet gitta 2 nhdm trong ca 3 thdi didm ddnh gid (p = 0,93, p = 0,21, p =
0,08). Nhu vay, hieu qua cua can thiep ddi vdi ITnh vyc chtt vidt la khdng rd ret
Nguydn nhdn cua tinh trang nay la do giao vidn ft chi ^ tdi viec day trd nhan
bid't vd chtt vidt vi coi dd Id vdn dd chi cdn quan tdm khi tie 5, 6 tudi va cia
trudng tidu hoc sau ndy. Giap vien quan tam nhidu tdi cac vdn de tdm ly cia tre
nhu khd khan trong giap tidp hay khd nang chi y, kha nang tuang tac vdi ngudi
Idn. Ddy cung chinh la vdn dd ma phu huynh va giao vien trudng mdu gido ban
khoan nhidu, chi chua phai Id va'n dd nhan bie't chi vidt. He qua la tidu ITnh vyc
ndy cd chi sd tha'p va khdng cd sy cdi thien rd ret trong ITnh vyc ndy.

CHi S6 CHO'VIET
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10 8
10 6
10 4
10.2
10
9.8

9.6

/

*
—•— TtlifC nghiem
—•— Doi chiing

0 thang

3 thang

6 thang

Bieu do 3: Chi so chij: vie't giifa nhom thuc nghiem vd ddi chdng
- Tong hap ve linh vuc giao tiep: Ket qua danh gia ITnh vuc giao tiep cua
tre dupc the hien d bang sau:
Bdng 5: Ke'l qud ddnh gid ITnh vuc giao tie'p
"""""""-—......Tiidi diem
Nhom
-.-.^

Thang 0
(Diem TB)

Thang 3
(Diem TB)

Thang 6
(Diem TB)

Thuc nghiem

73,67

81,72

83,83

Ddi ching

73,27

74,81

74,46

T- test (p)

0,871

0,03

0,03

Ghi chu: Diem TB Id TB diem chudn ctia ITnh vifc (Standard score, xem 2.2.)

TAP CHI'TAM Lf HOC, Sd 1 (166), 1-2013

55

Tai thdi didm 0, chi sd giua hai nhdm la tuang ddng, kidm djnh khdng
cho thd'y sy khac bidt cd y nghia (p = 0,871). Tuy nhidn, co sy thay ddi rd ret
theo chidu hudng giao tie'p cia nhdm thuc nghidm cd cai thidn td't vdi sU khdc
biet cd y nghTa. Ngay t i thang thi 3 da cd sy khdc bidt trong didm sd thuc
nghidm va dd'i ching (p = 0,03). Didu nay ching td dap ing vd giao tid'p cua tre
vdi chuong trinh la khd nhanh. Cdc quan sat cho thd'y; giao vien cd the nhanh
chdng thidt lap quan hd td't vdi tre, ddng thdi vdi mdt sd ndi dung cua chuang
trinh (day nhan bid't dd vat bdng hinh anh, chai trd choi va got tdn dd vdt...) dd
gay hing thi cho tre, t i dd tre khdng chi cd kha nang giao tid'p vdi giao vidn
ma cdn tang cudng duoc ngdn ngtt (chu yd'u Id bidu dat). Chidu hudng cai thien
cua tre thudc nhdm thyc nghiem tie'p tyc dupc duy tri de'n thdi didm thang thi
6, trong khi nhdm dd'i ching ft thay ddi. Kidm djnh cho kdt qua cd sy khdc bidt
gitta 2 nhdm tai thdi diem thdng thi 6 (p = 0,03).
Nhu vay, chuang trinh can thiep cd tac dung td't dd'i vdi tre trong linh
vyc giao tiep. Hidu qua cua can thiep ddi vdi linh vyc nay xay ra kha sdm.

CHi s6GrA0 Tiep
90
86
82
78

—•— Tlii^c nghi$m

74

—•— o i l Chung

70
66
62
0 Ihdng

3 IhSng

6 thing

--- -- - Bieu do 4: Chi sd giao tie'p ciia nhflm thirc nghiem va do'i chTcng
3.2. Ke't qud ve Hnh vuc ky ndng sinh hoat thudng ngdy giiia nhom
thuc nghiem vd ddi chimg
Ket qud cua ITnh vyc nay the hiSn d bang 6.
Ky nang sinh hoat thudng ngay cua nhdm thuc nghidm cd su cai thien
on dmh, trong khi ky nang nay d nhdm dd'i ching cd su gidm sit d thdng thi 15.
Bieu do the hien ro net 2 chidu hudng bien ddi cdch xa nhau. Tuy vdy, chua cd
sy khac biet cd y nghTa thd'ng kd gitta hai nhdm. Didu dd ching td, tac ddng
can thidp dd'i vdt Imh vyc ky nang sinh hoat thu&ng ngdy chua cd hidu qua cao.

56

TAPCHl'TAMLf H p C S d l (166), 1 ^ 2013


Nguyen nhan cua Hien tupng nay la d chd: Da phSn cac tre tham gia vao thuc
nghiem cd miic dd chSm phat trien thudc loai nhe, cac ky nang sinh hoat
thudng ngay cd kha nang hlnh thanh dupc trong cudc sdng thudng ngay va
khdng qua khac biet vdi cac Ire khac. Do vay, cac muc tieu can thiep ciia giao
vien khdng hudng den ITnh vuc nay.
Bdng 6: Ket qud ky ndng sinh hoat thudng ngdy

~~
Nhiim

^ T ' h i i diem
_^

Thang 0
(Diem TB)

Thang 3
(Die'm TB)

Thang 6
(Diem TB)

Thuc nghiem

83,16

84,91

8.').21

Doi ching

82,70

83,62

81,14,. .

T-test (p)

0,88

0,72

0,13

Ghi chli (Diem TB): TB diem chud'n cila ITnh vifc (Standard .score, xem 2.2 )

CHi SO KY NANG Sf NH HOAT THU-aNG NGAY

- Thi/c nghiem
-D6ichi>ng

Bieu do 5: Chi soky ndng sinh hoat thu&ng ngdy
cua nhdm thuc nghiem vd doi chung
3.3. Ket qud ve linh vuc xd hpi hda giiia nhdm thttc nghiem vd doi chimg
Ke't qua the hien d bahg 7.
Kiem dinh tai thdi
0,10). Ket qua cua ca hai
nhdm thuc nghiem cd chi
nhdm thuc nghiem va dd'i

diem 0, khdng cd su khac biet giija hai nhdm (p =
nhdm d^u cd xu hudng tang len kha rd. Trong dd,
sd tang nhanh hon. Tai thdi diem thang thii 3, gifla
chiing da cd sir khac biet (p = 0,001). Tuong tu, tai

TAP CHI TAM LV HOC, Sd 1 (166), 1-2013

57


thdng thi 6, vdh cd sy khdc bidt gitta hai nhdm. Ddy la kd't qua cd thd dU bao
duac. Chuang trinh can thiep cd kha nhidu ndi dung lidn quan de'n vide thic
ddy kha nang tuang tdc, xa hdi hda cua trd. Hoat ddng can thiep cua gido vien
vdi tre chu ydu dupc tidn hdnh dudi cdc hinh thic cing chai, cung trd chuydn.
Do vay, kha nang tuang tdc cua Ire dupc rdn luydn nhidu vd cd sy cai thi^n
nhanli chdng. Hon ntta, vdi nhing trd nay viec thidu hut giao tidp tryc tidp
thudng xUydn trong mdi trudng ldp hpc ddng Ire Id kha phd bid'n, vi vay sy dap
ing cua trd trong ITnh vyc ndy hpp I)*.
Bdng 7: Ke'l qud ddnh gid ITnh vuc xd hfli hfla
~~ •—--^^^^TThdi diem
Nhiim
^^ —-—...._

Thang0
(Diem TB)

Thdng 3
(Diem TB)

Thang 6
(Diem TB)

Thuc nghiem

74,70

79.86

81,35

Dd'i ching

69,04

71,93

74.63

T-test

0,10

0.001

0.003

Gin chil (Diem TB): TB diem chudn ciia ITnh virc (Standard score, .xem 2 2 )

CHl S6 XA HOl HOA

So
86
82
78

—•— Thi/c nghiem

. 74

—•— 06i chi/ng

70
1

^

62
0 Ihang

3 Ihang

6 Ihang

Bieu dd 6: Chi so xd hfli hfla ciia nhflm thuc nghiem vd dfl'i chiing
3.4. Ke't qud veRnh vtic van dpnggiOa nhdm thifc nghiem vd ddi chdng
Kdt qua thd hien d bang 8.

58

TAP CHI TAM LV HOC, Sd 1 (166), 1-2013


Bdng 8: Chi sd'ITnh vuc van ddng ciia nhom thuc nghiem vd doi chitng
—--___Th6i diem
Nhom

—-^^.^

Thang 0
(Diem TB)

Thang 3
(Didm TB)

Thang 6
(Diem TB)

Thirc nghiem

83,92

84,51

91,30

Ddi chihig

84,74

88,0

84,78

T-test (p)

0,79

0,21

0,57

Ghi chli (Diem TB): TB diem chudn cua ITnh vifc (Standard score, xem 2.2.)

LTnh vuc van ddng ciia tre cung cd sir thay ddi nhung chua lao ra su
khac biet cd y nghTa gifla hai nhdm. Mot dieu dang luu y la chi sd' cua nhdm
ddi chiing tai thdi didm thang 0 cao hPn so vdi nhdm thuc nghiem, mac dii
khdng cd su khac biet. Tai thang thii 3, nhdm ddi chiing thay ddi manh, nhdm
thuc nghiem thay ddi khdng nhieu. Tai thang thii 6 nhdm ddi chiing giam so vdi
thang ihii 3 va tuong duong vdi thdi diem 0. Dieu nay chua cd co sd de giai thfch.

CHl S6 VAN DONG

- Thyc nghidm
- 06i chi>ng

Bieu do 7: Chi sdvdn dpng cua nhom thuc nghiem vd ddi chdng
3.5. Kit qud ve chi sd hdnh vi thich ifng tong hap giiia nhdm thitc
nghiem vd dd'i chiing
Day la chi sd tong hpp quan trpng nha't trong viec danh gia si; phat trien
cua tre. Chi sd nay cho bie't su phat trien tong quat ciia tre trong su so sanh ddi
chieu vdi nhflng ire khac. Hieu qua co ban ciia chudng tnnh the hiert d chi sd nay.

TAP CHI'TAM Ly HOC, Sd 1 (166), 1 - 2013

59

Kdt qud ddnh gid chi sd hanh vi thich ing cua 2 nhdm tai 3 thdi didm
ddnh gia dupc the hien P bang 9.
Bdng 9: Chi .so hdnh vi thich Ttng long hap tfiiu nhflm thuc nghiem vd dfl'i chdng
--~-__^^^Thdi diem
Nhom

"^—•—.__

Thuc nghiem
Ddi china
T-lesI (P)

Thdng 3
(Diem TB)
80,22
76,82
0.241

Thang 0
(Diem TB)
75,73
74,59
0,685

Thang 6
(Diem TB)
82,89
76,48
0,006

Ghi chil (Diem TB): TB dtcm chud'n ciia Itnh vuc (Standard score, xem 2.2.)
Kidm dinh T-test vdi cdc mdu ddc lap tai thoi diem 0 cho ket qud p =
0,685, khdng cd sy khac biet. Nhu vay, giia nhdm thyc nghiem vd dd'i ching
cd su tuong ddng vd chi sd hanh vi thi'ch ung lai thdi didm trudc thyc nghidm.
Trong qua trinh tidn hdnh can thiep, chi sd cua nhdm thuc nghidm cd xu hudng
tang ddn. Tuy nhien, tai thdi didm thdng thi 3 vdn chua cd sy khac biet cd y
nghTa giia 2 nhdm, vdi p = 0,241. Nhu vay, thdi gian can thiep 3 thang da bdt
dau tao ra nhirng tien bd trong hanh vi cua tre, thd hien o sy tang len cua chi sd
hdnh Vi thfch img. Tuy vay, vdi thdi lupng 1 gid/Idn/tudn - thdi lupng khdng
nhidu thi viec chua tao ra sy tidn bd rd ret cd y nghTa d tre la didu khdng ndm
ngodi dy doan.
(Hi St5 HANH VlTWiCH UNG TtbNG HOP
84

^---^

82

y*^

80
78
y^

j^..

^

—•—Thuc nghl &n

76
_^^

—•—B6i chimg

74
72
70
0thang

3thang

6thang

Bieu dd 8: Chi sd hdnh vi thich Ttng long lutp
cua nhflm ihuc nghiem vd dfl'i chimg

60

TAP CHi TAM LV HOC, Sd 1 (166), 1-2013


Ddnh gid Idn thi 3, sau 6 thdng can thidp, kdt qud kidm dinh cho thdy,
cd su khac biet cd y nghTa gitta 2 nhdm vdi p = 0,006. Cd sy khdc biet cd y
nghTa gitta chi sd hdnh vi thich ing gitta nhdm thyc nghidm va nhdm ddi
chting. Nhu vdy, cd thd ke't Iuan: chuong trinh can thidp cd hieu qud. Didn bidn
cua cdc chi sd dupc thd hien tai bidu dd 8.
Nhin vao bidu dd cd the thdy, didm khdi ddu cua cd 2 nhdm la khd gdn
nhau, nhdm dd'i ching hdu nhu it bidn ddng, trong khi chi sd cua nhdm thyc

nghiem ngay cang tang, thd hidn sy tidn bd rd net. Dac bidt, chieu hudng tidn
bd dupc khdc hpa khi thdi gian can thidp cua nhdm thyc nghiem cang ddi thi sy
khdc biet trong ket qud cdng ldn. Didu ndy khdng dinh rdng chuong trinh can
thiep cd hidu qua td't.
4. Ke't luin
Thyc nghidm can thiep cho tre cham phdt tridn tri tue duoc tridn khai
tren CO sd chuong trinh Portage da cd hidu qud, thd hidn d sy cai thien rd net cbi
sd hanh vi thich ing tdng hpp va cdc chi sd thudc ITnh vyc giao tie'p vd xa hdi
hda. Cdc ITnh vuc: ky nang sinh hoat thudng ngdy va ITnh vuc van ddng cd tidn
bd nhtmg chua cd sy khdc biet cd y nghTa. Tac dpng cia can thiep de'n cac tidu
ITnh vuc cd hieu qud khdng gidng nhau.
Nhu vay, cd thd s i dung chuang trinh can thiep sdm Portage cho tre
cham phat trien tri tue d mic nhe (low) vdi mdt sd luu y sau:
- Cd the huan luyen ddi ngu gido vien cd nen tang vd tam ly gido due s i
dung chuong trinh Portage de can thiep cho tre.
- De Xac ddng cd hieu qua gido vidn can xac dinh chi'nh xac ITnh vyc
cham phat trien cua trd, t i dd thidt kd hoat ddng phi hop.
- Cdn kdt hap chat che vdi gia dinh, su tham gia cua gia dinh rat quan
trpng dd cd dupc sy tidn bd cua tre.
- De can thiep cd hieu qua can duoc tie'n hanh trong khoang thdi gian
dai, lien tue vd thudng xuydn.
Ke't qua thyc nghiem cung dat ra mdt sd vdn dd cdn dupc phan tich va
nghidn ciu tid'p theo: thdi gian can thiep cua mdt Idn hay sd ldn can thidp trong
mdt tuan cd anh hudng de'n hieu qua can thiep hay khdng? Mic dp dap ing ddi
vdi cdc tdc ddng can thiep d trd phu thudc vdo cdc yeu to nao? Cd thd can c i
vdo cac chi bdo nao dd dy dodn hieu qua cua can thiep? D6 tra ldi cac cau hdi
ndy, viec phdn tich sdu ke't qua thyc nghidm ndy va thidt ke, tidn hanh cac thyc
nghiem khdc vdi cdc myc dich tuong tu Id rd't cdn thidt.

TAPCHITAMLtHOCSdl (166), 1-2013

Tai lieu tham khao
1. NguySn Van Ddng, Tdm ly hoc phdl irien. NXB Chtnh tri Qud'c gia, 2004.
2. Nguyen Die Son, Mile dfi phdt trie'n Idm ly cita Ire d mdi sd trudng mdm non Hd
Ndi. Tap chf TSm ly hoc, trang 14-24, sd 3 - 2012.
3. Nguydn Anh Tuyet, Tdm ly hpc Ire em. NXB Dai hpc Qud'c gia Ha Ndi, 1997.
4. Julia Herwig and Portage Project Staff, Portage Guide Binh lo 6 user's guide and
Portage aclivities & routine. Cooperative Education Service Agency 5 Portage
Project, Wiscosin, USA, 2003.
5. Vineland II Adaptive Behavior Scale, Manual, 2005, Pearson, Inc.

62

TAP CHiTAM Lt HOC, Sd 1 (166), 1 - 2013