自閉症スペクトル障害の子どもにおける行動問題に対する親の訓練対親教育の効果:ランダム化臨床試験

Karen Bearss¹, Cynthia Johnson², Tristram Smith³

¹Department of Pediatrics, Marcus Autism Center, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia.

JAMA

|April 22, 2015

まとめ

親の訓練は,親の教育と比較して,自閉症スペクトル障害 (ASD) の子供における破壊的な行動を著しく減少させた. 親が報告したアウトカムが改善したものの,臨床的意義は不明である.

科学分野:

児童心理学児童心理学について
発達障害発達障害について
行動干渉行動干渉

背景:

破壊的な行動は,自閉症スペクトル障害 (ASD) の子どもに多く見られます.
ASDに関連する破壊的な行動に対する既存の行動介入には,大規模なランダム化試験の評価がない.
親の訓練は,ASDの子供の破壊的な行動を管理するための潜在的な介入です.

研究の目的:

自閉症スペクトル障害 (ASD) の子どもにおける破壊的な行動の管理における親の訓練の有効性を評価する.
ランダム化試験の設定で,親の訓練と親の教育を比較する.
標準化された測定法を用いて,破壊的な行動や不順守の変化を評価する.

主な方法:

ASDと破壊的な行動を持つ180人の子供 (3~7歳) を含む24週間のランダム化試験です.
親の訓練グループ (n=89) と親の教育グループ (n=91) の比較.
両親が報告した異常行動チェックリスト,刺激性,家庭状況アンケート,自閉症スペクトル障害,臨床医が評価した臨床的全体的な印象によって測定された結果.

主要な成果:

親の訓練は,親教育と比較して,親が報告した両方の測定値で破壊的な行動のスコアを大幅に低下させた.
異常な行動チェックリスト - 親の教育で31.8%対親の教育で47.7%減少した.
親の教育グループ (39.6%) と比べて,親の教育グループ (68.5%) の参加者の割合がクリニック・グローバル・インプレッション・スケールでポジティブな反応を示した.

結論:

親の訓練は,親の報告に基づいて,自閉症スペクトル障害の子供における破壊的な行動を減らすために,親教育よりも効果的です.
観察された改善の臨床的意義については,さらなる調査が必要である.
盲目の臨床医によって評価されたように,親の訓練は,より高いポジティブな臨床応答の割合を示しました.

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