家长培训与家长教育对自闭症谱系障碍儿童行为问题的影响:一项随机临床试验
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
概括
与家长教育相比,家长培训显著减少了自闭症谱系障碍 (ASD) 儿童的破坏性行为. 虽然父母报告的结果有所改善,但临床意义尚不清楚.
科学领域:
- 儿童心理学 儿童心理学
- 发展障碍 发展障碍 发展障碍
- 行为干预 行为干预
背景情况:
- 在患有自闭症谱系障碍 (ASD) 的儿童中,破坏性行为很普遍.
- 现有的与自闭症相关的破坏性行为行为干预措施缺乏大规模随机试验评估.
- 家长培训是管理ASD儿童破坏性行为的一个潜在干预措施.
研究的目的:
- 评估家长培训在治疗自闭症谱系障碍 (ASD) 儿童中破坏性行为的有效性.
- 在随机试验环境中,将家长培训与家长教育进行比较.
- 用标准化措施评估破坏性行为和违规行为的变化.
主要方法:
- 一项为期24周的随机试验,涉及180名患有自闭症和破坏性行为的儿童 (3至7岁).
- 在家长培训组 (n=89) 和家长教育组 (n=91) 之间的比较.
- 通过家长报告的异常行为检查清单-易怒和家庭情况调查问卷-自闭症谱系障碍和临床医生评级的临床总体印象来衡量结果.
主要成果:
- 与家长教育相比,家长培训在家长报告的两个措施上都导致破坏性行为得分显著降低.
- 异常行为检查清单-随着家长培训,易怒度下降了47.7%,而随着家长教育下降了31.8%.
- 与家长教育组 (39.6%) 相比,家长培训组 (68.5%) 的参与者在临床全球印象量表上呈现出更高比例的积极反应.
结论:
- 基于家长的报告,家长培训在减少自闭症谱系障碍儿童的破坏性行为方面比家长教育更有效.
- 观察到的改善的临床意义需要进一步调查.
- 父母培训显示,盲目临床医生评估的积极临床反应率更高.
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