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自闭症干预多层次实施策略的有效性:两项相关实施试验的结果
Lauren Brookman-Frazee1, Anna S Lau2, Scott C Roesch3
1University of California San Diego; Child and Adolescent Services Research Center, San Diego.
Journal of the American Academy of Child and Adolescent Psychiatry
|January 15, 2025
概括
专注于领导者的策略显著改善了基于证据的自闭症干预 (EBI) 忠实性和儿童的结果. 提供者层面的策略没有显著的影响,突出了领导者在为自闭症儿童实施EBI方面的影响.
科学领域:
- 实施科学 实施科学
- 自闭症谱系障碍 (ASD) 研究研究
- 儿童心理学 儿童心理学
背景情况:
- 翻译基于证据的ASD干预措施 (TEAMS) 倡议旨在改善EBI的实施.
- 测试了两种策略:领导者的TEAMS领导研究所 (TLI) 和提供者的TEAMS个性化提供者策略 (TIPS).
- 该研究的重点是实施EBI在心理健康和自闭症儿童教育环境中.
研究的目的:
- 评估领导层和提供者层面对自闭症护理中的EBI实施策略的有效性.
- 确定TLI和TIPS是否改善EBI忠实性,提供者认证和儿童临床结果.
- 评估这些策略在不同服务系统中的影响.
主要方法:
- 一个集群随机化混合型3试验,涉及65个项目/地区,跨越4个队伍.
- 策略与自闭症个性化心理健康干预 (AIM HI) 和课堂关键响应教学 (CPRT) 进行了测试.
- 在6个月的时间里,使用治疗意图模型分析了387名提供者和385名儿童的数据.
主要成果:
- 随着时间的推移,TLI显著提高了EBI忠实度,并显示了儿童结局T分数的显著降低.
- 没有发现TLI对EBI认证有重大影响.
- TIPS对任何测量结果都没有显著影响.
结论:
- 专注于领导者的策略,特别是TLI,在促进自闭症EBI的实施和临床结果方面是有效的.
- 调查结果支持使用领导层级干预措施来加强公共服务系统中EBI的采用.
- 像TIPS这样的提供者级策略可能需要进一步改进或不同的方法来影响结果.
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