适应性干预在社区中适应性干预学校年龄,具有自闭症谱系障碍的最小口语儿童:主要目标结果
Connie Kasari1, Stephanie Shire2, Wendy Shih1
1UCLA, Los Angeles, California.
Journal of the American Academy of Child and Adolescent Psychiatry
|January 26, 2025
概括
这项研究发现,离散试验训练 (DTT) 和混合干预 (JASP-EMT) 改善自闭症儿童的沟通之间没有显著差异. 一种自适应的方法,从DTT开始,根据响应进行调整,显示出适度的收益.
科学领域:
- 发展心理学 发展心理学
- 行为科学 行为科学
- 临床心理学 临床心理学
背景情况:
- 关于在5-8岁的极小口语自闭症儿童中进行口语语言发展的最佳干预措施的研究有限.
- 这项研究探讨了需要基于证据的策略来改善这一群体中自发的沟通表达的需求.
- 在AIM-ASD研究 (NCT01751698) 中,研究了适应性干预方法.
研究的目的:
- 构建和评估一项为期16周的2个阶段的适应性干预,以改善极小口语自闭症儿童的自发沟通发言.
- 为了比较开始与离散试验培训 (DTT) 与混合干预 (JASP-EMT) 的有效性.
- 在8个预先规定的选项中,确定最有利的适应性干预策略.
主要方法:
- 一个连续的,多次分配的随机化试验设计被采用194个极少语言自闭症儿童 (5-8岁).
- 第1阶段涉及DTT或JASP-EMT的随机化 (0-6周),响应状态决定了第2阶段的随机化.
- 第二阶段 (7至16周) 涉及重新随机化以继续,增加家长培训 (P),或根据初始反应结合干预措施.
主要成果:
- 在开始DTT与JASP-EMT之间,对于社会交流发言 (SCU) 变化的主要结果 (p = .41) 没有发现显著差异.
- 最有利的干预措施是从DTT开始的适应性方法,并为早期响应者增加家长培训,并为缓慢响应者结合DTT+JASP-EMT.
- 这种适应性干预导致从基线到第16周的估计平均SCU增加7.68 (95% CI = 2.13-13.24) .
结论:
- 最初的干预选择 (DTT与JASP-EMT) 在16周后没有显著影响口语结果.
- 适应性干预策略,特别是从DTT开始并根据响应进行调整的策略,显示出适度的好处.
- 需要进一步的研究来完善最佳的适应性干预策略,以适应这一群体.
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