对自闭症谱系障碍的早期强化行为和自然发展行为干预措施的有效性和经验:混合方法系统审查和元分析
Dong-Gyun Han1, Yoonjae Lee1, Hee-Sun Kim2
1Department of Psychiatry, College of Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Child and adolescent psychiatry and mental health
|December 26, 2025
概括
应用行为分析 (ABA) 干预措施在改善自闭症谱系障碍 (ASD) 儿童的发展和行为结果方面表现出有效性. 然而,成本和培训质量等挑战需要进一步的研究和政策改进.
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:
- 自闭症谱系障碍 (ASD) 的特点是社会沟通缺陷和重复性行为.
- 应用行为分析 (ABA) 干预措施广泛用于ASD,但证据质量和与通常治疗 (TAU) 的比较是有限的.
- 之前的研究往往具有偏见的高风险和关于ABA有效性的低质量证据.
研究的目的:
- 对患有自闭症儿童和青少年的基于ABA的干预措施的有效性进行系统审查和元分析.
- 评估定量结果和定性经验,解决先前研究的方法限制.
- 将ABA干预与通常治疗 (TAU) 进行比较.
主要方法:
- 按照PRISMA指南进行混合方法系统审查和元分析,搜索七个数据库,截至2023年8月.
- 包括25项研究 (16项RCT,9项定性),评估适应性行为,认知,语言和社会化等结果.
- 用于元分析的随机效应模型,对干预强度和TAU比较进行子组分析.
主要成果:
- 与对照组相比,在适应性行为,日常生活技能,语言技能和联合注意力方面观察到显著的改善.
- 高强度的ABA干预比低强度干预对语言技能产生更大的影响.
- 与TAU进行的比较显示,TAU对适应性行为,日常生活技能和语言技能产生了显著的积极影响.
结论:
- 已证实,ABA干预措施在改善ASD儿童的发育和行为结果方面是有效的.
- 定性数据揭示了感知到的好处,以及诸如财务限制和可变的培训质量等障碍.
- 系统性挑战需要政策倡议,改进培训,以及进一步研究ABA对ASD核心症状的影响.
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