Smith C, Felce D, Jones E, Lowe K
Welsh Centre for Learning Disabilities Applied Research Unit, University of Wales College of Medicine, Cardiff, UK.
J Intellect Disabil Res. 2002 Nov;46(Pt 8):594-604. doi: 10.1046/j.1365-2788.2002.00433.x.
Active support training was fully conducted in 38 community houses accommodating 106 adults with intellectual disabilities (ID; group 1), but not in a further 36 accommodating 82 adults with ID (group 2). The aims of the present study were to analyse whether staff became more effective in supporting resident activity after the implementation of active support, and whether there was evidence of differential responsiveness by people with differing status in relation to adaptive behaviour, psychiatric diagnosis, challenging behaviour or autism.
Observations of staff:resident interaction and resident engagement in activity were taken before and after active support training. Changes in Yule's Q statistics, indicating the likelihood that resident engagement in activity followed staff giving residents verbal instruction or non-verbal assistance, were compared for the two groups. In addition, changes in similar statistics were compared for residents within group 1: (1) with Adaptive Behaviour Scale (ABS) scores above and below 180; and (2) with and without severe challenging behaviour, the triad of social impairments and mental illness.
Yule's Q for engagement given non-verbal assistance significantly increased post-training among group 1, but not among group 2. Similar significant increases were found among group 1 residents with ABS scores below 180 without challenging behaviour, with and without the triad of social impairments, and without mental illness, but not with an ABS score above 180, with challenging behaviour and with mental illness.
The present analysis reinforces previous studies on the effectiveness of active support training for adults with more severe ID (i.e. with ABS scores below 180). Active support was as effective for people with the triad of social impairments as for those without it. However, the effectiveness of support offered to people with challenging behaviour or mental illness did not significantly increase.
在容纳106名成年智障人士的38所社区之家全面开展了积极支持训练（第1组），而在另外容纳82名成年智障人士的36所社区之家未开展（第2组）。本研究的目的是分析实施积极支持训练后工作人员在支持居民活动方面是否变得更有效，以及是否有证据表明在适应性行为、精神疾病诊断、挑战性行为或自闭症方面具有不同状况的人存在差异反应。
在积极支持训练前后观察工作人员与居民的互动以及居民参与活动的情况。比较两组Yule's Q统计量的变化，该统计量表明居民参与活动跟随工作人员给予居民口头指示或非言语协助的可能性。此外，比较第1组内居民的类似统计量变化：（1）适应性行为量表（ABS）得分高于和低于180分的居民；（2）有和没有严重挑战性行为、社会障碍三联征和精神疾病的居民。
第1组中，训练后给予非言语协助时参与度的Yule's Q显著增加，而第2组未增加。在第1组中，ABS得分低于180分、没有挑战性行为、有和没有社会障碍三联征以及没有精神疾病的居民中发现了类似的显著增加，但ABS得分高于180分、有挑战性行为和有精神疾病的居民中未发现。
本分析强化了先前关于积极支持训练对更严重智障成年人（即ABS得分低于180分）有效性的研究。积极支持对有社会障碍三联征的人和没有该三联征的人同样有效。然而，为有挑战性行为或精神疾病的人提供的支持有效性并未显著增加。
