Ducharme Joseph M, Drain Tammy L
University of Toronto, Toronto, Ontario, Canada.
J Am Acad Child Adolesc Psychiatry. 2004 Feb;43(2):163-71. doi: 10.1097/00004583-200402000-00011.
Children with autism often demonstrate distress and oppositionality when exposed to requests to complete academic or household tasks. Errorless academic compliance training is a success-focused, noncoercive intervention for improving child cooperation with such activities. In the present study, the authors evaluated treatment and generalization effects of this intervention on four children diagnosed with autism.
In a multiple baseline across-subjects design, parents delivered a range of academic and nonacademic requests to their children to determine the probability of compliance for each request. A hierarchy of academic requests ranging from those yielding high compliance (level 1) to those yielding low compliance (level 4) was then developed. Treatment began with the concentrated delivery of level 1 requests, with praise and reward for compliant responses. Over several weeks, children were gradually introduced to requests from subsequent probability levels with continued reward for compliance.
High compliance levels were demonstrated throughout and following treatment. Evidence of generalization to untrained academic requests and nonacademic requests emerged. Treatment gains were maintained up to 6 months after treatment.
Errorless academic compliance training appears to be an effective intervention for enhancing generalized compliance in children with autism.
自闭症儿童在被要求完成学业或家务任务时，常常表现出痛苦和反抗情绪。无错误学业依从性训练是一种以成功为导向、非强制性的干预措施，旨在提高儿童在此类活动中的合作性。在本研究中，作者评估了该干预措施对四名自闭症儿童的治疗效果及泛化效果。
采用多基线被试间设计，家长向孩子提出一系列学业和非学业要求，以确定每个要求得到依从的概率。随后制定了一个学业要求等级体系，从依从率高的要求（1级）到依从率低的要求（4级）。治疗从集中提出1级要求开始，对依从性反应给予表扬和奖励。在几周时间里，逐渐让孩子接触后续概率等级的要求，并持续对依从行为给予奖励。
在治疗期间及治疗后，均表现出高依从率。出现了向未训练的学业要求和非学业要求泛化的证据。治疗效果在治疗后长达6个月内得以维持。
无错误学业依从性训练似乎是提高自闭症儿童泛化依从性的一种有效干预措施。
