Kroeger K A, Nelson W M
Division of Developmental Disabilities, The Kelly O'Leary Center for Autism Spectrum Disorders, Cincinnati Children's Hospital Medical Center, OH 45229, USA.
J Intellect Disabil Res. 2006 Feb;50(Pt 2):101-8. doi: 10.1111/j.1365-2788.2005.00734.x.
The incidence of children dually diagnosed with Down syndrome and autism is estimated to be as high as 11%. There is a paucity of research investigating linguistic treatment interventions for such children. This single-subject experiment examined a programme designed to increase the language production and verbal behaviour of a 9-year-old dually diagnosed boy who had been receiving a 15-h/week home-based applied behaviour analysis (ABA) programme.
Training principles were derived from previously empirically validated research in discrete trail learning and natural environment teaching, as well as modified incidental teaching procedures. The crux of the language programme involved withholding reinforcement until a spoken request was made.
Language production noticeably increased for each target area after the introduction of the language programme and was maintained at a 9-month follow-up session.
A combined treatment approach incorporating direct instruction, natural environment teaching and incidental teaching can be effective in increasing and maintaining responsive and spontaneous speech in a child with Down syndrome diagnosed with autism. Replication studies are needed with such multiple dually diagnosed children to further evaluate the effectiveness and generalizability of this combined language programme.
据估计,同时患有唐氏综合征和自闭症的儿童发病率高达11%。针对这类儿童的语言治疗干预研究较少。这项单受试者实验考察了一个旨在提高一名9岁同时患有这两种疾病男孩的语言表达和言语行为的项目,该男孩此前每周在家接受15小时的应用行为分析(ABA)项目。
训练原则源自先前在离散式训练学习和自然环境教学中经实证验证的研究,以及改良的附带教学程序。语言项目的关键在于在发出口头请求之前不给予强化。
引入语言项目后,每个目标领域的语言表达都显著增加,并在9个月的随访中得以维持。
结合直接教学、自然环境教学和附带教学的综合治疗方法,对于提高和维持一名被诊断患有自闭症的唐氏综合征儿童的反应性和自发性言语可能是有效的。需要对更多同时患有这两种疾病的儿童进行重复研究,以进一步评估这种综合语言项目的有效性和普遍性。