Centro Nacional de Epidemiología, Instituto de Salud Carlos III, CIBERNED, Madrid, Spain.
Clin Psychol Rev. 2010 Jun;30(4):387-99. doi: 10.1016/j.cpr.2010.01.008. Epub 2010 Feb 11.
A number of clinical trials and single-subject studies have been published measuring the effectiveness of long-term, comprehensive applied behavior analytic (ABA) intervention for young children with autism. However, the overall appreciation of this literature through standardized measures has been hampered by the varying methods, designs, treatment features and quality standards of published studies. In an attempt to fill this gap in the literature, state-of-the-art meta-analytical methods were implemented, including quality assessment, sensitivity analysis, meta-regression, dose-response meta-analysis and meta-analysis of studies of different metrics. Results suggested that long-term, comprehensive ABA intervention leads to (positive) medium to large effects in terms of intellectual functioning, language development, acquisition of daily living skills and social functioning in children with autism. Although favorable effects were apparent across all outcomes, language-related outcomes (IQ, receptive and expressive language, communication) were superior to non-verbal IQ, social functioning and daily living skills, with effect sizes approaching 1.5 for receptive and expressive language and communication skills. Dose-dependant effect sizes were apparent by levels of total treatment hours for language and adaptation composite scores. Methodological issues relating ABA clinical trials for autism are discussed.
已经发表了许多临床试验和单病例研究，以衡量长期、全面的应用行为分析（ABA）干预对自闭症儿童的有效性。然而，由于发表研究的方法、设计、治疗特征和质量标准各不相同，通过标准化措施对该文献进行整体评估受到了阻碍。为了填补这一文献空白，采用了最先进的荟萃分析方法，包括质量评估、敏感性分析、元回归、剂量反应荟萃分析和不同指标研究的荟萃分析。结果表明，长期、全面的 ABA 干预在自闭症儿童的智力功能、语言发展、日常生活技能和社会功能方面具有（积极）中等到大的效果。尽管所有结果都显示出有利的效果，但与语言相关的结果（智商、接受性和表达性语言、沟通）优于非语言智商、社会功能和日常生活技能，接受性和表达性语言以及沟通技能的效应大小接近 1.5。语言和适应综合评分的总治疗时间水平显示出剂量依赖性效应大小。讨论了与自闭症的 ABA 临床试验相关的方法学问题。
