意大利社区环境中针对自闭症儿童和青少年的强化干预：一项单组纵向研究。
Intensive intervention for children and adolescents with autism in a community setting in Italy: a single-group longitudinal study.
机构信息
Department of Medicine and Public Health, University of L'Aquila, Italy.
出版信息
Child Adolesc Psychiatry Ment Health. 2010 Sep 1;4:23. doi: 10.1186/1753-2000-4-23.
BACKGROUND
Previous studies have shown favourable results with intensive behavioural treatment for children with autism: evidence has emerged that treatment can be successfully implemented in a community setting and in adolescent participants. The aim of this study was to describe the 2-year adaptive functioning outcome of children and adolescents with autism treated intensively within the context of special autism centres, as well as to evaluate family satisfaction with the activity of the centres.
METHODS
Sixty participants with autism (20 females and 40 males, aged between 4 and 18 years) attending the semi-residential rehabilitation centres for autism located in the Abruzzo region (Central Italy) were followed up and their adaptive functioning was evaluated both at baseline and after one and two years using the Vineland Adaptive Behaviour Scales (VABS). Parents' satisfaction with the service was evaluated using the Orbetello Satisfaction Scale for Children and Adolescent Mental Health.
RESULTS
The increase in VABS scores was significant on several domains in the different gender and age categories. It is worth noting that male children had improved a great deal (roughly, an effect size >0.20) in the domains of communication, daily living and motor skills (effect sizes 0.34, 0.45 and 0.27 respectively) whereas in male adolescents, a notable increase in VABS scores was recorded in the domain of socialization only (effect size 0.23). On the other hand, adaptive behaviour in female children increased in the domains of socialization and motor skills (effect sizes 0.27 and 0.42 respectively) whereas in female adolescents, good results were achieved in the domains of daily living, socialization and motor skills (effect sizes 0.22, 0.26 and 0.20 respectively).The level of satisfaction of users of the service over time was found to be substantial, even when they had recently started the program.
CONCLUSIONS
Our results support the implementation of special autism treatment community centres, based on a parent co-directed rehabilitative, intensive and early intervention. Further experimental research designed to document the effectiveness of services provided to children and adolescents with autism in the community is recommended.
背景
先前的研究表明，密集行为治疗对自闭症儿童有良好的效果：有证据表明，治疗可以在社区环境中成功实施，并适用于青少年参与者。本研究的目的是描述在特殊自闭症中心环境中接受密集治疗的自闭症儿童和青少年的 2 年适应功能结果，并评估家庭对中心活动的满意度。
方法
60 名自闭症儿童和青少年（20 名女性和 40 名男性，年龄在 4 至 18 岁之间）参加了位于意大利中部阿布鲁佐地区的自闭症半住宿康复中心，使用适应行为量表（VABS）在基线、1 年和 2 年时对他们的适应功能进行评估。使用奥贝托洛儿童和青少年心理健康满意度量表（Orbetello Satisfaction Scale for Children and Adolescent Mental Health）评估父母对服务的满意度。
结果
在不同性别和年龄组的多个领域，VABS 评分的增加具有统计学意义。值得注意的是，男童在沟通、日常生活和运动技能领域有了很大的改善（大致效应量>0.20），分别为 0.34、0.45 和 0.27；而在男青少年中，仅在社交领域记录到 VABS 评分的显著增加（效应量为 0.23）。另一方面，女童的适应行为在社交和运动技能领域增加（效应量分别为 0.27 和 0.42），而在女青少年中，在日常生活、社交和运动技能领域取得了较好的结果（效应量分别为 0.22、0.26 和 0.20）。随着时间的推移，用户对服务的满意度水平被发现是实质性的，即使他们最近才开始该项目。
结论
我们的研究结果支持基于父母共同指导的康复、密集和早期干预的特殊自闭症治疗社区中心的实施。建议进行进一步的实验研究，以记录为社区中自闭症儿童和青少年提供的服务的有效性。
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