Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute, University of California, Davis, USA.
J Child Psychol Psychiatry. 2010 Dec;51(12):1300-20. doi: 10.1111/j.1469-7610.2010.02308.x. Epub 2010 Sep 24.
There is a scarcity of empirically validated treatments for infants and toddlers under age 3 years with autism spectrum disorders (ASD), as well as a scarcity of empirical investigation into successful intervention characteristics for this population. Yet early screening efforts are focused on identifying autism risk in children under age 3 years. In order to build ASD interventions for infants and toddlers upon a foundation of evidence-based characteristics, the current paper presents the results of a systematic literature search and effect size analysis of efficacious interventions for infants and toddlers with other developmental disorders: those who were born prematurely, have developmental impairments, or are at high risk for developmental impairments due to the presence of a biological or familial condition associated with developmental impairments. A review of 32 controlled, high-quality experimental studies revealed that the most efficacious interventions routinely used a combination of four specific intervention procedures, including (1) parent involvement in intervention, including ongoing parent coaching that focused both on parental responsivity and sensitivity to child cues and on teaching families to provide the infant interventions, (2) individualization to each infant's developmental profile, (3) focusing on a broad rather than a narrow range of learning targets, and (4) temporal characteristics involving beginning as early as the risk is detected and providing greater intensity and duration of the intervention. These four characteristics of efficacious interventions for infants and toddlers with other developmental challenges likely represent a solid foundation from which researchers and clinicians can build efficacious interventions for infants and toddlers at risk for or affected by ASD.
对于 3 岁以下患有自闭症谱系障碍(ASD)的婴儿和幼儿,目前缺乏经过实证验证的治疗方法,也缺乏对此人群成功干预特征的实证研究。然而,早期筛查工作的重点是在 3 岁以下儿童中识别自闭症风险。为了在基于循证特征的基础上为婴儿和幼儿构建 ASD 干预措施,本文介绍了对其他发育障碍婴儿和幼儿进行有效干预的系统文献搜索和效应量分析的结果:那些早产儿、有发育障碍或因存在与发育障碍相关的生物或家族状况而有发育障碍高风险的儿童。对 32 项对照、高质量的实验研究进行综述后发现,最有效的干预措施通常采用四种特定干预程序的组合,包括:(1)家长参与干预,包括持续的家长指导,既关注家长的反应能力和对孩子线索的敏感性,也教授家庭如何为婴儿提供干预;(2)根据每个婴儿的发育情况进行个体化;(3)关注广泛而非狭窄的学习目标;(4)从风险被发现开始尽早开始的时间特征,并提供更高的干预强度和时长。对于患有其他发育挑战的婴儿和幼儿,这些有效干预的四个特征可能为研究人员和临床医生为有 ASD 风险或受 ASD 影响的婴儿和幼儿构建有效干预措施提供了坚实的基础。