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对自闭症学龄前儿童进行关键反应治疗的简要家长培训。

Brief parent training in pivotal response treatment for preschoolers with autism.

机构信息

Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada.

出版信息

J Child Psychol Psychiatry. 2010 Dec;51(12):1321-30. doi: 10.1111/j.1469-7610.2010.02326.x.

Abstract

BACKGROUND

Evidence of improved outcomes with early behavioural intervention has placed the early treatment of autism as a health priority. However, long waiting lists for treatment often preclude timely access, raising the question of whether parents could be trained in the interim. Parent training in pivotal response treatment (PRT) has been shown to enhance the communication skills of children with autism. This is typically provided within a 25-hour programme, although less intensive parent training may also be effective. The main objective of the present study was to evaluate the efficacy of brief training in PRT for parents of preschoolers with autism, who were awaiting, or unable to access, more comprehensive treatment.

METHOD

Eight preschoolers with autism and their parents participated in the study. A non-concurrent multiple (across-participants) baseline design was used, in which parents were seen individually for three 2-hour training sessions on PRT. Child and parent outcomes were assessed before, immediately after, and 2 to 4 months following training using standardised tests, questionnaires and behaviour coded directly from video recordings.

RESULTS

Overall, children's communication skills, namely functional utterances, increased following training. Parents' fidelity in implementing PRT techniques also improved after training, and generally these changes were maintained at follow-up. A moderate to strong relationship was found between parents' increased ability to implement PRT techniques and improvement in the children's communication skills.

CONCLUSION

Our findings suggest that brief parent training in PRT promises to provide an immediate, cost-effective intervention that could be adopted widely.

摘要

背景

早期行为干预改善预后的证据将自闭症的早期治疗作为一项优先健康事项。然而,治疗的长等待名单通常排除了及时获得治疗的机会,这就提出了一个问题,即父母是否可以在这段时间内接受培训。关键性反应治疗(PRT)的父母培训已被证明可以提高自闭症儿童的沟通能力。这通常在 25 小时的课程中进行,尽管较少的强化父母培训也可能有效。本研究的主要目的是评估对等待或无法接受更全面治疗的学龄前自闭症儿童的父母进行 PRT 短期培训的效果。

方法

8 名自闭症学龄前儿童及其父母参加了这项研究。使用非连续多个(参与者之间)基线设计,父母单独参加了 3 次 2 小时的 PRT 培训。在培训之前、之后立即以及培训后 2 至 4 个月使用标准化测试、问卷和直接从视频记录中编码的行为对儿童和家长的结果进行评估。

结果

总体而言,儿童的沟通技能(即功能性话语)在培训后增加。父母实施 PRT 技术的保真度也在培训后提高,并且这些变化通常在随访时保持。发现父母实施 PRT 技术能力的提高与儿童沟通技能的提高之间存在中度至强的关系。

结论

我们的研究结果表明,PRT 的简短父母培训有望提供一种即时、具有成本效益的干预措施,可以广泛采用。

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