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随机对照试验研究即兴音乐治疗对自闭症谱系障碍儿童的有效性(TIME-A):研究方案。

Randomised controlled trial of improvisational music therapy's effectiveness for children with autism spectrum disorders (TIME-A): study protocol.

机构信息

Aalborg University, Faculty of Humanities, Department of Communication and Psychology, Aalborg Øst, Denmark.

出版信息

BMC Pediatr. 2012 Jan 5;12:2. doi: 10.1186/1471-2431-12-2.

Abstract

BACKGROUND

Previous research has suggested that music therapy may facilitate skills in areas typically affected by autism spectrum disorders such as social interaction and communication. However, generalisability of previous findings has been restricted, as studies were limited in either methodological accuracy or the clinical relevance of their approach. The aim of this study is to determine effects of improvisational music therapy on social communication skills of children with autism spectrum disorders. An additional aim of the study is to examine if variation in dose of treatment (i.e., number of music therapy sessions per week) affects outcome of therapy, and to determine cost-effectiveness.

METHODS/DESIGN: Children aged between 4;0 and 6;11 years who are diagnosed with autism spectrum disorder will be randomly assigned to one of three conditions. Parents of all participants will receive three sessions of parent counselling (at 0, 2, and 5 months). In addition, children randomised to the two intervention groups will be offered individual, improvisational music therapy over a period of five months, either one session (low-intensity) or three sessions (high-intensity) per week. Generalised effects of music therapy will be measured using standardised scales completed by blinded assessors (Autism Diagnostic Observation Schedule, ADOS) and parents (Social Responsiveness Scale, SRS) before and 2, 5, and 12 months after randomisation. Cost effectiveness will be calculated as man years. A group sequential design with first interim look at N = 235 will ensure both power and efficiency.

DISCUSSION

Responding to the need for more rigorously designed trials examining the effectiveness of music therapy in autism spectrum disorders, this pragmatic trial sets out to generate findings that will be well generalisable to clinical practice. Addressing the issue of dose variation, this study's results will also provide information on the relevance of session frequency for therapy outcome.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN78923965.

摘要

背景

先前的研究表明,音乐治疗可能有助于提高自闭症谱系障碍患者在社交互动和沟通等方面的技能。然而,由于研究在方法学准确性或方法的临床相关性方面存在局限性,先前研究结果的普遍性受到限制。本研究旨在确定即兴音乐治疗对自闭症谱系障碍儿童社交沟通技能的影响。本研究的另一个目的是检验治疗剂量(即每周音乐治疗次数)的变化是否会影响治疗效果,并确定成本效益。

方法/设计:将 4 岁零 0 个月至 6 岁零 11 个月被诊断为自闭症谱系障碍的儿童随机分配到三个条件之一。所有参与者的家长将接受三次家长咨询(在 0、2 和 5 个月时)。此外,随机分配到两个干预组的儿童将在五个月内接受个体即兴音乐治疗,每周一次(低强度)或三次(高强度)。音乐治疗的一般效果将使用由盲法评估者(自闭症诊断观察量表,ADOS)和家长(社交反应量表,SRS)在随机分组前和随机分组后 2、5 和 12 个月完成的标准化量表进行测量。成本效益将计算为人年。采用具有首次中间观察的 N = 235 的分组序贯设计,以确保具有足够的功效和效率。

讨论

本研究针对需要更严格设计的试验来检验音乐治疗在自闭症谱系障碍中的有效性,旨在产生对临床实践具有良好普遍性的结果。针对剂量变化的问题,本研究的结果还将提供关于治疗效果与治疗次数相关性的信息。

试验注册

当前对照试验 ISRCTN78923965。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a23/3280156/df32d5d3558b/1471-2431-12-2-1.jpg

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