Associazione di Volontariato "Una Breccia nel Muro", Rome, Italy.
Res Dev Disabil. 2013 Sep;34(9):2967-85. doi: 10.1016/j.ridd.2013.06.007. Epub 2013 Jun 29.
This paper presents a comprehensive synthesis of six meta-analyses of early intensive behavioral interventions (EIBI) for young children with autism spectrum disorders published from 2009 to 2011. Analysis was conducted in three steps to account for different formats of treatment delivery and the extent to which parents took part in treatment. The three components of the synthesis were (a) descriptive analysis, (b) effect size analysis, and (c) mediator analysis via partial correlation and linear regressions. We completed the analysis by obtaining standardized mean difference effect sizes for 13 comparative studies ordered by comparison study type and 22 mean change effect sizes ordered by treatment delivery type. Results suggest that EIBI leads generally to positive medium-to-large effects for three available outcome measures: intellectual functioning, language skills and adaptive behaviors. Although favorable effects were apparent across comparative studies, analysis by type of delivery format revealed that EIBI programs that include parents in treatment provision are more effective. Mediator analyses suggest that treatment variables and child characteristics impact program effectiveness when accounting for the extent of parent inclusion. Clinical implications toward individualized treatment tailoring are discussed.
本文综合了六项元分析,这些元分析是针对 2009 年至 2011 年间发表的早期密集行为干预(EIBI)对自闭症谱系障碍幼儿的影响。分析分为三个步骤,以考虑不同的治疗方式和家长参与治疗的程度。综合分析的三个组成部分是:(a)描述性分析,(b)效果量分析,(c)通过偏相关和线性回归进行中介分析。我们通过对按比较研究类型排序的 13 项比较研究和按治疗方式排序的 22 项平均变化效果大小获得标准化均数差效应大小,完成了分析。结果表明,EIBI 通常会对三种可用的结果衡量标准产生积极的中等至较大影响:智力功能、语言技能和适应行为。尽管在比较研究中都表现出有利的效果,但按治疗方式的类型进行分析表明,包括家长参与治疗提供的 EIBI 计划更为有效。中介分析表明,在考虑家长参与程度的情况下,治疗变量和儿童特征会影响计划的有效性。讨论了针对个体化治疗定制的临床意义。