Oslo University Hospital, Norway.
Oslo University Hospital, Norway.
J Am Acad Child Adolesc Psychiatry. 2014 Feb;53(2):188-98. doi: 10.1016/j.jaac.2013.09.019. Epub 2013 Oct 17.
This study reports 12-month follow-up data from a randomized controlled trial of preschool-based social communication treatment for young children with autism.
A total of 61 children (48 males) with autism, 29 to 60 months of age, had earlier been randomized either to 8 weeks of preschool-based social communication treatment in addition to standard preschool program (n = 34) or to standard preschool program only (n = 27). Significant short-term effects on targeted social communication skills have previously been published. Long-term gains in social communication, language and global social functioning and communication were assessed from video-taped preschool teacher-child and mother-child interactions, Early Social Communication Scales, Reynell Developmental Language Scale, and Social Communication Questionnaire.
Compared with those in the control group, the treated children achieved significantly larger improvements in joint attention and joint engagement from baseline to 12-month follow-up. However, no effects were detected on language and global ratings of social functioning and communication. The treatment effect on child initiation of joint attention increased with increasing level of sociability at baseline, whereas nonverbal IQ and expressive language had no moderating effect.
This study is the first to show that, similar to specialist-delivered treatment, preschool-based treatment may produce small but possibly clinically important long-term changes in social communication in young children with autism. The treatment did not affect language and global ratings of social functioning and communication. More studies are needed to better understand whether treatment effects may be improved by increasing the intensity and duration of the treatment. Clinical trial registration information--Joint Attention Intervention and Young Children With Autism; http://clinicaltrials.gov/; NCT00378157.
本研究报告了一项针对自闭症幼儿的基于幼儿园的社交沟通治疗的随机对照试验的 12 个月随访数据。
共有 61 名（48 名男性）自闭症儿童，年龄在 29 至 60 个月之间，先前随机分为接受基于幼儿园的社交沟通治疗（外加标准幼儿园课程）组（n=34）或仅接受标准幼儿园课程组（n=27）。先前已发表了针对目标社交沟通技能的短期显著效果。从幼儿园教师-儿童和母亲-儿童互动的视频、早期社交沟通量表、雷内尔发展语言量表和社交沟通问卷评估社交沟通、语言和整体社会功能和沟通的长期增益。
与对照组相比，治疗组在从基线到 12 个月随访期间，在共同注意力和共同参与方面的改善显著更大。然而，在语言和整体社会功能和沟通评分方面没有发现影响。治疗对儿童发起共同注意力的效果随着基线时社交能力的增加而增加，而非言语智商和表达语言则没有调节作用。
这项研究是第一个表明，与专业人员提供的治疗类似，基于幼儿园的治疗可能会在自闭症幼儿的社交沟通方面产生小但可能具有临床意义的长期变化。治疗对语言和整体社会功能和沟通评分没有影响。需要更多的研究来更好地理解是否可以通过增加治疗的强度和持续时间来提高治疗效果。临床试验注册信息——共同注意力干预和自闭症幼儿；http://clinicaltrials.gov/；NCT00378157。
