KU Marcia Burgess Autism Specific Early Learning and Care Centre (ASELCC) , Liverpool, NSW , Australia ; Academic Unit of Child Psychiatry, School of Psychiatry, University of New South Wales , Sydney, NSW , Australia.
Academic Unit of Child Psychiatry, School of Psychiatry, University of New South Wales , Sydney, NSW , Australia ; Infant, Child and Adolescent Mental Health (ICAMHS), South Western Sydney Local Health District , Liverpool, NSW , Australia.
Front Pediatr. 2014 May 9;2:40. doi: 10.3389/fped.2014.00040. eCollection 2014.
The presence of maladaptive behaviors in young people with autism spectrum disorder (ASD) can significantly limit engagement in treatment programs, as well as compromise future educational and vocational opportunities. This study aimed to explore whether the Early Start Denver Model (ESDM) treatment approach reduced maladaptive behaviors in preschool-aged children with ASD in a community-based long day care setting. The level of maladaptive behavior of 38 children with ASD was rated using an observation-based measure on three occasions during the intervention: on entry, 12 weeks post-entry, and on exit (post-intervention) over an average treatment duration of 11.8 months. Significant reductions were found in children's maladaptive behaviors over the course of the intervention, with 68% of children showing a treatment response by 12 weeks and 79% on exit. This change was accompanied by improvement in children's overall developmental level as assessed by the Mullen scales of early learning, but not by significant changes on the Vineland Adaptive Behavior Scales-II or Social Communication Questionnaire. Replication with a larger sample, control conditions, and additional measures of maladaptive behavior is necessary in order to determine the specific factors underlying these improvements; however, the findings of the present study suggest that the ESDM program may be effective in improving not only core developmental domains, but also decreasing maladaptive behaviors in preschool-aged children with ASD.
自闭症谱系障碍（ASD）儿童的适应不良行为的存在会严重限制其参与治疗计划的程度，并且会影响其未来的教育和职业机会。本研究旨在探索早期丹佛模式（ESDM）治疗方法是否可以减少在社区日间护理环境中接受治疗的学龄前 ASD 儿童的适应不良行为。使用基于观察的措施，在干预的三个时间点（进入、进入 12 周后和退出（干预后））对 38 名 ASD 儿童的适应不良行为进行了评分，平均治疗持续时间为 11.8 个月。在干预过程中，儿童的适应不良行为明显减少，其中 68%的儿童在 12 周时出现治疗反应，79%的儿童在退出时出现治疗反应。这种变化伴随着儿童整体发展水平的提高，根据早期学习的穆伦量表进行评估，但在维兰德适应行为量表-II 或社会沟通问卷上没有显著变化。为了确定这些改善的具体因素，需要在更大的样本、对照条件和额外的适应不良行为措施下进行复制；然而，本研究的结果表明，ESDM 计划不仅可能有效改善核心发展领域，而且可能减少学龄前 ASD 儿童的适应不良行为。
