Zwaigenbaum Lonnie, Bauman Margaret L, Choueiri Roula, Kasari Connie, Carter Alice, Granpeesheh Doreen, Mailloux Zoe, Smith Roley Susanne, Wagner Sheldon, Fein Deborah, Pierce Karen, Buie Timothy, Davis Patricia A, Newschaffer Craig, Robins Diana, Wetherby Amy, Stone Wendy L, Yirmiya Nurit, Estes Annette, Hansen Robin L, McPartland James C, Natowicz Marvin R
Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada;
Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts;
Pediatrics. 2015 Oct;136 Suppl 1(Suppl 1):S60-81. doi: 10.1542/peds.2014-3667E.
This article reviews current evidence for autism spectrum disorder (ASD) interventions for children aged <3 years, based on peer-reviewed articles published up to December 2013. Several groups have adapted treatments initially designed for older, preschool-aged children with ASD, integrating best practice in behavioral teaching methods into a developmental framework based on current scientific understanding of how infants and toddlers learn. The central role of parents has been emphasized, and interventions are designed to incorporate learning opportunities into everyday activities, capitalize on "teachable moments," and facilitate the generalization of skills beyond the familiar home setting. Our review identified several comprehensive and targeted treatment models with evidence of clear benefits. Although some trials were limited to 8- to 12-week outcome data, enhanced outcomes associated with some interventions were evaluated over periods as long as 2 years. Based on this review, recommendations are proposed for clinical practice and future research.
本文基于截至2013年12月发表的同行评审文章,综述了针对3岁以下儿童自闭症谱系障碍(ASD)干预措施的当前证据。几个研究团队对最初为年龄较大的学龄前ASD儿童设计的治疗方法进行了调整,将行为教学方法的最佳实践融入到基于当前对婴幼儿学习方式的科学理解的发展框架中。父母的核心作用得到了强调,干预措施旨在将学习机会融入日常活动中,利用“可教时刻”,并促进技能在熟悉的家庭环境之外的泛化。我们的综述确定了几种具有明显益处证据的全面且有针对性的治疗模式。尽管一些试验仅限于8至12周的结果数据,但某些干预措施带来的改善结果在长达2年的时间内进行了评估。基于此综述,提出了针对临床实践和未来研究的建议。