Murza Kimberly A, Schwartz Jamie B, Hahs-Vaughn Debbie L, Nye Chad
Audiology & Speech Language Sciences, University of Northern Colorado, Greeley, CO, USA.
Communication Sciences and Disorders, University of Central Florida, Orlando, FL, USA.
Int J Lang Commun Disord. 2016 May;51(3):236-51. doi: 10.1111/1460-6984.12212. Epub 2016 Mar 8.
A core social-communication deficit in children with autism spectrum disorder (ASD) is limited joint attention behaviours-important in the diagnosis of ASD and shown to be a powerful predictor of later language ability. Various interventions have been used to train joint attention skills in children with ASD. However, it is unclear which participant, intervention and interventionist factors yield more positive results.
The purpose of this systematic review and meta-analysis was to provide a quantitative assessment of the effectiveness of joint attention interventions aimed at improving joint attention abilities in children with ASD.
METHODS & PROCEDURES: The researchers searched six databases for studies meeting the inclusion criteria at two levels: title/abstract and full-text stages. Two independent coders completed data extraction using a coding manual and form developed specifically for this research study. Meta-analysis procedures were used to determine the overall effects of several comparisons including treatment type, treatment administrator, intervention characteristics and follow-up.
Fifteen randomized experimental studies met inclusion criteria. All comparisons resulted in statistically significant effects, though overlapping confidence intervals suggest that none of the comparisons were statistically different from each other. Specifically, treatment administrator, dosage and design (control or comparison, etc.) characteristics of the studies do not appear to produce significantly different effects.
CONCLUSIONS & IMPLICATIONS: The results of this meta-analysis provide strong support for explicit joint attention interventions for young children with ASD; however, it remains unclear which children with ASD respond to which type of intervention.
自闭症谱系障碍（ASD）儿童的核心社交沟通缺陷是联合注意行为受限——这在ASD诊断中很重要，并且已被证明是后期语言能力的有力预测指标。已采用各种干预措施来训练ASD儿童的联合注意技能。然而，尚不清楚哪些参与者、干预措施和干预者因素能产生更积极的效果。
本系统评价和荟萃分析的目的是对旨在提高ASD儿童联合注意能力的联合注意干预措施的有效性进行定量评估。
研究人员在六个数据库中检索符合纳入标准的研究，分两个阶段进行：标题/摘要阶段和全文阶段。两名独立的编码员使用专门为本研究开发的编码手册和表格完成数据提取。荟萃分析程序用于确定包括治疗类型、治疗实施者、干预特征和随访在内的几项比较的总体效果。
15项随机实验研究符合纳入标准。所有比较均产生了具有统计学意义的效果，尽管置信区间重叠表明没有一项比较在统计学上彼此不同。具体而言，研究的治疗实施者、剂量和设计（对照或比较等）特征似乎并未产生显著不同的效果。
这项荟萃分析的结果为针对ASD幼儿的明确联合注意干预提供了有力支持；然而，尚不清楚哪些ASD儿童对哪种类型的干预有反应。
