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自闭症谱系障碍幼儿社会 ABCs 照护者介导干预的跨站点随机对照试验。

Cross-site randomized control trial of the Social ABCs caregiver-mediated intervention for toddlers with autism spectrum disorder.

机构信息

Autism Research Centre, Bloorview Research Institute/University of Toronto, Toronto, ON.

Departments of Pediatrics and Psychology & Neuroscience, Dalhousie University, Halifax, NS.

出版信息

Autism Res. 2017 Oct;10(10):1700-1711. doi: 10.1002/aur.1818. Epub 2017 Jun 2.

Abstract

To evaluate the efficacy of the Social ABCs parent-mediated intervention for toddlers with suspected or confirmed autism spectrum disorder (ASD), through a cross-site randomized control trial, sixty-three parent-toddler dyads (toddler age: 16-30 months) were randomized into treatment (Social ABCs) or control (service-as-usual) conditions. Video data were obtained at three key time-points: Baseline; Post-training (PT; week 12); and Follow-Up (week 24). Analyses included 62 dyads. Treatment allocation significantly accounted for PT gains, all favouring the Treatment group, in (1) child functional vocal responsiveness to parent prompts (R  = 0.43, P < .001), (2) child vocal initiations (R  = 0.28, P < .001), (3) parent smiling (R  = 0.09, P = .017), and (4) fidelity of implementation (R  = 0.71, P < .001). A trend was observed for increased social orienting (R  = 0.06, P = 0.054); gains in parent smiling significantly predicted increases in child smiling and social orienting. Parents in the treatment condition reported significant gains in self-efficacy following the intervention (P = 0.009). No differential effects emerged for performance on standardized measures. The Social ABCs is a relatively low-resource, efficacious intervention, with potential to be a cost-effective means of intervening at the first signs of possible ASD. Autism Res 2017, 10: 1700-1711. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Clinical Trial Title: Social ABCs for Toddlers with Signs of Autism Spectrum Disorder: RCT of a Parent-Mediated Intervention http//ClinicalTrials.gov identifier: NCT02428452.

摘要

为了评估社会 ABC 家长介导干预对疑似或确诊自闭症谱系障碍(ASD)幼儿的疗效,通过一项跨站点随机对照试验,将 63 对家长-幼儿对子(幼儿年龄:16-30 个月)随机分为治疗(社会 ABC)或对照组(常规服务)。在三个关键时间点获取视频数据:基线;培训后(PT;第 12 周);和随访(第 24 周)。分析包括 62 对。治疗分配显著解释了 PT 收益,所有这些都有利于治疗组,在(1)儿童对父母提示的功能性发声反应(R=0.43,P<0.001),(2)儿童发声发起(R=0.28,P<0.001),(3)家长微笑(R=0.09,P=0.017),和(4)实施保真度(R=0.71,P<0.001)。观察到社会定向(R=0.06,P=0.054)增加的趋势;家长微笑的增加显著预测了儿童微笑和社会定向的增加。接受干预后,治疗组的家长自我效能感显著提高(P=0.009)。在标准化测量上没有出现差异效果。社会 ABC 是一种相对资源较少、有效的干预措施,有可能成为早期干预自闭症的一种具有成本效益的手段。自闭症研究 2017, 10: 1700-1711。©2017 国际自闭症研究协会,威利期刊,公司。临床试验标题:社会 ABC 对有自闭症谱系障碍迹象的幼儿:家长介导干预的 RCT http//ClinicalTrials.gov 标识符:NCT02428452。

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