Department of Pediatrics, Emory University School of Medicine, 1920 Briarcliff Road NE, Atlanta, GA, USA.
Marcus Autism Center, 1920 Briarcliff Road NE, Atlanta, GA, USA.
Clin Child Fam Psychol Rev. 2017 Dec;20(4):391-402. doi: 10.1007/s10567-017-0237-2.
Parent training (PT) has emerged as a promising treatment for disruptive behavior in children with autism spectrum disorder (ASD). This review summarizes the essential elements of PT for disruptive behavior in children with ASD and evaluates the available evidence for PT using both descriptive and meta-analytic procedures. We searched Medline, PsycINFO, and PubMed databases (1980-2016) in peer-reviewed journals for randomized controlled trials (RCTs) of PT for disruptive behavior in children with ASD. The systematic search of 2023 publications yielded eight RCTs involving a total of 653 participants. We calculated effect sizes using either raw post-treatment means and standard deviations for each treatment group (PT and control) or group mean differences with associated 95% confidence intervals (CIs). Differences in post-treatment means were converted to a standardized difference in means (SMD) for each primary outcome. Results support the efficacy of PT for disruptive behavior in children with ASD, with a SMD of -0.59 [95% CI (-0.88, -0.30); p < 0.001]. Across these eight studies, there was significant heterogeneity in the effect of PT on disruptive behavior. This variability is likely due to differences in sample size, number of treatment sessions, study duration, and control condition employed. Current findings provide solid support for the efficacy of PT for disruptive behavior in children with ASD. Future studies should focus on effectiveness trials to promote wider implementation of PT in clinical settings.
家长培训(PT)已成为治疗自闭症谱系障碍(ASD)儿童破坏性行为的一种有前途的方法。本综述总结了针对 ASD 儿童破坏性行为的 PT 的基本要素,并使用描述性和荟萃分析程序评估了针对 PT 的现有证据。我们在同行评议期刊的 Medline、PsycINFO 和 PubMed 数据库中(1980-2016 年)搜索了针对 ASD 儿童破坏性行为的 PT 的随机对照试验(RCT)。对 2023 项出版物的系统搜索共产生了 8 项 RCT,涉及 653 名参与者。我们使用每组(PT 和对照组)的原始治疗后平均值和标准差或组平均值差异及其相关的 95%置信区间(CI)计算效应大小。治疗后平均值的差异转换为每个主要结果的标准化均数差异(SMD)。结果支持 PT 对 ASD 儿童破坏性行为的疗效,SMD 为-0.59 [95%CI (-0.88, -0.30); p < 0.001]。在这八项研究中,PT 对破坏性行为的影响存在显著的异质性。这种可变性可能归因于样本量、治疗次数、研究持续时间和使用的对照条件的差异。目前的研究结果为 PT 治疗 ASD 儿童破坏性行为的疗效提供了有力支持。未来的研究应侧重于有效性试验,以促进 PT 在临床环境中的更广泛实施。