van der Meer Larah, Matthews Tamyra, Ogilvie Emily, Berry Alice, Waddington Hannah, Balandin Susan, O'Reilly Mark F, Lancioni Giulio, Sigafoos Jeff
School of Education, Victoria University of Wellington, New Zealand.
School of Health and Social Development, Deakin University, Geelong, Victoria, Australia.
Am J Speech Lang Pathol. 2017 Nov 8;26(4):1279-1295. doi: 10.1044/2017_AJSLP-16-0125.
The aim of this review was to summarize and evaluate studies on training direct-care staff to provide communication intervention to adults with intellectual disability.
Systematic searches identified 22 studies. These were summarized and evaluated in terms of (a) participants; (b) settings; (c) training aims and procedures; (d) research designs; (e) reliability, integrity, and social validity; (f) outcomes; (g) generalization and follow-up; and (h) certainty of evidence.
A total of 437 staff and 254+ adults with intellectual disability participated. Staff training most frequently involved combinations of verbal instruction, role play, modeling, practice, and feedback. Reliability was assessed in 18 studies with acceptable standards for most of these studies. Treatment integrity and social validity were assessed in 1 and 3 studies, respectively, with positive outcomes. Generalization and maintenance were assessed in 5 and 8 studies, respectively, with predominantly positive outcomes. Most studies reported positive outcomes for staff and positive or mixed outcomes for the adults with intellectual disability. Certainty of evidence was rated as conclusive in 1 study, suggestive in 14 studies, and inconclusive in 7 studies.
There is sufficient evidence to conclude that direct-care staff can be taught to provide effective communication intervention to adults with intellectual disability. Professionals involved in providing training and support to direct-care staff could expect positive outcomes from multicomponent training programs that include opportunities for practice and feedback.
本综述旨在总结和评估关于培训直接护理人员为成年智障人士提供沟通干预的研究。
系统检索确定了22项研究。从以下方面对这些研究进行了总结和评估：(a)参与者；(b)环境；(c)培训目标和程序；(d)研究设计；(e)信度、完整性和社会效度；(f)结果；(g)推广和随访；(h)证据的确定性。
共有437名工作人员和254名以上成年智障人士参与。工作人员培训最常涉及口头指导、角色扮演、示范、练习和反馈的组合。18项研究评估了信度，其中大多数研究的标准可接受。分别有1项和3项研究评估了治疗完整性和社会效度，结果均为阳性。分别有5项和8项研究评估了推广和维持情况，结果大多为阳性。大多数研究报告工作人员取得了积极成果，成年智障人士取得了积极或混合成果。1项研究将证据确定性评为结论性，14项研究为提示性，7项研究为非结论性。
有充分证据表明，可以教会直接护理人员为成年智障人士提供有效的沟通干预。参与为直接护理人员提供培训和支持的专业人员可以预期，包括练习和反馈机会的多成分培训项目会取得积极成果。
