School of Applied Psychology, Griffith University, Southport, Queensland, Australia.
Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.
J Intellect Disabil Res. 2018 Jul;62(7):650-659. doi: 10.1111/jir.12504. Epub 2018 May 23.
The finding of positive outcomes at the group level for children with autism spectrum disorder (ASD) who complete comprehensive early intervention programmes often masks considerable individual variability. We therefore aimed to identify subgroups of children based on their response to intervention and to compare outcome variables between groups at two points in time.
We used model-based cluster analysis to explore response to intervention using a longitudinal design for 210 children with ASD who had completed an early intervention programme. Children were assessed on entry at time 1 and again at time 2, which was after 12 months or when they exited the programme (whichever came first) using measures of ASD symptoms (Social Communication Questionnaire), cognition (Mullen Scales of Early Learning) and adaptive behaviour (Vineland Adaptive Behaviour Scales-II).
A two-cluster solution was identified, including a high change group who improved consistently more than the low change group across measures, and showed significantly fewer autism symptoms, higher non-verbal and verbal cognition and adaptive behaviour composite scores at time 1.
The findings indicated that children's response to early intervention is not uniform but instead included subgroups characterised by patterns of high and low change. Further research is needed to identify clinically relevant mediators of differential response group membership.
全面早期干预计划完成后，自闭症谱系障碍（ASD）儿童在群体层面上取得积极成果的发现往往掩盖了相当大的个体差异。因此，我们旨在根据他们对干预的反应来确定儿童亚组，并在两个时间点比较组间的结果变量。
我们使用基于模型的聚类分析，通过纵向设计探索 210 名完成早期干预计划的 ASD 儿童对干预的反应。儿童在时间 1 时进行评估，然后在时间 2 时再次进行评估，时间 2 是在 12 个月后或他们退出计划时（以先到者为准），使用 ASD 症状（社交沟通问卷）、认知（Mullen 早期学习量表）和适应行为（Vineland 适应行为量表-II）进行评估。
确定了一个两群解决方案，包括一个高变化组，在所有测量指标上的改善都明显高于低变化组，并且在时间 1 时表现出明显较少的自闭症症状、更高的非言语和言语认知以及适应性行为综合评分。
研究结果表明，儿童对早期干预的反应并不一致，而是包括以高变化和低变化为特征的亚组。需要进一步研究以确定不同反应组特征的临床相关中介因素。
