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一项针对 ASD 成人的过渡支持计划的 RCT 结果:对自我决定和生活质量的影响。

Results of a RCT on a Transition Support Program for Adults with ASD: Effects on Self-Determination and Quality of Life.

机构信息

School of Communication Sciences and Disorders, McGill University, and Centre for Research on Brain Language and Music, Montreal, QC, Canada.

Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada.

出版信息

Autism Res. 2018 Dec;11(12):1712-1728. doi: 10.1002/aur.2027. Epub 2018 Nov 19.

Abstract

Few evidence-based services exist for people with Autism Spectrum Disorder (ASD) as they transition into adulthood, particularly those that foster appreciation of one's own goals and strengths. We developed a transition service for adults with ASD (without Intellectual Disability), and conducted a randomized controlled trial (RCT) focusing on self-report of Quality of Life and Self-Determination outcomes. Thirty participants aged 18-29 were randomized to immediate or delayed intervention, with 26 participants analyzed after 4 were lost to follow-up. Curriculum was tailored to participants' self-expressed needs in three areas: social communication, self-determination, and working with others. Groups of four-to-six participants with ASD and two facilitators met weekly for 10 weeks. Positive intervention effects were observed on self-report of Quality of Life; the intervention group scored on average 2 points higher than the control group, 95% CI [-0.2, 3.9]. Positive effects were also observed on the Self Determination Scale (Interpersonal Cognitive Problem-Solving subdomain), where the intervention group scored 2 points higher than control group 95% CI [0.082, 3.4]. In addition, participants rated skills targeted by the curriculum 6 points higher after versus before intervention, 95% CI [3.7, 8.6]. This was echoed by a subset of parents rating their child's skills as seven points higher after versus before intervention, 95% CI [1, 14]. Autism Research 2018, 11: 1712-1728. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: These findings indicate that it is possible to increase Self-Determination and subjective Quality of Life in adults with ASD through a brief group-format service, and provide a model for doing so. Self-Determination abilities are linked to improved adult outcomes in individuals with other disabilities. These often overlooked factors should be incorporated in programming for adults with ASD as they transition to adulthood.

摘要

针对自闭症谱系障碍(ASD)患者成年过渡阶段,目前存在的循证服务很少,特别是那些培养人们欣赏自身目标和优势的服务。我们为 ASD 成人(无智力残疾)开发了一项过渡服务,并进行了一项随机对照试验(RCT),重点关注生活质量和自我决定的自我报告结果。30 名年龄在 18-29 岁的参与者被随机分配到立即干预组或延迟干预组,其中 26 名参与者在随访中失去 4 名后进行了分析。课程根据参与者在三个领域的自我表达需求进行了调整:社会沟通、自我决定和与他人合作。4-6 名 ASD 参与者和 2 名协调员组成一组,每周会面一次,为期 10 周。在生活质量的自我报告中观察到了积极的干预效果;干预组的平均得分比对照组高 2 分,95%置信区间[-0.2, 3.9]。在自我决定量表(人际认知解决问题子域)上也观察到了积极的效果,干预组的得分比对照组高 2 分,95%置信区间[0.082, 3.4]。此外,参与者在干预后对课程目标技能的评价比干预前高 6 分,95%置信区间[3.7, 8.6]。这与一组父母对孩子技能的评价相呼应,他们在干预后比干预前的评价高 7 分,95%置信区间[1, 14]。自闭症研究 2018, 11: 1712-1728. © 2018 国际自闭症研究协会,威利在线期刊,公司。

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