Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Perelman School of Medicine, University of Pennsylvania, Philadelphia.
J Am Acad Child Adolesc Psychiatry. 2020 Mar;59(3):373-380. doi: 10.1016/j.jaac.2019.03.029. Epub 2019 Apr 3.
Computer-assisted interventions (CAIs) are popular for educating children with autism, but their effectiveness is not well established. This study evaluated the effectiveness of 1 CAI designed to improve children's language, cognitive, and academic skills, TeachTown: Basics, in a large urban school district.
Teachers (n = 59) in autism support classrooms and their consented students in kindergarten through second grade (n = 154) were randomized to TeachTown: Basics or waitlist control. Child outcome was measured at baseline and after 1 academic year using the Bracken Basic Concepts Scale-Receptive and Expressive versions and the Differential Ability Scales, Second Edition (DAS-II). Random effects regression models that included clustering of time within students and students within classrooms were used to test whether the change over time in each outcome differed between groups.
There were no statistically significant differences in outcomes for children who received TeachTown: Basics or treatment as usual. Increased time spent using TeachTown: Basics was associated with worse receptive language outcomes for children in the experimental group after 1 academic year. However, there was no association between minutes spent using TeachTown and changes in expressive language or DAS-II score.
Despite growing enthusiasm for CAIs in autism treatment, the present findings indicate that CAI might not be effective at improving language and cognitive outcomes for children with autism spectrum disorder. The decision to implement CAIs in schools should be carefully balanced against the evidence for effectiveness of these programs. Schools might be better served by investing in treatment strategies with established evidence.
RCT of TeachTown in Autism Support Classrooms: Innovation and Exnovation; https://clinicaltrials.gov/; NCT02695693.
计算机辅助干预(CAI)在自闭症儿童教育中很受欢迎,但它们的效果尚未得到充分证实。本研究评估了一款旨在提高儿童语言、认知和学术技能的 CAI——TeachTown:基础知识,在一个大型城市学区的有效性。
自闭症支持教室的教师(n=59)及其同意的幼儿园至二年级(n=154)学生被随机分配到 TeachTown:基础知识或候补控制组。使用 Bracken 基本概念量表接受性和表达性版本和差异能力量表,第二版(DAS-II),在基线和 1 个学年后测量儿童的结果。包括学生和班级内时间聚类的随机效应回归模型用于测试组间每个结果随时间变化是否存在差异。
接受 TeachTown:基础知识或常规治疗的儿童在结果上没有统计学上的显著差异。实验组儿童在接受治疗 1 学年后,接受 TeachTown:基础知识的时间增加与接受性语言结果较差相关。然而,使用 TeachTown 的分钟数与表达性语言或 DAS-II 分数的变化之间没有关联。
尽管 CAI 在自闭症治疗中越来越受到欢迎,但目前的研究结果表明,CAI 可能无法有效改善自闭症谱系障碍儿童的语言和认知结果。在学校实施 CAI 的决定应根据这些项目的有效性证据仔细权衡。学校可能最好投资于具有既定证据的治疗策略。
TeachTown 在自闭症支持教室中的 RCT:创新和拓展;https://clinicaltrials.gov/;NCT02695693。