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在儿童保育环境中对有自闭症和其他发育迟缓风险的幼儿进行发育筛查和早期干预:一项可行性试验。

Developmental screening and early intervention in a childcare setting for young children at risk for autism and other developmental delays: A feasibility trial.

机构信息

University of California, Los Angeles, California.

The University of California, San Diego, California.

出版信息

Autism Res. 2019 Sep;12(9):1423-1433. doi: 10.1002/aur.2160. Epub 2019 Jun 26.

Abstract

Efforts to decrease disparity in diagnosis and treatment for under-resourced children with developmental delays, such as autism spectrum disorder, have led to increased interest in developing programs in community settings. One potential setting that has already demonstrated feasibility in conducting universal screening is the childcare setting. The current study conducted developmental screening in a total of 116 children ages 16-80 months of age in an urban low-income community childcare center. Parents of 20 children who screened positive were enrolled in the intervention phase of the study, where children received a staff-delivered targeted early intervention or a waitlist control condition. Given the small and imbalanced sample sizes, confidence intervals from mixed effect models were used to measure changes across time for each group. Of the children who received treatment, there was an average increase in child initiated joint engagement, symbolic play, and language use. This study provides initial feasibility data for the implementation of a screening and early intervention program to service a predominantly low-resource and ethnically diverse population within the childcare system in a large metropolitan city. Autism Res 2019, 12: 1423-1433. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Identifying and delivering treatment services for young children with developmental delays, such as autism spectrum disorder, may be most successful in community settings, especially for those children from under-resourced areas. This study found preliminary evidence that the childcare setting is a good place to conduct screening and deliver early interventions for children at risk for autism and other developmental delays.

摘要

努力减少资源匮乏的发育迟缓儿童(如自闭症谱系障碍)在诊断和治疗方面的差距,促使人们越来越关注在社区环境中开展项目。在开展普遍筛查方面,已经有一个潜在环境证明了其可行性,那就是儿童保育环境。本研究在一个城市低收入社区的儿童保育中心共对 116 名 16-80 个月大的儿童进行了发育筛查。对 20 名筛查呈阳性的儿童的家长进行了研究的干预阶段的登记,这些儿童接受了由工作人员提供的有针对性的早期干预或候补对照条件。由于样本量小且不平衡,混合效应模型的置信区间用于衡量每个组随时间的变化。在接受治疗的儿童中,儿童发起的联合参与、象征性游戏和语言使用方面平均有所增加。本研究为在大都市的儿童保育系统中为主要资源匮乏和种族多样化的人群实施筛查和早期干预计划提供了初步可行性数据。自闭症研究 2019 年,12:1423-1433. © 2019 自闭症国际研究协会,威利期刊公司。概述:为发育迟缓的幼儿(如自闭症谱系障碍)识别和提供治疗服务,在社区环境中可能最成功,尤其是对于那些来自资源匮乏地区的儿童。本研究初步发现证据表明,儿童保育环境是对自闭症和其他发育迟缓风险儿童进行筛查和提供早期干预的好地方。

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