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系统综述:影响自闭症谱系障碍幼儿家长介导干预效果和可推广性的因素。

Systematic review of factors that may influence the outcomes and generalizability of parent-mediated interventions for young children with autism spectrum disorder.

机构信息

Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.

Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada.

出版信息

Autism Res. 2019 Sep;12(9):1304-1321. doi: 10.1002/aur.2168. Epub 2019 Jul 11.

Abstract

Parent mediated interventions have the potential to positively influence the interactions and developmental outcomes of children with autism spectrum disorder (ASD). However, a range of factors relating to children, parents and caregivers, and study design may impact on outcomes and thus the generalizability of these interventions to the broader community. The objective of this review was to examine factors that may influence the feasibility, appropriateness, effectiveness, and generalizability of parent mediated interventions for children with ASD. We conducted a systematic review, yielding 41 articles. There was substantial variability in the intervention type, intensity, and study quality. Notably, 46 different inclusion/exclusion criteria were reported across studies including factors relating to children's development, access to other services, comorbidities, parental factors, and access to the intervention. Fifteen articles included examination of 45 different factors potentially associated with, or influencing, intervention outcomes including child (e.g., language skills, ASD severity, cognition) and parent (e.g., adherence and fidelity, education) factors. Although there is clear evidence for an increasingly sophisticated (e.g., systematic phased research for some interventions) and diverse (e.g., studies in geographical diverse contexts including low-resource communities) approach to research examining parent mediated interventions, there remains a need for improved study quality and measurement consistency in research, including a detailed examination of factors that may predict, moderate, and mediate intervention effectiveness for children and their parents. Autism Res 2019, 12: 1304-1321. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Parent mediated interventions-in which parents adapt their own behavior or deliver interventions to help their children learn-appear to be effective for some children with autism spectrum disorder. In this review, we identified a range of child, parent, and study design factors that may influence intervention outcomes and ultimately the uptake of these approaches in the community. We suggest that research in this area could be further improved by ensuring that studies include diverse groups of children and parents, and by using study designs that help to establish not only if interventions work, but for whom they work best and why.

摘要

家长介导的干预措施有可能对自闭症谱系障碍(ASD)儿童的互动和发展结果产生积极影响。然而,与儿童、父母和照顾者以及研究设计相关的一系列因素可能会影响结果,从而影响这些干预措施在更广泛社区中的可推广性。本综述的目的是研究可能影响自闭症谱系障碍儿童家长介导干预措施的可行性、适当性、有效性和可推广性的因素。我们进行了系统综述,共纳入 41 篇文章。干预类型、强度和研究质量存在很大差异。值得注意的是,46 项不同的纳入/排除标准在研究中报告,包括与儿童发展、获得其他服务、合并症、父母因素和干预措施获得相关的因素。15 篇文章探讨了 45 个可能与干预结果相关或影响干预结果的不同因素,包括儿童(例如,语言技能、ASD 严重程度、认知)和父母(例如,依从性和保真度、教育)因素。尽管有明确的证据表明,针对家长介导干预措施的研究方法越来越复杂(例如,一些干预措施采用系统分阶段研究)和多样化(例如,在包括资源匮乏社区在内的地理多样化背景下进行研究),但仍需要提高研究质量和测量一致性,包括详细研究可能预测、调节和介导儿童及其父母干预效果的因素。Autism Res 2019, 12: 1304-1321. © 2019 国际自闭症研究协会,Wiley 期刊,公司。

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