Child and Adolescent Services Research Center (CASRC), University of California San Diego, San Diego, CA, USA.
Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
Autism. 2020 Feb;24(2):338-351. doi: 10.1177/1362361319859726. Epub 2019 Jul 16.
Heterogeneity of treatment response is common in children with autism spectrum disorder. Thus, many providers vary the intervention used based on child characteristics and learning domain. An improved understanding of how to match treatments to different children and domain areas may enhance efforts to individualize treatment and improve treatment response. This study evaluated the relative efficacy of discrete trial training and pivotal response training for teaching young children at risk for autism spectrum disorder receptive and expressive language, play, and imitation skills. Using a single-subject adapted alternating treatments design, children received both the treatments for 12 weeks. Data were collected during treatment and at 3-month follow-up. All participants acquired target skills in both treatments and demonstrated some generalization, maintenance, and spontaneous skill use. Pivotal response training and discrete trial training were each more effective for some children and domains. The results suggest that early rates of learning may be predictive of longer-term treatment response and useful in informing treatment decisions.
自闭症谱系障碍儿童的治疗反应存在异质性。因此，许多治疗师会根据儿童的特点和学习领域来改变干预措施。更好地了解如何将治疗方法与不同的儿童和领域相匹配，可能会增强个性化治疗和提高治疗反应的效果。本研究评估了离散trial 训练和关键反应训练在教授自闭症谱系障碍高风险幼儿接受性和表达性语言、游戏和模仿技能方面的相对效果。使用单一被试适应交替治疗设计，儿童接受两种治疗方法各 12 周。在治疗期间和 3 个月随访时收集数据。所有参与者在两种治疗方法中都获得了目标技能，并表现出一些泛化、维持和自发技能使用。关键反应训练和离散 trial 训练对一些儿童和领域更有效。结果表明，早期的学习速度可能是长期治疗反应的预测因素，并有助于治疗决策。
