Viswanathan Shonima A, Russell Paul S S
Department of Psychiatry, Child and Adolescent Psychiatry Unit, Christian Medical College, Vellore, Tamil Nadu, India.
J Family Med Prim Care. 2019 Jul;8(7):2218-2222. doi: 10.4103/jfmpc.jfmpc_441_19.
The predictive factors of parent mediated, Early Intervention (EI) for children with Autism Spectrum Disorders (ASD) have not been studied in India; we document the structural therapeutic factors, which predict the EI outcome.
Data of 77 children with an ICD 10 diagnosis of Pervasive Developmental Disorder (ASD in DSM 5), and completed a 12-week EI with proven effectiveness was collected from the database of a teaching hospital. We studied the structural therapeutic factors associated with EI outcome, as measured by Psycho-Educational Profile-Revised (PEP-R), while controlling the confounders with multiple linear regression analyses.
The Fine-motor skills improved in residential patients (t = 2.54, = 0.02; 15 units). As the duration of intervention decreased at home per day, there was a significant decrease in Gross-motor skills (t = -2.67, = 0.02; -15 units). With increase in duration of intervention in hospital per day, there was a significant increase (t = 2.86, = 0.01; 30 units) in the Eye-hand integration. Cognitive-verbal skills acquisition decreased (t = -2.90, = 0.01; 33 units) as the duration of intervention decreased at hospital. The use of medication did not predict any of the outcome factors.
The above mentioned predictive factors should be monitored and titrated in the family context when children with ASD undergo parent mediated, EI programme. It is important to that the multidisciplinary family medicine teams reinforce these parents, who are the main column of support in primary-care settings for children with neuro-developmental disabilities in India.
在印度,尚未对自闭症谱系障碍(ASD)儿童的家长介导早期干预(EI)的预测因素进行研究;我们记录了预测EI结果的结构性治疗因素。
从一家教学医院的数据库中收集了77名被国际疾病分类第10版诊断为广泛性发育障碍(相当于DSM-5中的ASD)且完成了为期12周且已证实有效的EI的儿童的数据。我们研究了与EI结果相关的结构性治疗因素,该结果通过修订后的心理教育档案(PEP-R)进行衡量,同时使用多元线性回归分析控制混杂因素。
住院患者的精细运动技能有所改善(t = 2.54,p = 0.02;提高15个单位)。随着在家每天干预时间的减少,粗大运动技能显著下降(t = -2.67,p = 0.02;下降15个单位)。随着在医院每天干预时间的增加,眼手协调能力显著提高(t = 2.86,p = 0.01;提高30个单位)。随着在医院干预时间的减少,认知语言技能的获得有所下降(t = -2.90,p = 0.01;下降33个单位)。药物的使用并未预测任何结果因素。
当患有ASD的儿童接受家长介导的EI项目时,应在家庭环境中监测并调整上述预测因素。多学科家庭医学团队加强这些家长的支持非常重要,在印度,这些家长是初级保健环境中神经发育障碍儿童的主要支持支柱。