Department of Special Education.
Lynch School of Education and Human Development.
Psychol Bull. 2020 Jan;146(1):1-29. doi: 10.1037/bul0000215. Epub 2019 Nov 25.
In this comprehensive systematic review and meta-analysis of group design studies of nonpharmacological early interventions designed for young children with autism spectrum disorder (ASD), we report summary effects across 7 early intervention types (behavioral, developmental, naturalistic developmental behavioral intervention [NDBI], TEACCH, sensory-based, animal-assisted, and technology-based), and 15 outcome categories indexing core and related ASD symptoms. A total of 1,615 effect sizes were gathered from 130 independent participant samples. A total of 6,240 participants, who ranged in age from 0-8 years, are represented across the studies. We synthesized effects within intervention and outcome type using a robust variance estimation approach to account for the nesting of effect sizes within studies. We also tracked study quality indicators, and report an additional set of summary effect sizes that restrict included studies to those meeting prespecified quality indicators. Finally, we conducted moderator analyses to evaluate whether summary effects across intervention types were larger for proximal as compared with distal effects, and for context-bound as compared to generalized effects. We found that when study quality indicators were not taken into account, significant positive effects were found for behavioral, developmental, and NDBI intervention types. When effect size estimation was limited to studies with randomized controlled trial (RCT) designs, evidence of positive summary effects existed only for developmental and NDBI intervention types. This was also the case when outcomes measured by parent report were excluded. Finally, when effect estimation was limited to RCT designs and to outcomes for which there was no risk of detection bias, no intervention types showed significant effects on any outcome. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
在这项针对自闭症谱系障碍(ASD)幼儿的非药物性早期干预的小组设计研究的综合系统评价和荟萃分析中,我们报告了 7 种早期干预类型(行为、发育、自然发展行为干预[NDBI]、TEACCH、基于感觉的、动物辅助和基于技术的)和 15 个结果类别在核心和相关 ASD 症状方面的综合效果。从 130 个独立的参与者样本中收集了 1615 个效应量。共有 6240 名年龄在 0-8 岁之间的参与者分布在这些研究中。我们使用稳健的方差估计方法在干预和结果类型内综合效果,以解释研究内效应大小的嵌套性。我们还跟踪了研究质量指标,并报告了另一组汇总效应大小,这些大小限制了包括符合特定质量指标的研究。最后,我们进行了调节分析,以评估干预类型的综合效果是否大于近端效果与远端效果,以及上下文相关效果与广义效果。我们发现,当不考虑研究质量指标时,行为、发育和 NDBI 干预类型都有显著的积极效果。当效应量估计仅限于随机对照试验(RCT)设计的研究时,只有发育和 NDBI 干预类型存在积极的综合效果。当排除父母报告测量的结果时也是如此。最后,当效应估计仅限于 RCT 设计和不存在检测偏差风险的结果时,没有任何干预类型对任何结果显示出显著效果。(PsycINFO 数据库记录(c)2019 APA,保留所有权利)。