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针对自闭症谱系障碍幼儿和学龄前儿童核心症状及语言发展的基于实证的发展与行为干预项目

[Empirically based developmental and behavioral intervention programs targeting the core symptoms and language development in toddlers and preschool children with autism spectrum disorder].

作者信息

Freitag Christine M., Jensen Katrin, Teufel Karoline, Luh Marvin, Todorova Antoaneta, Lalk Christopher, Vllasaliu Leonora

机构信息

Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Autismus-Therapie- und Forschungszentrum, Universitätsklinikum Frankfurt, Goethe-Universität Frankfurt am Main.

Institut für Medizinische Biometrie und Informatik (IMBI), Universitätsklinikum Heidelberg.

出版信息

Z Kinder Jugendpsychiatr Psychother. 2020;48(3):224-243. doi: 10.1024/1422-4917/a000714. Epub 2020 Mar 16.

Abstract

Empirically based developmental and behavioral intervention programs targeting the core symptoms and language development in toddlers and preschool children with autism spectrum disorder This systematic review summarizes findings of articles included in the German AWMF-S3 clinical guideline on early intervention in autism spectrum disorders (ASD). We present the current state-of the art of evidence-based interventions for toddlers and preschool-aged children with ASD, specifically targeting the core symptoms and language development. We included studies on manualized developmental and behavioral interventions for children with ASD aged <7 years according to DSM-III(R), DSM-IV(TR), DSM-5, and ICD-10. The publication dates ranged from 1 January 2011 to 31 August 2018 or as included in the NICE-children guidelines. Studies were included by an iterative hierarchy: systematic review > randomized-controlled trial > clinically controlled trial. Outcome measures were core ASD symptoms and precursor abilities, or language abilities. The interventions were collated by (1) frequency and (2) approach. The studies focused on low-intensive interventions targeting parental synchrony, the child's initiations, reciprocity, joint attention, play and imitation skills as well as comprehensive interventions. Improvement of core ASD symptoms regarding social communication was observed for low-intensive training of parental synchrony and child's reciprocity as well as for low-intensive comprehensive developmental interventions implementing natural-learning paradigms. High-frequency discrete trial interventions did not improve social communication. Language abilities improved by comprehensive interventions. In conclusion, intervention recommendations are summarized.

摘要

针对自闭症谱系障碍幼儿和学龄前儿童核心症状及语言发展的基于实证的发展和行为干预项目 本系统评价总结了德国AWMF-S3关于自闭症谱系障碍(ASD)早期干预的临床指南中所纳入文章的研究结果。我们展示了针对ASD幼儿和学龄前儿童基于证据的干预措施的当前技术水平,特别针对核心症状和语言发展。我们纳入了根据《精神疾病诊断与统计手册》第三版(修订版)、第四版(修订版)、第五版以及《国际疾病分类》第十版,对年龄小于7岁的ASD儿童进行的标准化发展和行为干预研究。出版日期范围为2011年1月1日至2018年8月31日,或纳入英国国家卫生与临床优化研究所(NICE)儿童指南中的日期。研究通过迭代层次纳入:系统评价>随机对照试验>临床对照试验。结局指标为ASD核心症状、前驱能力或语言能力。干预措施按(1)频率和(2)方法进行整理。研究聚焦于针对父母同步性、儿童主动性、互惠性、共同注意、玩耍和模仿技能的低强度干预以及综合干预。观察到,对于父母同步性和儿童互惠性的低强度训练以及实施自然学习范式的低强度综合发展干预,ASD社会沟通方面的核心症状有所改善。高频离散试验干预并未改善社会沟通。综合干预使语言能力得到提高。总之,总结了干预建议。

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