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社区环境中综合强化早期干预后自闭症症状的改善

Improvement of Autism Symptoms After Comprehensive Intensive Early Interventions in Community Settings.

作者信息

Haglund Nils, Dahlgren SvenOlof, Råstam Maria, Gustafsson Peik, Källén Karin

机构信息

Nils Haglund, PhD, Lund University, Lund, Sweden.

SvenOlof Dahlgren, PhD, University of Gothenburg, Gothenburg, Sweden.

出版信息

J Am Psychiatr Nurses Assoc. 2021 Nov-Dec;27(6):483-495. doi: 10.1177/1078390320915257. Epub 2020 Apr 23.

Abstract

BACKGROUND

Preschool children with autism in southern Sweden participated in a comprehensive Naturalistic Developmental Behavioral Intervention (NDBI) program.

AIMS

To evaluate the ongoing NDBI program by comparing the pre- and postintervention outcomes in terms of improved autism symptom severity.

METHOD

The improvement of Autism Diagnostic Observation Schedule (ADOS-R) test results between baseline and evaluation among children participating in the NDBI program ( = 67) was compared with the results among children receiving community treatment as usual ( = 27) using analysis of covariance.

RESULTS

The study showed that children in the NDBI group improved their ADOS-R total scores between baseline and evaluation (-0.8 scores per year; 95% CI [-1.2, -0.4]), whereas no improvement was detected in the comparison group (+0.1 scores per year; 95% CI [-0.7, +0.9]). The change in the NDBI group versus the change in the comparison group was statistically significant after adjusting for possible confounders as well. Children in the NDBI group also significantly improved their ADOS severity scores, but the scores were not significantly different from those of the comparison group.

CONCLUSIONS

The results from the current naturalistic study must be interpreted cautiously, but they do support earlier studies reporting on improvement of autism symptoms after early intensive interventions. Results from observational studies are difficult to interpret, but it is nevertheless of uttermost importance to evaluate costly autism intervention programs. The results do indicate that children with autism benefit from participating in early comprehensive intensive programs.

摘要

背景

瑞典南部的自闭症学龄前儿童参与了一项全面的自然主义发展行为干预(NDBI)计划。

目的

通过比较干预前后自闭症症状严重程度的改善情况来评估正在进行的NDBI计划。

方法

使用协方差分析,将参与NDBI计划的儿童(n = 67)在基线和评估之间的自闭症诊断观察量表(ADOS-R)测试结果的改善情况与接受常规社区治疗的儿童(n = 27)的结果进行比较。

结果

研究表明,NDBI组的儿童在基线和评估之间提高了他们的ADOS-R总分(每年-0.8分;95%CI[-1.2,-0.4]),而在对照组中未检测到改善(每年+0.1分;95%CI[-0.7,+0.9])。在调整了可能的混杂因素后,NDBI组与对照组的变化在统计学上也具有显著差异。NDBI组的儿童也显著提高了他们的ADOS严重程度评分,但与对照组的评分没有显著差异。

结论

当前自然主义研究的结果必须谨慎解释,但它们确实支持了早期关于早期强化干预后自闭症症状改善的研究报告。观察性研究的结果难以解释,但评估成本高昂的自闭症干预计划仍然至关重要。结果确实表明,自闭症儿童从参与早期全面强化计划中受益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/684a/8581718/e32f2ffc09f4/10.1177_1078390320915257-fig1.jpg

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