Department of Psychiatry and Behavior Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Autism Res. 2020 Jul;13(7):1072-1078. doi: 10.1002/aur.2308. Epub 2020 Apr 23.
This study evaluated the feasibility, acceptance, and potential clinical benefit of brief applied behavior analysis (ABA)-based interventions for children and adolescents with autism spectrum disorder (ASD) displaying challenging behaviors during hospitalizations. Participants included 36 children diagnosed with ASD, 6-17 years of age, who were medically or psychiatrically hospitalized. Children in the intervention group received a brief ABA intervention and were compared to children in the evaluation and monitoring-only group. Families and staff recommended the intervention, children receiving the intervention demonstrated significantly more improvement in unblinded ratings of clinical severity, data from physicians indicated a positive effect of the intervention on levels of staffing and restraints and attending medical providers universally reported satisfaction and benefit of the intervention. Improvements in challenging behaviors were not significantly different as reported by parents, and the length of hospitalization did not differ between the groups. Ultimately, the outcomes of this pilot study suggest incorporating specialized ABA-based assessment and intervention during hospitalization may be feasible and well accepted by clinicians and families. However, future research must address potent methodological challenges related to capturing meaningful data during hospitalizations in order to answer questions of ultimate pragmatic, clinical, and system-level benefits. Trial Registration ClinicalTrials.gov Identifier NCT02339935, Registered 16 January 2015, First participant consented 23 February 2015. Autism Res 2020, 13: 1072-1078. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Inpatient hospitalizations for children with autism spectrum disorder (ASD) and severe behavior are common, challenging, and costly in terms of human experience. This study evaluated the benefit of brief applied behavior analysis-based interventions to children and adolescents with ASD displaying challenging behaviors during hospitalizations. Families and staff evaluating the procedures noted perceived potential benefits of the intervention, but this initial pilot study did not document changes in hospitalization length or blinded rating of improvement.
这项研究评估了针对在住院期间表现出挑战性行为的自闭症谱系障碍（ASD）儿童和青少年进行简短应用行为分析（ABA）干预的可行性、可接受性和潜在临床益处。参与者包括 36 名被诊断患有 ASD 的儿童，年龄在 6-17 岁之间，他们因医疗或精神原因住院。干预组的儿童接受了简短的 ABA 干预，并与仅接受评估和监测的组的儿童进行了比较。家庭和工作人员推荐了干预措施，接受干预的儿童在临床严重程度的非盲评估中表现出显著的改善，医生的数据表明干预对人员配备和约束的水平有积极影响，主治医疗服务提供者普遍报告对干预的满意和受益。父母报告的挑战行为改善程度没有显著差异，两组的住院时间也没有差异。最终，这项试点研究的结果表明，在住院期间纳入专门的基于 ABA 的评估和干预可能是可行的，并且得到了临床医生和家庭的认可。然而，未来的研究必须解决在住院期间获取有意义数据的潜在方法学挑战，以便回答最终在实践、临床和系统层面上的有益问题。试验注册 ClinicalTrials.gov 标识符 NCT02339935，于 2015 年 1 月 16 日注册，第一位参与者同意于 2015 年 2 月 23 日同意。自闭症研究 2020，13：1072-1078。©2020 自闭症国际研究协会，威利期刊，公司。 摘要：自闭症谱系障碍（ASD）儿童和严重行为患者的住院治疗在人类体验方面是常见的、具有挑战性的和昂贵的。本研究评估了针对在住院期间表现出挑战性行为的 ASD 儿童和青少年进行简短应用行为分析（ABA）干预的益处。评估程序的家庭和工作人员指出了干预措施的潜在好处，但这项初步试点研究没有记录住院时间或盲法评估改善的变化。
