采用多模式干预对边缘智力功能儿童发展进程的干预:一项随机对照试验的结果
Intervening on the Developmental Course of Children With Borderline Intellectual Functioning With a Multimodal Intervention: Results From a Randomized Controlled Trial.
作者信息
Blasi Valeria, Zanette Michela, Baglio Gisella, Giangiacomo Alice, Di Tella Sonia, Canevini Maria Paola, Walder Mauro, Clerici Mario, Baglio Francesca
机构信息
IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
Department of Health Sciences, University of Milan, Milan, Italy.
出版信息
Front Psychol. 2020 Apr 21;11:679. doi: 10.3389/fpsyg.2020.00679. eCollection 2020.
UNLABELLED
An adverse social environment is a major risk factor for borderline intellectual functioning (BIF), a condition characterized by an intelligence quotient (IQ) within the low range of normality (70-85) with difficulties in the academic achievements and adaptive behavior. Children with BIF show impairments in planning, language, movement, emotion regulation, and social abilities. Moreover, the BIF condition exposes children to an increased risk of school failures and the development of mental health problems, and poverty in adulthood. Thus, an early and effective intervention capable of improving the neurodevelopmental trajectory of children with BIF is of great relevance.
AIM
The present work aims to report the results of a randomized controlled trial (RCT) in which an intensive, integrated and innovative intervention, the movement cognition and narration of the emotions (MCNT) was compared to standard speech therapy (SST) for the treatment of children with BIF.
METHODS
This was a multicenter, interventional, single blind RCT with two groups of children with BIF: the experimental treatment (MCNT) and the treatment as usual (SST). A mixed factorial ANOVA was carried out to assess differences in the effectiveness between treatments. Primary outcome measures were: WISC III, Child Behavior Checklist (CBCL), Vineland II, and Movement ABC.
RESULTS
MCNT proved to be more effective than SST in the increment of full-scale IQ ( = 0.0220), performance IQ ( < 0.0150), socialization abilities ( = 0.0220), and behavior ( = 0.0016). No improvement was observed in motor abilities. Both treatments were linked to improvements in verbal memory, selective attention, planning, and language comprehension. Finally, children in the SST group showed a significant worsening in their behavior.
CONCLUSION
Our data show that an intensive and multimodal treatment is more effective than a single domain treatment for improving intellectual, adaptive and behavioral functioning in children with BIF. These improvements are relevant as they might represent protective factors against the risk of school failure, poverty and psychopathology to which children with BIF are exposed in the adult age. Limitations of the study are represented by the small number of subjects and the lack of a no-treatment group.
CLINICAL TRIAL REGISTRATION
ISRCTN Registry (isrctn.com), identifier ISRCTN81710297.
未标注
不良社会环境是边缘智力功能(BIF)的主要风险因素,BIF的特征是智商(IQ)处于正常范围的低水平(70 - 85),在学业成绩和适应性行为方面存在困难。患有BIF的儿童在计划、语言、运动、情绪调节和社交能力方面存在缺陷。此外,BIF状况使儿童面临学业失败以及心理健康问题发展和成年后贫困的风险增加。因此,一种能够改善患有BIF儿童神经发育轨迹的早期有效干预措施具有重要意义。
目的
本研究旨在报告一项随机对照试验(RCT)的结果,该试验将一种强化、综合且创新的干预措施,即情绪的运动认知与叙述(MCNT)与标准言语治疗(SST)用于治疗患有BIF的儿童进行了比较。
方法
这是一项多中心、干预性、单盲RCT,有两组患有BIF的儿童:实验性治疗组(MCNT)和常规治疗组(SST)。进行了混合因子方差分析以评估治疗之间有效性的差异。主要结局指标为:韦氏儿童智力量表第三版(WISC III)、儿童行为检查表(CBCL)、文兰适应行为量表第二版(Vineland II)和运动ABC量表。
结果
事实证明,MCNT在提高全量表智商(P = 0.0220)、操作智商(P < 0.0150)、社交能力(P = 0.0220)和行为(P = 0.0016)方面比SST更有效。在运动能力方面未观察到改善。两种治疗均与言语记忆、选择性注意力、计划和语言理解能力的改善有关。最后,SST组儿童的行为出现了显著恶化。
结论
我们的数据表明,对于改善患有BIF儿童的智力、适应性和行为功能,强化多模式治疗比单一领域治疗更有效。这些改善具有重要意义,因为它们可能代表了针对患有BIF儿童在成年后所面临的学业失败、贫困和精神病理学风险的保护因素。本研究的局限性在于受试者数量较少且缺乏无治疗组。
临床试验注册
国际标准随机对照试验编号注册库(isrctn.com),标识符ISRCTN81710297 。
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