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与纳入针对自闭症谱系障碍风险婴儿的照顾者实施干预临床试验相关的因素。

Factors associated with enrollment into a clinical trial of caregiver-implemented intervention for infants at risk for autism spectrum disorder.

作者信息

Bradshaw Jessica, Trumbull Ashley, Stapel-Wax Jennifer, Gillespie Scott, George Nisha, Saulnier Celine, Klaiman Cheryl, Woods Juliann, Call Nathan, Klin Ami, Wetherby Amy

机构信息

University of South Carolina, USA.

Emory University, USA.

出版信息

Autism. 2020 Oct;24(7):1874-1884. doi: 10.1177/1362361320928829. Epub 2020 Jun 29.

Abstract

Early intervention helps to address developmental delays in young children with autism spectrum disorder. Yet, research suggests there are barriers to enrollment into research studies that test the effectiveness of these interventions for infants at risk. This study identifies family characteristics that were associated with agreement to enroll in a clinical trial of early intervention for 12-month-old infants at risk for autism spectrum disorder. As part of a large longitudinal study, infants were evaluated for early signs of autism spectrum disorder at 1 year of age. Of the fifty-seven infants who were showing signs of autism and deemed eligible for the early intervention trial, 44% declined enrollment. Results suggest that families were more likely to decline enrolling into the intervention study if the mother was working full time, the total household income was between US$60,000 and US$100,000, and they lived further from the clinic. In contrast, infant autism symptoms and parental concern at 12 months were not significantly associated with enrollment. These findings highlight the need for intervention studies that are more accessible to parents, for example, intervention that takes place in the home, in addition to more research on how parental understanding of, and willingness to act on, early social-communication delays impact intervention study enrollment. Future research can then examine how to address these barriers to enrollment in early intervention studies. Such findings will shed light on best practices for dissemination of early identification and intervention strategies.

摘要

早期干预有助于解决患有自闭症谱系障碍的幼儿的发育迟缓问题。然而,研究表明,在测试这些干预措施对有风险的婴儿的有效性的研究中,存在参与障碍。本研究确定了与同意参加针对有自闭症谱系障碍风险的12个月大婴儿的早期干预临床试验相关的家庭特征。作为一项大型纵向研究的一部分,在婴儿1岁时对其进行自闭症谱系障碍早期迹象的评估。在57名表现出自闭症迹象并被认为有资格参加早期干预试验的婴儿中,44%拒绝参与。结果表明,如果母亲全职工作、家庭总收入在6万美元至10万美元之间且他们住得离诊所较远,家庭更有可能拒绝参加干预研究。相比之下,12个月时婴儿的自闭症症状和父母的担忧与参与情况没有显著关联。这些发现凸显了开展对父母来说更容易参与的干预研究的必要性,例如在家庭中进行的干预,此外还需要更多关于父母对早期社交沟通延迟的理解以及采取行动的意愿如何影响干预研究参与情况的研究。未来的研究可以探讨如何消除早期干预研究中的这些参与障碍。此类发现将为早期识别和干预策略的传播的最佳实践提供启示。

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