Social Cognition Clinic - TEAMM, Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Brazil.
Development Disorders Program, Universidade Presbiteriana Mackenzie, Sao Paulo, Brazil.
J Intellect Disabil Res. 2020 Aug;64(8):629-643. doi: 10.1111/jir.12759. Epub 2020 Jun 30.
Poor eye contact and joint attention are early signs of autism spectrum disorder (ASD) and important prerequisites for developing other socio-communicative skills. Teaching parents evidence-based techniques to improve these skills can impact the overall functioning of children with ASD. We aimed to analyse the impact of conducting a group parent-training intervention with video modelling to improve the intelligent quotient (IQ), social and communication functioning and to minimise symptoms in children with ASD and intellectual disability (ID).
Study design: A multicentre, single-blinded, randomised clinical pilot trial of parent training using video modelling was conducted.
Sixty-seven parents of children with ASD, aged between 3 and 6 years and with IQs between 50 and 70, were randomised: 34 to the intervention group and 33 to the control group. Intervention program: The intervention group received parent training over 22 sessions, and the control group received the standard community treatment.
Pre-evaluation and post-evaluation (week 28), the following were used: Autism Diagnostic Interview, Vineland Adaptive Behaviour Scale I, Snijders-Oomen Nonverbal Intelligence Test, Autism Behaviour Checklist and Hamilton Depression Rating Scale.
Intention to treat and complier-average causal effect (CACE) were used to estimate the effects of the intervention.
There was a statistically significant improvement in the Vineland standardized communication scores in CACE (Cohen's d = 0.260). There was a non-statistically significant decrease in autism symptomatology (Autism Behaviour Checklist total scores) and a significant increase in the non-verbal IQ in the intervention group. After the false discovery rate correction was applied, IQ remained statistically significant under both paradigms. The effect size for this adjusted outcome under the intention-to-treat paradigm was close to 0.4, and when considering adherence (CACE), the effect sizes were more robust (IQ's Cohen's d = 0.433).
Parent training delivered by video modelling can be a useful technique for improving the care given to children with ASD and ID, particularly in countries that lack specialists.
眼神交流和共同注意力不佳是自闭症谱系障碍（ASD）的早期迹象，也是发展其他社交沟通技能的重要前提。教授家长基于证据的技巧来改善这些技能可以影响 ASD 儿童的整体功能。我们旨在分析通过小组家长培训干预措施与视频建模相结合来提高智商（IQ）、社交和沟通功能，并减轻患有 ASD 和智力障碍（ID）儿童症状的效果。
研究设计：一项使用视频建模进行家长培训的多中心、单盲、随机临床试验。
67 名 3 至 6 岁、智商在 50 至 70 之间的 ASD 儿童的家长被随机分组：34 名进入干预组，33 名进入对照组。干预计划：干预组接受 22 次家长培训，对照组接受标准社区治疗。
预评估和后评估（第 28 周）使用以下工具：自闭症诊断访谈、文兰适应性行为量表 I、斯尼德斯-奥本非言语智力测验、自闭症行为检查表和汉密尔顿抑郁评定量表。
意向治疗和符合者平均因果效应（CACE）用于估计干预效果。
在 CACE 中，维兰标准化沟通评分有统计学意义的提高（Cohen's d=0.260）。自闭症症状（自闭症行为检查表总分）有非统计学意义的下降，干预组的非言语智商有显著提高。在应用虚假发现率校正后，两种模式下的智商仍具有统计学意义。意向治疗模式下调整后结果的效应大小接近 0.4，而考虑到依从性（CACE），效应大小更稳健（智商的 Cohen's d=0.433）。
视频建模提供的家长培训可以成为改善对 ASD 和 ID 儿童护理的有用技术，特别是在缺乏专家的国家。
