Fu Linyan, Weng Jiao, Feng Min, Xiao Xiang, Xiao Ting, Fu Junli, Qiu Nana, Li Chunyan, Da Yun, Ke Xiaoyan
Child Mental Health Research Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China.
Three Hospital of Longyan, Longyan, China.
Front Pediatr. 2020 Dec 2;8:581893. doi: 10.3389/fped.2020.581893. eCollection 2020.
Interindividual variability is important in the evolution of adaptative profiles of children with ASD having benefited from an early intervention make up for deficits in communication, language and social interactions. Therefore, this paper aimed to determine the nature of factors influencing the efficacy variability of a particular intervention technique i.e., "Play-based communication and behavior intervention" (PCBI). The participants comprised 70 13-30-month-old toddlers with ASD enrolled in PCBI for 12 weeks. The Autism Treatment Evaluation Checklist (ATEC) was used to evaluate the efficacy of PCBI. Video recordings of 5 min of free-play before and after PCBI were used to examine behaviors of mothers and children and parent-child dyadic synchrony. Hierarchical multiple regression analyses and machine learning algorithms were performed to explore the effect of these potential predictors (mothers' factors, children's factors and videotaped mother-child interaction) of intervention efficacy. The hierarchical regression analysis and the machine learning algorithms indicated that parenting stress, level of completion of training at home and mother-child dyadic synchrony were crucial factors in predicting and monitoring the efficacy of PCBI. In summary, the findings suggest that PCBI could be particularly beneficial to children with ASD who show a good performance in the mother-child dyadic synchrony evaluation. A better dyadic mother-child synchrony could enhance the PCBI efficacy through adapted emotional and behavioral responses of the mother and the child and has a beneficial influence on the child's psychological development.
个体间差异对于受益于早期干预的自闭症谱系障碍（ASD）儿童适应性特征的演变很重要，早期干预弥补了他们在沟通、语言和社交互动方面的缺陷。因此，本文旨在确定影响一种特定干预技术，即“基于游戏的沟通与行为干预”（PCBI）效果差异的因素的性质。研究参与者包括70名年龄在13至30个月的ASD幼儿，他们参加了为期12周的PCBI。使用自闭症治疗评估清单（ATEC）来评估PCBI的效果。PCBI前后5分钟自由玩耍的视频记录用于检查母亲和孩子的行为以及亲子二元同步性。进行了分层多元回归分析和机器学习算法，以探索这些干预效果潜在预测因素（母亲因素、孩子因素和录制的母子互动）的影响。分层回归分析和机器学习算法表明，育儿压力、在家完成训练的程度以及亲子二元同步性是预测和监测PCBI效果的关键因素。总之，研究结果表明，PCBI可能对在亲子二元同步性评估中表现良好的ASD儿童特别有益。更好的亲子二元同步性可以通过母亲和孩子适应性的情感和行为反应提高PCBI的效果，并对孩子的心理发展产生有益影响。
