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在学龄前接受不同形式早期干预的自闭症儿童的长期结局:一项针对15名年轻成年人的试点研究。

Long-term outcome of children with autism who received different forms of early intervention during their preschool years: a pilot study of 15 young adults.

作者信息

Jónsdóttir Sigrídur Lóa, Brynjarsdóttir Birta, Saemundsen Evald, Sigurdsson Jón Fridrik

机构信息

The State Diagnostic and Counselling Centre, Kópavogur, Iceland.

Faculty of Medicine, University of Iceland, Reykjavík, Iceland.

出版信息

Scand J Child Adolesc Psychiatr Psychol. 2018 Jul 10;6(1):28-39. doi: 10.21307/sjcapp-2018-006. eCollection 2018.

Abstract

BACKGROUND

Studies on early intervention have reported significant gains for many children with autism. Knowledge on how these children fare in adulthood is limited.

OBJECTIVE

To examine long-term outcome of children with autism who received different forms of early intervention.

METHOD

Participants were 15 young people who had all been diagnosed with ICD-10 childhood autism during the preschool years. Five received intervention based on the UCLA model for early intensive behavioral intervention, and 10 received eclectic treatment. Participants were followed from their first autism diagnosis during the preschool years (time 1) to the age of six years (time 2). The participants are now in their twenties (time 3), and at this point in time, information on autism symptoms, co-occurring disorders, quality of life, functioning, participation, adaptive behavior, and overall outcome was gathered from parents. Six of the participants answered questionnaires on quality of life, functioning, and participation.

RESULTS

The groups were comparable on all measures at time 1. Reassessment at time 2 showed that the early intensive behavioral intervention group had made significant gains in IQ, and that autism symptoms had decreased significantly, whereas such changes were not found for the eclectic treatment group. At time 3, most participants had considerable autism symptoms. Approximately half of them had received diagnosis of a co-occurring condition. Their quality of life and adaptive behavior was less favorable than that of the general population, but only a third had "poor" overall outcome. However, at time 3, hardly any differences were found between the groups.

CONCLUSIONS

To maintain gains made during the preschool years, appropriate intervention and services may need to be extended into adulthood. These services should take into account the perceived needs of the individual, as expressed by himself/herself and his/her family.

摘要

背景

关于早期干预的研究报告称,许多自闭症儿童都取得了显著进步。但对于这些儿童成年后的情况了解有限。

目的

研究接受不同形式早期干预的自闭症儿童的长期预后。

方法

研究对象为15名年轻人,他们在学龄前均被诊断为ICD - 10儿童自闭症。其中5人接受基于加州大学洛杉矶分校早期密集行为干预模式的干预,10人接受综合治疗。研究对象从学龄前首次被诊断为自闭症(时间1)开始随访至6岁(时间2)。这些参与者现在二十多岁(时间3),此时从家长处收集了关于自闭症症状、共病、生活质量、功能、参与度、适应性行为和总体预后的信息。6名参与者回答了关于生活质量、功能和参与度的问卷。

结果

在时间1时,两组在所有测量指标上具有可比性。在时间2重新评估时发现,早期密集行为干预组在智商方面有显著提高,自闭症症状显著减少,而综合治疗组未发现此类变化。在时间3时,大多数参与者仍有相当程度的自闭症症状。其中约一半被诊断患有共病。他们的生活质量和适应性行为比一般人群差,但只有三分之一的人总体预后“较差”。然而,在时间3时,两组之间几乎没有差异。

结论

为维持学龄前取得的进步,可能需要将适当的干预和服务扩展至成年期。这些服务应考虑个体及其家庭所表达的自身需求。

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