Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy.
Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland.
J Autism Dev Disord. 2022 Oct;52(10):4286-4300. doi: 10.1007/s10803-021-05297-x. Epub 2021 Oct 22.
Parents of children with ASD (N = 86; mean age 44.8 months; 67 boys) were randomized to either WHO Caregiver Skills Training (CST) delivered in public health settings in Italy or enhanced treatment-as-usual. Primary blinded outcomes were 3-months post-intervention change scores of autism severity and engagement during caregiver-child interaction. CST was highly acceptable to caregivers and feasibly delivered by trained local clinicians. Intention-to-treat analysis showed a large and significant effect on parent skills supporting joint engagement and a smaller significant effect on flow of interaction. Expected changes in child autism severity and joint engagement did not meet statistical significance. Analysis of secondary outcomes showed a significant effect on parenting stress, self-efficacy, and child gestures. Strategies to improve the effectiveness of CST are discussed.
自闭症儿童的家长（N=86；平均年龄 44.8 个月；67 名男孩）被随机分配到在意大利公共卫生机构进行的世界卫生组织（WHO）照顾者技能培训（CST）或强化常规治疗组。主要的盲法结局指标是干预后 3 个月自闭症严重程度和照顾者-儿童互动期间参与度的变化评分。CST 受到照顾者的高度认可，且由经过培训的当地临床医生进行是可行的。意向性治疗分析显示，对支持共同参与的父母技能有很大且显著的影响，对互动流畅性也有较小但显著的影响。儿童自闭症严重程度和共同参与的预期变化没有达到统计学意义。对次要结局的分析显示，在育儿压力、自我效能和儿童手势方面有显著影响。讨论了提高 CST 有效性的策略。
