Sridhar Aksheya, Kuhn Jocelyn, Faja Susan, Sabatos-DeVito Maura, Nikolaeva Julia I, Dawson Geraldine, Nelson Charles A, Webb Sara J, Bernier Raphael, Jeste Shafali, Chawarska Katarzyna, Sugar Catherine A, Shic Frederick, Naples Adam, Dziura James, McPartland James C
Boston Children's Hospital/Harvard Medical School, Boston, MA, USA.
Boston Medical Center, Boston, MA, USA.
Res Autism Spectr Disord. 2022 Jun;94. doi: 10.1016/j.rasd.2022.101950. Epub 2022 Mar 24.
When designing and interpreting results from clinical trials evaluating treatments for children on the autism spectrum, a complicating factor is that most children receive a range of concurrent treatments. Thus, it is important to better understand the types and hours of interventions that participants typically receive as part of standard of care, as well as to understand the child, family, and geographic factors that are associated with different patterns of service utilization. In this multi-site study, we interviewed 280 caregivers of 6-to-11-year-old school-aged children on the autism spectrum about the types and amounts of interventions their children received in the prior 6 weeks. Reported interventions were coded as " practice" or " interventions," reflecting the level of empirical support. Results indicated that children received a variety of interventions with varying levels of empirical evidence and a wide range of hours (0 to 79.3 hours/week). Children with higher autism symptom levels, living in particular states, and who identified as non-Hispanic received more intervention hours. Higher parental education level related to more hours of interventions. Children who were younger, had lower cognitive ability, and with higher autism symptom levels received a greater variety of interventions overall. Thus, based on our findings, it would seem prudent when designing clinical trials to take into consideration a variety of factors including autism symptom levels, age, cognitive ability, ethnicity, parent education and geographic location. Future research should continue to investigate the ethnic, racial, and socioeconomic influences on school-aged intervention services.
在设计和解读评估自闭症谱系儿童治疗方法的临床试验结果时，一个复杂因素是大多数儿童同时接受多种治疗。因此，更深入了解作为标准治疗的一部分参与者通常接受的干预类型和时长，以及了解与不同服务利用模式相关的儿童、家庭和地理因素非常重要。在这项多地点研究中，我们采访了280名6至11岁自闭症谱系学龄儿童的照料者，询问他们的孩子在之前6周内接受的干预类型和数量。报告的干预措施被编码为“实践”或“干预”，以反映实证支持水平。结果表明，儿童接受了各种实证证据水平不同且时长范围广泛（0至79.3小时/周）的干预。自闭症症状水平较高、居住在特定州且被认定为非西班牙裔的儿童接受的干预时长更多。父母教育水平较高与更多的干预时长相关。年龄较小、认知能力较低且自闭症症状水平较高的儿童总体上接受的干预种类更多。因此，基于我们的研究结果，在设计临床试验时考虑包括自闭症症状水平、年龄、认知能力、种族、父母教育程度和地理位置等多种因素似乎是谨慎之举。未来的研究应继续调查种族、民族和社会经济对学龄期干预服务的影响。
