Child Developmental and Behavioral Center, The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Guangzhou, 510630, China.
World J Pediatr. 2023 Aug;19(8):741-752. doi: 10.1007/s12519-022-00555-z. Epub 2022 Jun 13.
Several studies have shown the effectiveness of the Early Start Denver Model (ESDM), but few studies have explored the long-term efficacy of ESDM. This study aimed to explore the efficacy and moderating factors of ESDM in Chinese toddlers with autism spectrum disorder (ASD) in a longitudinal way.
A total of 60 toddlers with ASD were recruited and randomly divided into two groups: ESDM group all received 24 weeks intervention; Control group were waiting for intervention. Baseline assessment (T0) was conducted before intervention, including Gesell Developmental Scale (GDS) and Psycho-educational Profile-3rd Edition (PEP-3). All toddlers with ASD were examined in the first assessment (T1) at 6 months and in the second assessment (T2) at 12 months.
In T1 assessment, the increments in speech and personal communication development quotient in GDS were significantly larger in the ESDM group than in the control group (P = 0.010, 0.047). In T2 assessment, the ESDM group had higher elevation in cognitive verbal/preverbal (CVP), social reciprocity and characteristic verbal behaviors assessed by PEP-3 (P = 0.021, 0.046, 0.014). In addition, the severity of stereotyped behavior was negatively associated with improvement in CVP. Family income was positively associated with improvement in speech and CVP (all P < 0.05).
ESDM can effectively improve speech and communication in toddlers with ASD after 24-week intervention. More importantly, ESDM can promote cognition and social interaction and can reduce stereotyped verbal behavior in toddlers with ASD in longitudinal observation. The severity of stereotyped behavior and family ecological factors may be considered as affecting the efficacy of ESDM.
多项研究表明，早期丹佛模式（ESDM）具有有效性，但很少有研究探索 ESDM 的长期疗效。本研究旨在以纵向方式探索 ESDM 对中国自闭症谱系障碍（ASD）幼儿的疗效及其调节因素。
共招募了 60 名 ASD 幼儿，并随机分为两组：ESDM 组均接受 24 周的干预；对照组等待干预。在干预前进行基线评估（T0），包括 Gesell 发育量表（GDS）和心理教育概况-第 3 版（PEP-3）。所有 ASD 幼儿在 6 个月时进行首次评估（T1），在 12 个月时进行第二次评估（T2）。
在 T1 评估中，ESDM 组 GDS 言语和个人沟通发展商的增量明显大于对照组（P=0.010，0.047）。在 T2 评估中，ESDM 组 PEP-3 评估的认知言语/前言语（CVP）、社会互惠和特征言语行为的升高幅度更高（P=0.021，0.046，0.014）。此外，刻板行为的严重程度与 CVP 的改善呈负相关。家庭收入与言语和 CVP 的改善呈正相关（均 P<0.05）。
ESDM 可在 24 周干预后有效提高 ASD 幼儿的言语和沟通能力。更重要的是，ESDM 可以促进认知和社会互动，并在纵向观察中减少 ASD 幼儿的刻板言语行为。刻板行为的严重程度和家庭生态因素可作为影响 ESDM 疗效的因素。
