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教师和家长报告的自闭症个体和非谱系延迟个体的适应不良行为轨迹。

Teacher- and parent-reported trajectories of maladaptive behaviors among individuals with autism and non-spectrum delays.

机构信息

University of California, Los Angeles, CA, USA.

出版信息

Autism Res. 2023 Jan;16(1):174-189. doi: 10.1002/aur.2854. Epub 2022 Nov 11.

Abstract

People with autism spectrum disorder (ASD) and non-spectrum developmental delays frequently exhibit maladaptive behaviors throughout the lifespan, which can have pervasive effects on quality of life. Maladaptive behaviors have been shown to change over time as a function of various individual-level factors (e.g., cognitive ability), yet research is primarily limited to parent-reported measures. To expand upon this work, the present study aimed to examine trajectories of teacher- and parent-reported maladaptive behaviors (i.e., hyperactivity, irritability, social withdrawal) and to test whether individual-level predictors (e.g., autism features, verbal intelligence quotient) and school-related predictors (e.g., teacher type, student-adult ratio, personal aide, school type) impact these trajectories among 165 individuals with ASD or non-spectrum delays from ages 9 to 18. Multilevel models revealed that, according to both teacher and parent report, participants showed the greatest improvement in hyperactivity, less but still notable improvement in irritability, and stable levels of social withdrawal over time. Higher verbal ability and fewer ASD features, in addition to mainstream school placement, emerged as important individual- and school-related differences associated with fewer maladaptive behaviors over time. The multi-informant perspective and longitudinal design provide novel insight into the manifestations of these maladaptive behaviors across different contexts and across time. Findings highlight the consistency of teacher- and parent-reported trajectories over time and further emphasize the importance of targeting maladaptive behaviors using a multisystem intervention approach in both school and home contexts.

摘要

自闭症谱系障碍(ASD)和非谱系发育迟缓患者在整个生命周期中经常表现出适应不良行为,这些行为会对生活质量产生广泛影响。适应不良行为随着时间的推移会发生变化,这与各种个体水平因素(例如认知能力)有关,但研究主要限于家长报告的测量。为了进一步研究这一问题,本研究旨在探讨教师和家长报告的适应不良行为(即多动、易怒、社交退缩)的轨迹,并检验个体水平预测因素(例如自闭症特征、言语智商)和学校相关预测因素(例如教师类型、学生与成人比例、个人助手、学校类型)是否会影响 165 名 ASD 或非谱系延迟患者在 9 至 18 岁之间的这些轨迹。多层次模型显示,根据教师和家长的报告,参与者的多动行为改善最大,易怒行为的改善较小,但仍很明显,社交退缩行为则保持稳定。较高的言语能力和较少的自闭症特征,以及主流学校的安置,是与随着时间的推移减少适应不良行为相关的重要个体和学校差异。多信息源的视角和纵向设计为这些适应不良行为在不同背景和不同时间的表现提供了新的见解。研究结果强调了教师和家长报告的轨迹随时间的一致性,并进一步强调了在学校和家庭环境中使用多系统干预方法来针对适应不良行为的重要性。

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Trajectories of Dysregulation in Children with Autism Spectrum Disorder.自闭症谱系障碍儿童的失调轨迹。
J Clin Child Adolesc Psychol. 2021 Nov-Dec;50(6):858-873. doi: 10.1080/15374416.2021.1907752. Epub 2021 Apr 19.
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The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond.自闭症的诊断:从卡纳到 DSM-III 到 DSM-5 及以后。
J Autism Dev Disord. 2021 Dec;51(12):4253-4270. doi: 10.1007/s10803-021-04904-1. Epub 2021 Feb 24.

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