自然主义发展行为干预在自闭症幼儿早期干预中的作用：一项观察性研究。
The Role of Naturalistic Developmental Behavioral Interventions in Early Intervention for Autistic Toddlers: An Observational Study.
机构信息
Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL.
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco.
出版信息
Am J Speech Lang Pathol. 2023 Mar 9;32(2):439-451. doi: 10.1044/2022_AJSLP-22-00190. Epub 2023 Jan 11.
PURPOSE
Naturalistic developmental behavioral interventions (NDBIs) have demonstrated initial promise in facilitating social communication development for autistic toddlers, but their highly structured protocols may be a barrier toward their use by early intervention (EI) providers who must individualize intervention according to family-centered principles. This study aimed to characterize the extent to which EI speech-language pathologists (SLPs) use NDBI strategies, and the range of skills and behaviors addressed during their EI sessions, to contextualize the role of NDBIs within the scope of needs of families with autistic children in EI.
METHOD
This observational study included 25 families with an autistic toddler and their EI SLP. One home-based session was recorded for each family, and an observational measure was used to describe SLPs' NDBI strategy use. Qualitative content analyses were also used to characterize the strategies SLPs recommended to families, and the child skills and behaviors they discussed.
RESULTS
SLPs did not implement NDBI strategies with high quality, but they implemented developmental NDBI strategies with significantly higher quality than behavioral NDBI strategies. SLPs discussed many strategies and skills across disciplines within the session.
CONCLUSIONS
SLPs may require further training to implement NDBI strategies, but given the breadth and depth of skills addressed during sessions, researchers should investigate and report on the impact of NDBIs on a wider range of communication skills and developmental domains. This will facilitate clinical decision making and make these interventions better aligned with family-centered EI principles.
SUPPLEMENTAL MATERIAL
目的
自然发展行为干预（NDBI）已初步证明在促进自闭症幼儿社交沟通发展方面具有潜力，但由于其高度结构化的方案可能会成为早期干预（EI）提供者使用的障碍，他们必须根据以家庭为中心的原则对干预措施进行个性化。本研究旨在描述 EI 言语治疗师（SLP）使用 NDBI 策略的程度，以及他们在 EI 会议期间解决的技能和行为范围，以便在 EI 中为自闭症儿童的家庭需求范围内确定 NDBI 的作用。
方法
本观察性研究包括 25 个有自闭症幼儿的家庭及其 EI SLP。为每个家庭录制了一个家庭会议，并使用观察性措施来描述 SLP 使用 NDBI 策略的情况。还使用定性内容分析来描述 SLP 向家庭推荐的策略以及他们讨论的儿童技能和行为。
结果
SLP 并没有高质量地实施 NDBI 策略，但他们实施了发展性 NDBI 策略，其质量明显高于行为性 NDBI 策略。SLP 在会议中讨论了许多跨学科的策略和技能。
结论
SLP 可能需要进一步培训才能实施 NDBI 策略，但鉴于会议中涉及的技能的广度和深度，研究人员应该调查和报告 NDBI 对更广泛的沟通技能和发展领域的影响。这将有助于临床决策，并使这些干预措施更好地与以家庭为中心的 EI 原则保持一致。
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