简短报告：远程医疗音乐增强型自闭症相互模仿训练：一项虚拟家长指导干预的单病例可行性研究。
Brief Report: Telehealth Music-Enhanced Reciprocal Imitation Training in Autism: A Single-Subject Feasibility Study of a Virtual Parent Coaching Intervention.
作者信息
Liu Talia, Martinez-Torres Keysha, Mazzone Julie, Camarata Stephen, Lense Miriam
机构信息
Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA, USA.
Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
出版信息
J Autism Dev Disord. 2023 Aug 2. doi: 10.1007/s10803-023-06053-z.
PURPOSE
Telehealth delivery increases accessibility of parent-mediated interventions that teach parents skills and support autistic children's social communication. Reciprocal Imitation Training (RIT), an evidence-based Naturalistic Developmental Behavioral Intervention (NDBI) focused on imitation skills, a common difficulty in autism, holds promise for telehealth-based parent training. Imitation is also a core component of musical play during childhood and the affordances of musical play/song naturally shape parent-child interactions. We evaluate the feasibility of a music-based, telehealth adaptation of RIT-music-enhanced RIT (tele-meRIT)-as a novel format for coaching parents in NDBI strategies.
METHODS
This single-subject, multiple baseline design study included 4 autistic children (32-53 months old) and their mothers. Parent-child dyads were recorded during 10-min free play probes at baseline, weekly tele-meRIT sessions, and one-week and one-month follow-up. Probes were coded for parents' RIT implementation fidelity, parent vocal musicality, and children's rate of spontaneous imitation.
RESULTS
No parent demonstrated implementation fidelity during baseline. All parents increased their use of RIT strategies, met fidelity by the end of treatment, and maintained fidelity at follow-up. Parent vocal musicality also increased from baseline. Intervention did not consistently increase children's imitation skills. A post-intervention evaluation survey indicated high parent satisfaction with tele-meRIT and perceived benefits to their children's social and play skills more broadly.
CONCLUSION
Implementing tele-meRIT is feasible. Although tele-meRIT additionally involved coaching in incorporating rhythmicity and song into play interactions, parents achieved fidelity in the RIT principles, suggesting one avenue by which music can be integrated within evidence-based parent-mediated NDBIs.
目的
远程医疗服务增加了家长介导干预措施的可及性，这些干预措施旨在教授家长技能并支持自闭症儿童的社交沟通。相互模仿训练（RIT）是一种基于证据的自然发展行为干预（NDBI），专注于模仿技能，这是自闭症中常见的困难，有望用于基于远程医疗的家长培训。模仿也是儿童期音乐游戏的核心组成部分，音乐游戏/歌曲的特性自然地塑造了亲子互动。我们评估基于音乐的RIT远程医疗改编形式——音乐增强型RIT（远程meRIT）——作为指导家长掌握NDBI策略的一种新形式的可行性。
方法
这项单受试者、多基线设计研究纳入了4名自闭症儿童（32 - 53个月大）及其母亲。在基线期、每周的远程meRIT课程、一周和一个月随访期间的10分钟自由游戏探测中，对亲子二元组进行记录。对探测内容进行编码，以评估家长实施RIT的保真度、家长的声乐音乐性以及儿童的自发模仿率。
结果
在基线期没有家长表现出实施保真度。所有家长都增加了对RIT策略的使用，在治疗结束时达到保真度，并在随访时保持保真度。家长的声乐音乐性也从基线期有所提高。干预并没有持续提高儿童的模仿技能。干预后的评估调查表明家长对远程meRIT满意度很高，并更广泛地认为对孩子的社交和游戏技能有益。
结论
实施远程meRIT是可行的。尽管远程meRIT还涉及指导如何将节奏和歌曲融入游戏互动，但家长在RIT原则方面达到了保真度，这表明音乐可以通过一种途径融入基于证据的家长介导的NDBIs中。
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