Henan Provincial Medical Key Lab of Child Developmental Behavior and Learning, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China.
Autism Res. 2023 Aug;16(8):1640-1649. doi: 10.1002/aur.3006. Epub 2023 Aug 11.
The early start Denver model (ESDM) has been extensively studied as a promising early intervention approach for young children with autism spectrum disorder (ASD). Various methodological drawbacks from earlier ESDM investigations must be rectified to expand the application scopes. For this purpose, the present study recruited a very large sample of 249 autistic children (aged 24-47 months), and used a randomized controlled design to compare outcomes from a mixed ESDM (M-ESDM) intervention with a mixed discrete trial teaching (M-DTT) intervention which remains one of the most commonly-used programming for early intervention. Over the course of a 12-week period, both groups (i.e., M-ESDM and M-DTT groups) received 25 h of intensive intervention per week using individual, group, and parent coaching techniques. Findings showed that: (i) the M-ESDM significantly outperformed the M-DTT in enhancing children's developmental abilities in gross motor and personal-social skills for toddlers and preschoolers, as well as in language for preschoolers with mild/moderate ASD and toddlers; and (ii) the M-ESDM dramatically reduced the severity of autistic symptoms in toddlers with severe ASD only, when compared to the M-DTT. However, the M-ESDM did not outperform the M-DTT in terms of improving children's developmental abilities in adaptability and fine motor for toddlers and preschoolers, as well as in language for preschoolers with severe ASD. In addition, when compared to the M-DTT, the M-ESDM did not show an advantage in reducing the severity of autistic symptoms in toddlers with mild/moderate ASD and preschoolers. Clinical Trial Registration: Chinese Clinical Trial Registry. Registration number ChiCTR200039492.
早期丹佛模式（ESDM）已被广泛研究，作为一种有前途的自闭症谱系障碍（ASD）幼儿早期干预方法。必须纠正早期 ESDM 研究中的各种方法缺陷，以扩大应用范围。为此，本研究招募了 249 名自闭症儿童（24-47 个月）的大样本，采用随机对照设计，比较混合 ESDM（M-ESDM）干预与混合离散试验教学（M-DTT）干预的结果，后者仍然是早期干预中最常用的编程之一。在 12 周的时间里，两组（即 M-ESDM 和 M-DTT 组）每周接受 25 小时的强化干预，采用个体、小组和家长指导技术。研究结果表明：（i）M-ESDM 在提高幼儿粗大运动和个人社会技能以及轻度/中度 ASD 幼儿语言方面的发展能力方面明显优于 M-DTT；（ii）与 M-DTT 相比，M-ESDM 仅在严重 ASD 幼儿中显著降低了自闭症症状的严重程度。然而，M-ESDM 在提高幼儿适应能力和精细运动以及严重 ASD 幼儿语言方面的发展能力方面并不优于 M-DTT。此外，与 M-DTT 相比，M-ESDM 并没有显示出在减轻轻度/中度 ASD 幼儿和幼儿自闭症症状严重程度方面的优势。临床试验注册：中国临床试验注册中心。注册号 ChiCTR200039492。
