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自闭症谱系障碍行为干预措施效果评估:随机对照试验和准实验研究的系统评价。

Evaluation of the effectiveness of behavioral interventions for autism spectrum disorders: A systematic review of randomized controlled trials and quasi-experimental studies.

机构信息

Clinical Psychology, Clinical Psychophysiology and Clinical Neuropsychology Labs, Department of Medicine and Surgery, University of Parma, Parma, Italy.

Journey Autism & Behavioral Care Center, Charlestown, MA, USA.

出版信息

Clin Child Psychol Psychiatry. 2024 Jan;29(1):213-231. doi: 10.1177/13591045231205614. Epub 2023 Oct 6.

DOI:10.1177/13591045231205614
PMID:37803891
Abstract

The objective of this research was to assess the efficacy of behavioral therapy interventions in the treatment of autism spectrum disorders (ASD). The study utilized the PubMed and Embase databases to locate randomized controlled trials, quasi-experimental treatment studies, and randomized clinical trial comparisons. The experimental group received treatment based on an applied behavioral approach, such as PECS, DTT, PRT, TEACCH, ESDM, and EIBI. After examining seventeen studies, the researchers found that each type of behavioral intervention had a positive impact. Naturalistic protocols that employed PRT and PECS improved ASD symptoms in general, despite their targeting of particular cognitive domains such as language. ESDM enhanced receptive language, particularly in preschool-aged children. Structured and integrated interventions, like EIBI and TEACCH, improved overall adaptive functioning. Combining DTT with a TEACCH program produced greater benefits in linguistic, affective-social, and personal autonomy domains. However, there is a scarcity of high-quality research available on behavioral interventions for ASD. Further comparative studies are necessary to identify cost-efficient interventions. For example, PRT and PECS significantly improved social communication skills in only 15-40 hours over six months. The authors emphasized the need for continued research and the application of evidence-based interventions in specialized settings.

摘要

本研究旨在评估行为疗法干预在自闭症谱系障碍(ASD)治疗中的疗效。研究利用 PubMed 和 Embase 数据库定位了随机对照试验、准实验治疗研究和随机临床试验比较。实验组接受了基于应用行为方法的治疗,例如 PECS、DTT、PRT、TEACCH、ESDM 和 EIBI。在评估了十七项研究后,研究人员发现每种行为干预类型都有积极的影响。采用 PRT 和 PECS 的自然主义方案总体上改善了 ASD 症状,尽管它们针对特定的认知领域,如语言。ESDM 增强了接受性语言,特别是在学龄前儿童中。结构化和综合干预,如 EIBI 和 TEACCH,提高了整体适应功能。将 DTT 与 TEACCH 计划相结合,在语言、情感-社会和个人自主领域产生了更大的益处。然而,目前关于 ASD 的行为干预的高质量研究还很匮乏。需要进一步的比较研究来确定具有成本效益的干预措施。例如,PRT 和 PECS 在六个月内仅 15-40 小时内就显著提高了社交沟通技能。作者强调需要在专门的环境中进行持续的研究和应用基于证据的干预措施。

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