Kauley Nadine, John James Rufus, Barr Karlen R, Wu Weng Tong, Grove Rachel, Masi Anne, Eapen Valsamma
School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia.
Neuropsychiatr Dis Treat. 2024 Jan 8;20:35-48. doi: 10.2147/NDT.S435740. eCollection 2024.
This study aims to assess changes in the receptive and expressive language skills and to determine if the baseline characteristics such as communication, cognitive and motor skills, predict outcomes in preschool children with Autism Spectrum Disorder (ASD) following early intervention.
We recruited 64 children participating in the Early Start Denver Model (ESDM) early intervention program at an Autism Specific Early Learning and Care Center (ASELCC) in Australia. Baseline characteristics across various developmental domains was measured using the Mullen Scales of Early Learning (MSEL), Vineland Adaptive Behaviour Scales, 2nd Edition (VABS-II), and the ESDM Curriculum Checklist. Linear mixed-effects models were used to examine the effects of the intervention on outcomes. Fixed-effects such as time, groups (verbal and minimally verbal), and time-by-group interactions were assessed whilst adjusting for covariates. Further, multiple linear regression models were used to determine if the baseline characteristics were significant predictors of the outcomes following the early intervention.
Among the 64 children who participated in this study, 38 children were verbal, whereas 26 were deemed to have minimal verbal skills. The mean age of the sample was 4.1 years with a significant male predilection (83%) and from a culturally and linguistically diverse (CALD) background (64%). Findings of the linear mixed effects model showed significant within and between group differences in the ESDM subscales, indicating higher magnitude of changes in the verbal group compared to the minimally verbal group. Finally, the multiple linear regression models suggested that baseline MSEL visual reception and expressive language scores were predictive of changes in the ESDM receptive and expressive communication scores.
Understanding a child's baseline skill levels may provide valuable clues regarding what interventions would work best, or which interventions may be less suitable for individual preschool-aged children with ASD.
本研究旨在评估接受性和表达性语言技能的变化，并确定诸如沟通、认知和运动技能等基线特征是否能预测自闭症谱系障碍（ASD）学龄前儿童早期干预后的结果。
我们招募了64名在澳大利亚一家自闭症特定早期学习与护理中心（ASELCC）参加早期丹佛模式（ESDM）早期干预项目的儿童。使用莫伦早期学习量表（MSEL）、第二版文兰适应行为量表（VABS-II）和ESDM课程清单测量各个发育领域的基线特征。采用线性混合效应模型来检验干预对结果的影响。在调整协变量的同时，评估时间、组（语言组和极少语言组）以及时间与组的交互作用等固定效应。此外，使用多元线性回归模型来确定基线特征是否是早期干预后结果的显著预测因素。
在参与本研究的64名儿童中，38名儿童有语言能力，而26名被认为语言技能极少。样本的平均年龄为4.1岁，男性占比显著（83%），且来自文化和语言多元化（CALD）背景（64%）。线性混合效应模型的结果显示，ESDM分量表在组内和组间存在显著差异，表明与极少语言组相比，语言组的变化幅度更大。最后，多元线性回归模型表明，基线MSEL视觉接受和表达性语言得分可预测ESDM接受性和表达性沟通得分的变化。
了解儿童的基线技能水平可能为哪些干预措施最有效，或哪些干预措施可能不太适合个别患有ASD的学龄前儿童提供有价值的线索。
