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加拿大某省自闭症诊断后服务使用情况及家长对幼儿服务轨迹质量的看法洞察

A Window into the Use of Post-diagnostic Services for Autism and Parents' Perspective on the Quality of Early Childhood Services Trajectory in a Canadian Province.

作者信息

Rivard Mélina, Mello Catherine, Patel Shaneha, Morin Marjorie, Morin Diane

机构信息

Département de Psychologie, succursale Centre-ville, Université du Québec à Montréal, Montréal, Québec, C.P. 8888, H3C 3P8, Canada.

Department of Psychology, The Pennsylvania State University - Berks, State College, USA.

出版信息

J Autism Dev Disord. 2025 Mar;55(3):955-968. doi: 10.1007/s10803-024-06265-x. Epub 2024 Feb 17.

Abstract

The pathway for post-diagnostic services for autism tends to be complex, heterogeneous, and fraught with delays. This situation has repercussions for families' experience with care systems, the quality of early interventions, and family adjustment. To date, studies of parents' point of view on autism services have predominantly focused on the diagnostic phase of the services trajectory. The goal of the present study was to investigate the perspective of parents on autism early childhood services within a public healthcare and social services system in a Canadian province (Québec). Participants were 91 parents who completed a structured framework for the evaluation of the quality of services trajectories, the Evaluation of the services Trajectory in Autism by Parents (ETAP; Mello et al., in Research in Developmental Disabilities 133, 2023). Approximately three-quarters of families received interim services (e.g., punctual speech therapy interventions) for which they had overall neutral-to-positive appraisals but viewed as having comparably low validity and continuity. Although all children diagnosed with autism are entitled to receive early behavioral intervention (EBI) dispensed by the public health and social services system, approximately a quarter of families did not receive this service. Families who received EBI evaluated this service positively on all ETAP dimensions. The empathy (i.e., parent-provider relationships) dimension was rated highest for both interim and EBI services. Some systemic, family, and child-related factors were associated with the perceived quality of services for both interim and early childhood services. Our results emphasize the need for services for children and families as soon as possible, both during assessment and after diagnosis.

摘要

自闭症诊断后服务的途径往往复杂、多样且充满延误。这种情况会对家庭与护理系统的体验、早期干预的质量以及家庭适应产生影响。迄今为止,关于父母对自闭症服务观点的研究主要集中在服务轨迹的诊断阶段。本研究的目的是调查加拿大魁北克省一个公共医疗和社会服务系统中父母对自闭症幼儿服务的看法。参与者是91位父母,他们完成了一个用于评估服务轨迹质量的结构化框架,即《父母对自闭症服务轨迹的评估》(ETAP;梅洛等人,发表于《发育障碍研究》第133卷,2023年)。大约四分之三的家庭接受了临时服务(例如,准时的言语治疗干预),他们对这些服务总体评价为中性到积极,但认为其有效性和连续性相对较低。尽管所有被诊断为自闭症的儿童都有权接受公共卫生和社会服务系统提供的早期行为干预(EBI),但大约四分之一的家庭没有接受这项服务。接受EBI的家庭在ETAP的所有维度上对这项服务评价都很高。临时服务和EBI服务在同理心(即父母与服务提供者的关系)维度上的评分最高。一些系统、家庭和与儿童相关的因素与临时服务和幼儿服务的感知质量有关。我们的结果强调,在评估期间和诊断之后,都需要尽快为儿童和家庭提供服务。

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