Yeom Jung Sook, Kim Jeongmee
Department of Pediatrics, Gyeongsang National University of Hospital, Jinju, Korea.
Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Sciences, Jinju, Korea.
Clin Exp Pediatr. 2024 Jun;67(6):303-311. doi: 10.3345/cep.2023.01662. Epub 2024 May 21.
Responsive teaching (RT) interventions, which enhance developmental outcomes by improving children's engagement behaviors, are traditionally delivered in person. However, the coronavirus disease 2019 pandemic complicated this approach.
This study aimed to evaluate the efficacy and acceptance of online RT in children with developmental disabilities and their parents.
This pilot study was conducted in Jinju, South Korea, and enrolled parent-child dyads referred to Gyeongsang National University Hospital for developmental concerns between April and September 2022. The children underwent a comprehensive developmental evaluation. The parents received a 5-session RT intervention via ZOOM on a mostly weekly basis. The first 2 sessions involved child development and RT lectures, while the others involved coaching on 3 of the 66 RT strategies. Problem behaviors, parent-child interactions, and parenting stress were assessed pre- versus postintervention using the Korean versions of the Child Behavior Checklist, Maternal/Child Behavior Rating Scale, and Parent Stress Index 4th Edition Short Form, respectively. Acceptability was evaluated using a self-administered questionnaire.
Of the 30 recruited parent-child pairs, 23 (76%) completed the intervention and assessments. The children (mean age, 2.66±0.86 years) included 12 with language delays, 7 with autism spectrum disorder, and 4 with global delays. Predominantly mothers (96%) participated. Online RT significantly improved pivotal behaviors- including joint attention (P=0.04), cooperation (P=0.01), and affect (P=0.01)-and reduced overall problem behaviors (P=0.04). Parents reported less parenting stress (P=0.01), improved interactive behaviors with increased responsiveness (P<0.01), and decreased directiveness (P<0.01). High satisfaction with online RT interventions was also previously reported.
These findings suggest that online RT can improve children's emotional and behavioral outcomes and maternal interaction styles and reduce parenting stress, offering accessible interventions amid challenges such as limited access and pandemics.
响应式教学（RT）干预措施通过改善儿童的参与行为来提高发展成果，传统上是面对面实施的。然而，2019年冠状病毒病疫情使这种方法变得复杂。
本研究旨在评估在线响应式教学对发育障碍儿童及其父母的疗效和可接受性。
这项试点研究在韩国晋州进行，纳入了2022年4月至9月因发育问题转诊至庆尚国立大学医院的亲子对。对儿童进行了全面的发育评估。父母通过ZOOM平台接受了为期5节的响应式教学干预，大多为每周一次。前两节课涉及儿童发育和响应式教学讲座，其余几节课涉及66种响应式教学策略中的3种的指导。分别使用韩国版的儿童行为清单、母婴行为评定量表和父母压力指数第4版简表在干预前后评估问题行为、亲子互动和育儿压力。使用自填式问卷评估可接受性。
在招募的30对亲子对中，23对（76%）完成了干预和评估。这些儿童（平均年龄2.66±0.86岁）包括12名语言发育迟缓儿童、7名自闭症谱系障碍儿童和4名全面发育迟缓儿童。主要是母亲（96%）参与。在线响应式教学显著改善了关键行为，包括共同注意力（P=0.04）、合作（P=0.01）和情感（P=0.01），并减少了总体问题行为（P=0.04）。父母报告育儿压力减轻（P=0.01），互动行为改善，反应性增加（P<0.01），指导性降低（P<0.01）。此前也有报告称对在线响应式教学干预的满意度很高。
这些发现表明，在线响应式教学可以改善儿童的情绪和行为结果以及母亲的互动方式，并减轻育儿压力，在诸如获取机会有限和疫情等挑战中提供了可及的干预措施。
