Minjarez Mendy Boettcher, Gengoux Grace W, Paszek Katherine, Liang Jennifer A, Ardel Christina Mich, Hardan Antonio Y, Frazier Thomas
University of Washington and Seattle Children's Hospital, Washington, United States.
Stanford University School of Medicine, Stanford, United States.
J Autism Dev Disord. 2024 Jul 8. doi: 10.1007/s10803-024-06447-7.
Access to intervention is a barrier for children with autism. As parent-mediated interventions have emerged to address this need, understanding implementation components contributing to child gains is critically important. Existing literature documents relationships between parent treatment adherence and child progress; however, less is understood about components, such as frequency of learning opportunities, which could also affect child outcomes.
This study is a secondary analysis of data from a randomized controlled trial evaluating Pivotal Response Treatment group parent training (PRTG) compared to psychoeducation. Linear regression and mediational models were employed to identify potential predictors and mediators of outcome.
PRTG produced large increases in adherence and learning opportunities. In general, greater frequency of learning opportunities and adherence predicted better child outcomes. The best-fitting cross-sectional mediational models indicated at least partial mediational effects, whereby increased learning opportunities mediated the relationship between greater adherence and improved child outcomes.
This study provides preliminary evidence of how early gains in adherence may support parents to provide more frequent learning opportunities, which, in turn, yield positive effects on child social communication. Future large-scale research, with greater granularity of measurement, is needed to further understand the temporal relationships between these variables.
获得干预措施对于自闭症儿童来说是一个障碍。随着家长介导干预措施的出现以满足这一需求，了解有助于儿童取得进步的实施要素至关重要。现有文献记录了家长治疗依从性与儿童进步之间的关系；然而，对于诸如学习机会频率等也可能影响儿童结果的要素，我们了解得较少。
本研究是对一项随机对照试验数据的二次分析，该试验评估了关键反应治疗组家长培训（PRTG）与心理教育的效果。采用线性回归和中介模型来确定结果的潜在预测因素和中介因素。
PRTG使依从性和学习机会大幅增加。总体而言，学习机会频率越高和依从性越高，预测的儿童结果越好。拟合度最佳的横断面中介模型表明至少存在部分中介效应，即增加的学习机会介导了更高依从性与改善的儿童结果之间的关系。
本研究提供了初步证据，表明依从性的早期提高如何可能支持家长提供更频繁的学习机会，进而对儿童社会沟通产生积极影响。未来需要进行大规模研究，采用更精细的测量方法，以进一步了解这些变量之间的时间关系。
