Peterson Tami, Dodson Jessica, Sherwin Robert, Strale Frederick
Hyperbaric Oxygen Therapy, The Oxford Center, Brighton, USA.
Applied Behavior Analysis, The Oxford Center, Brighton, USA.
Cureus. 2024 Jun 15;16(6):e62427. doi: 10.7759/cureus.62427. eCollection 2024 Jun.
Introduction It is widely recognized that the prevalence and diagnosis of autism spectrum disorder (ASD) are more common in males than in females. Despite this, there is a significant gap in the body of autism research that investigates gender differences for treatment effects of applied behavior analysis (ABA) across a variety of measured variables. This research aims to comprehensively evaluate gender distinctions concerning target behavioral objectives, goals, and deficit variables. Materials and methods This study analyzed retrospective data from 100 participants, including 89 juveniles and four adults, with seven cases lacking age documentation, who underwent a three-month ABA program from March 19 to June 11, 2023. The ABA program included various methodologies such as functional analysis, discrete trial training, mass trials, and naturalistic training. Data on outcome measures, including target behavioral proficiency, age, average trials to proficiency, average teaching days to proficiency, open behavioral objectives, and target trends, were collected using the "Catalyst" software (Catalyst Software Corporation, New York, NY). Participant demographics were summarized using statistical analyses for categorical (gender and race/ethnicity) and continuous variables (percentage of mastered behavioral objectives, age, average trials, average teaching days, open objectives, percentage of failed objectives during maintenance, percentage of objectives with upward, downward, and flat trends). These statistics included mean, standard deviation, median, and range and were analyzed inferentially using nine separate two-sample independent t-tests and corresponding effect sizes using Cohen's d. Results There were no statistically significant disparities based on gender (p > 0.05) across all nine variables examined: Percentage of Targets Mastered, Age, Average Trials to Mastery, Average Teaching Days to Mastery, Open Targets, Percentage of Targets Failed in Maintenance, Percentage of Targets Trending Up, Percentage of Targets Trending Down, and Percentage of Targets Trending Flat, and wide confidence intervals were detected. Conclusions Non-significant gender differences in response to ABA treatments regarding these nine behavioral goals, mastery, and deficit variables may be relevant. They suggest that ABA treatments could be equally beneficial for both male and female autistic individuals. These results should be interpreted cautiously. The general pattern observed, characterized by broad confidence intervals, carries a degree of statistical uncertainty, which may suggest substantial gender differences. These results might question the prevailing beliefs about the variation in treatment response based on gender. This could profoundly impact clinical practices, implying that healthcare professionals should not favor one gender over another when suggesting ABA therapies. Instead, the treatment advice should be tailored to each child's unique requirements and traits, regardless of gender. The investigators expect these results to encourage additional research in this field. Comprehending the elements that affect treatment response is vital for improving treatment results and customizing care.
引言 人们普遍认识到,自闭症谱系障碍(ASD)的患病率和诊断在男性中比在女性中更为常见。尽管如此,在自闭症研究领域,针对各种测量变量调查应用行为分析(ABA)治疗效果的性别差异方面,仍存在显著差距。本研究旨在全面评估在目标行为目标、目的和缺陷变量方面的性别差异。
材料与方法 本研究分析了100名参与者的回顾性数据,其中包括89名青少年和4名成年人,7例缺乏年龄记录,这些参与者在2023年3月19日至6月11日接受了为期三个月的ABA项目。ABA项目包括各种方法,如功能分析、离散试验训练、大量试验和自然情境训练。使用“Catalyst”软件(纽约州纽约市Catalyst软件公司)收集关于结果测量的数据,包括目标行为熟练程度、年龄、达到熟练程度的平均试验次数、达到熟练程度的平均教学天数、开放行为目标和目标趋势。使用分类变量(性别和种族/族裔)和连续变量(掌握的行为目标百分比、年龄、平均试验次数、平均教学天数、开放目标、维持期间未通过目标的百分比、呈上升、下降和平稳趋势的目标百分比)的统计分析对参与者的人口统计学特征进行总结。这些统计数据包括均值、标准差、中位数和范围,并使用九个独立的双样本独立t检验进行推断性分析,并使用科恩d值计算相应的效应大小。
结果 在所有九个检查变量中,基于性别的差异均无统计学意义(p>0.05):掌握的目标百分比、年龄、达到掌握的平均试验次数、达到掌握的平均教学天数、开放目标、维持期间未通过目标的百分比、呈上升趋势的目标百分比、呈下降趋势的目标百分比和呈平稳趋势的目标百分比,并且检测到较宽的置信区间。
结论 关于这九个行为目标、掌握程度和缺陷变量,ABA治疗反应中无显著性别差异可能具有相关性。这表明ABA治疗对男性和女性自闭症个体可能同样有益。这些结果应谨慎解释。观察到的总体模式以较宽的置信区间为特征,存在一定程度的统计不确定性,这可能表明存在显著的性别差异。这些结果可能会质疑关于基于性别的治疗反应差异的普遍观念。这可能会对临床实践产生深远影响,意味着医疗保健专业人员在建议ABA治疗时不应偏袒某一性别。相反,治疗建议应根据每个孩子的独特需求和特征进行定制,而不论性别如何。研究人员期望这些结果能鼓励该领域的更多研究。了解影响治疗反应的因素对于改善治疗效果和定制护理至关重要。