Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
Int J Environ Res Public Health. 2024 Jul 19;21(7):940. doi: 10.3390/ijerph21070940.
Promoting appropriate behaviors in early childhood is crucial for children's future development. This systematic review aimed to explore the efficacy of social story (SS) intervention in teaching expected behaviors among preschool children. A structured search strategy was applied to five online electronic databases. The references were systematically screened in accordance with the PRISMA statements. Randomized or non-randomized controlled studies, as well as single-subject studies, in which SSs served as a behavioral training approach for children aged 2 to 6 years were included. Information related to study design, characteristics of the participants, target behaviors, and implementation of SS intervention was extracted. A meta-analysis was performed using the random-effects model, where similar outcomes were evaluated by similar intervention across multiple studies. Twenty-one studies were identified for qualitative analysis, while two studies formed the basis of the meta-analysis. SS interventions were employed to teach a variety of behaviors among typically developing children as well as those with various disabilities, such as autism, developmental delay, hearing impairments, attention deficit hyperactivity disorder, or other disabilities. The target behaviors included oral health practices, peer interaction, staying on-task, self-regulation, sleep habits, and controlling aggressive behavior during group activities. The SSs were used either alone or combined with other strategies, such as positive reinforcement, music therapy, role play, group discussion, video self-modeling, immediate practices, or additional audio commentary. Most studies reported improvements in appropriate behaviors and/or reductions in unfavorable behaviors. The meta-analysis indicated that children practiced more toothbrushing steps when using SS interventions compared to conventional oral health instruction (Z = 3.60, MD = 0.66, 95%CI 0.30 to 1.02, < 0.001). SS interventions have the potential to teach target behaviors, particularly toothbrushing behaviors, among preschool children. More well-designed randomized controlled trials are warranted to determine the efficacy of SS interventions among children with various developmental profiles.
在儿童早期促进适当行为对于儿童的未来发展至关重要。本系统评价旨在探讨社会故事（SS）干预在教授学龄前儿童预期行为方面的功效。采用结构化搜索策略在五个在线电子数据库中进行搜索。根据 PRISMA 声明系统地筛选参考文献。纳入的研究为 2 至 6 岁儿童使用 SS 作为行为训练方法的随机或非随机对照研究或单病例研究。提取了研究设计、参与者特征、目标行为以及 SS 干预实施的相关信息。使用随机效应模型对具有相似干预措施和相似结局的多项研究进行了荟萃分析。对 21 项研究进行了定性分析，而对 2 项研究进行了荟萃分析。SS 干预用于教授正常发育儿童以及患有各种残疾（如自闭症、发育迟缓、听力障碍、注意缺陷多动障碍或其他残疾）的儿童的各种行为。目标行为包括口腔健康行为、同伴互动、保持任务、自我调节、睡眠习惯以及在小组活动中控制攻击行为。SS 单独使用或与其他策略结合使用，如正强化、音乐疗法、角色扮演、小组讨论、视频自我示范、即时实践或附加音频评论。大多数研究报告称，适当行为有所改善，不良行为有所减少。荟萃分析表明，与常规口腔健康指导相比，儿童在使用 SS 干预时刷牙步骤更多（Z = 3.60，MD = 0.66，95%CI 0.30 至 1.02， < 0.001）。SS 干预有可能教授学龄前儿童目标行为，特别是刷牙行为。需要更多设计良好的随机对照试验来确定 SS 干预在具有各种发育特征的儿童中的功效。
