Qu Lu, Colombi Costanza, Chen Weiyun, Miller Alison, Miller Haylie, Ulrich Dale A
Shanghai Institute of AI for Education, East China Normal University, Shanghai, China.
School of Kinesiology, University of Michigan, Ann Arbor, USA.
J Autism Dev Disord. 2024 Sep 13. doi: 10.1007/s10803-024-06543-8.
The study aimed to examine the efficacy of a culturally-adapted, group-based parent coaching program for autistic children in China delivered via telehealth. A randomized controlled trial was conducted, with 18 parents allocated to the self-directed group that received the intervention through an online learning platform, and 19 parents allocated to the web + group therapy group, which included the same program along with weekly 1.5-hour group coaching sessions via videoconferencing. The primary outcomes were parents' mental health and children's adaptive functioning, while the secondary outcomes focused on the child behaviors, parenting stress and parenting style, and family quality of life. Linear Mixed Models were used to evaluate treatment effects across time and to model longitudinal trajectories of outcomes in both children and parents. Both intervention groups showed significant improvements in children's communication skills (F (1, 60.27) = 29.86, p < 0.001) and social engagement (F (1, 60.07) = 11.73, p = 0.001), as well as reductions in parenting stress (F (1, 59.07) = 8.76, p = 0.004) and anxiety levels (F (1, 57.62) = 4.84, p = 0.032). Additionally, the group-based parent coaching via videoconferencing was associated with greater improvements in children's quality of life (F (1, 59.95) = 5.90, p = 0.018) and parents' anxiety outcomes (F (1, 57.62) = 4.84, p = 0.032). This study demonstrated the efficacy of a culturally adapted telehealth intervention for both autistic children and their parents. The preliminary findings suggest positive outcomes in children's adaptive functioning and parents' mental well-being. Group-based parent coaching through videoconferencing could be a promising and practical model for in-home services, particularly for families with limited access to in-person services.
该研究旨在检验一项针对中国自闭症儿童的、经文化调适的、基于小组的家长指导项目通过远程医疗实施的效果。开展了一项随机对照试验，18名家长被分配到自主学习组，通过在线学习平台接受干预，19名家长被分配到网络+小组治疗组，该组包括相同的项目以及每周通过视频会议进行的1.5小时小组指导课程。主要结果是家长的心理健康和儿童的适应性功能，次要结果集中在儿童行为、育儿压力和育儿方式以及家庭生活质量。使用线性混合模型来评估不同时间的治疗效果，并对儿童和家长的结果纵向轨迹进行建模。两个干预组在儿童沟通技能（F(1, 60.27)=29.86, p<0.001）和社交参与（F(1, 60.07)=11.73, p=0.001）方面均有显著改善，同时育儿压力（F(1, 59.07)=8.76, p=0.004）和焦虑水平降低（F(1, 57.62)=4.84, p=0.032）。此外，通过视频会议进行的基于小组的家长指导与儿童生活质量的更大改善（F(1, 59.95)=5.90, p=0.018）和家长焦虑结果（F(1, 57.62)=4.84, p=0.032）相关。这项研究证明了一种经文化调适的远程医疗干预对自闭症儿童及其家长的有效性。初步研究结果表明在儿童适应性功能和家长心理健康方面有积极结果。通过视频会议进行的基于小组的家长指导可能是居家服务的一个有前景且实用的模式，特别是对于难以获得面对面服务的家庭。
