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针对自闭症谱系障碍转诊儿童破坏性行为的家长培训:一项随机对照试验。

Parent Training for Disruptive Behaviors in Referred Children with Autism Spectrum Disorder: A Randomized Controlled Trial.

作者信息

Breider Simone, de Bildt Annelies, Greaves-Lord Kirstin, Dietrich Andrea, Hoekstra Pieter J, van den Hoofdakker Barbara J

机构信息

Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Accare Child Study Center, Groningen, The Netherlands.

出版信息

J Autism Dev Disord. 2024 Sep 27. doi: 10.1007/s10803-024-06567-0.

Abstract

The purpose of this study was to investigate whether face-to-face and therapist-assisted online (i.e., blended) behavioral parent training are effective on reducing disruptive behaviors in children with autism spectrum disorder (ASD) in routine mental health care. Ninety-seven children with ASD (4-13 years; 76 boys) were randomized to face-to-face parent training, blended parent training, or a waitlist control condition. We assessed treatment effects on parent-rated child noncompliance (primary outcome) and irritability (secondary outcome). This involved comparing both formats separately to the control condition using linear regression models. Child behaviors at 6 months follow-up were also examined. Children in the face-to-face parent training condition improved significantly more on noncompliance and irritability than children in the waitlist condition and improvements sustained to 6 months follow-up. Children in the blended condition did not improve more than children in the waitlist condition and attrition was high. Our results extend findings from efficacy studies to routine mental health care and advocate the use of face-to-face parent training for disruptive behaviors in children with ASD. More research into blended parent training programs for children with ASD and disruptive behaviors in routine mental health care should be conducted to draw more definite conclusions about the value of blended parent training for these children. Trial registration number NL4712; date of registration 22-10-2014.

摘要

本研究的目的是调查在常规精神卫生保健中,面对面及有治疗师协助的在线(即混合式)行为家长培训对于减少自闭症谱系障碍(ASD)儿童的破坏性行为是否有效。97名ASD儿童(4至13岁;76名男孩)被随机分配至面对面家长培训组、混合式家长培训组或等待名单对照组。我们评估了治疗对家长评定的儿童不依从行为(主要结果)和易怒情绪(次要结果)的影响。这涉及使用线性回归模型分别将两种形式与对照组进行比较。还对6个月随访时的儿童行为进行了检查。面对面家长培训组的儿童在不依从行为和易怒情绪方面的改善明显大于等待名单组的儿童,且这些改善持续至6个月随访时。混合式培训组的儿童改善情况并不比等待名单组的儿童更好,且失访率很高。我们的结果将疗效研究的结果扩展至常规精神卫生保健领域,并提倡对ASD儿童的破坏性行为采用面对面家长培训。对于ASD儿童及常规精神卫生保健中破坏性行为的混合式家长培训项目,应开展更多研究,以便就混合式家长培训对这些儿童的价值得出更明确的结论。试验注册号NL4712;注册日期2014年10月22日。

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