Markfeld Jennifer E, Feldman Jacob I, Bush Catherine T, Yoder Paul J, Woynaroski Tiffany G
Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA.
Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA.
J Autism Dev Disord. 2025 Jun 23. doi: 10.1007/s10803-025-06928-3.
Low responsiveness to sensory stimuli, particularly stimuli that are social in nature (i.e., social hyporesponsiveness), predicts expressive language in autistic children and in infant siblings of autistic children (Sibs-autism), who are at high likelihood for a future diagnosis of autism and developmental language disorder. However, our understanding of whether social hyporesponsiveness can be addressed via early intervention to improve expressive language outcomes of Sibs-autism is limited. This randomized controlled trial investigated whether Project ImPACT, a caregiver-implemented Naturalistic Developmental Behavioral Intervention (NDBI), has an indirect effect on expressive language outcomes by reducing social hyporesponsiveness. Sibs-autism were randomized into a Project ImPACT group (n = 23) for 12 weeks of intervention, or into a non-Project ImPACT control group (n = 23). Social hyporesponsiveness was measured immediately following intervention, and expressive language was measured three months after the end of intervention. Project ImPACT indirectly influenced distal expressive language outcomes through social hyporesponsiveness, but only for infants whose caregivers had high levels of education at study entry. Clinical implications of the results are discussed.
对感觉刺激反应迟钝，尤其是对具有社交性质的刺激（即社交反应低下），可预测自闭症儿童及自闭症儿童的婴儿兄弟姐妹（自闭症患儿同胞）的表达性语言发展情况，这些患儿未来被诊断为自闭症和发育性语言障碍的可能性很高。然而，我们对于社交反应低下能否通过早期干预来改善自闭症患儿同胞的表达性语言结果的了解有限。这项随机对照试验调查了“影响计划”（Project ImPACT），一种由照料者实施的自然主义发展行为干预（NDBI），是否通过降低社交反应低下对表达性语言结果产生间接影响。自闭症患儿同胞被随机分为“影响计划”组（n = 23），接受为期12周的干预，或分为非“影响计划”对照组（n = 23）。干预结束后立即测量社交反应低下情况，干预结束三个月后测量表达性语言。“影响计划”通过社交反应低下间接影响远期表达性语言结果，但仅适用于研究开始时照料者受教育程度较高的婴儿。文中讨论了研究结果的临床意义。
