Early intensive behavioral treatment: Replication of the UCLA model in a community setting
Early intensive behavioral treatment: Replication of the UCLA model in a community setting
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DOI：
10.1097/00004703-200604002-00013
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发表时间：
2006-04-01
影响因子：
2.4
通讯作者：
Smith, Tristram
中科院分区：
文献类型：
--
作者：
Cohen, Howard;Amerine-Dickens, Mila;Smith, Tristram
虽然以前的研究表明早期强化行为治疗（EIBT）对自闭症儿童有良好的效果，但复制这些发现仍然很重要，特别是在社区环境中。作者进行了一项为期3年的前瞻性结果研究，比较了两组：（1）21名儿童，他们每周接受35至40小时的EIBT，来自一个社区机构，该机构复制了Lovaas的EIBT模型;（2）21名年龄和智商匹配的儿童，他们在当地公立学校的特殊教育班学习。采用准实验设计，根据父母的偏好分配到各组。由独立的检查员对智商（贝利婴儿发育量表或韦氏学前和小学智力量表）、语言（韦氏语言发育量表）、非语言技能（梅里尔-帕尔默心理测试量表）和适应行为（瓦兰适应行为量表）进行评估。以基线评分为协变量，以第1-3年评估为重复测量的协方差分析显示，治疗后，EIBT组获得的IQ（F = 5.21，p = 0.03）和适应行为评分（F = 7.84，p = 0.01）显著高于对照组。两组之间在语言理解（F = 3.82，p = 0.06）或非语言技能方面没有差异。在21名EIBT儿童中，有6名在3年级时完全接受了正规教育，没有任何援助，另外11名儿童接受了支助;相比之下，只有1名对照儿童主要接受正规教育。虽然这项研究受到非随机分组的限制，但它确实提供了EIBT可以在社区环境中成功实施的证据。
Although previous studies have shown favorable results with early intensive behavioral treatment (EIBT) for children with autism, it remains important to replicate these findings, particularly in community settings. The authors conducted a 3-year prospective outcome study that compared 2 groups: (1) 21 children who received 35 to 40 hours per week of EIBT from a community agency that replicated Lovaas' model of EIBT and (2) 21 age- and IQ-matched children in special education classes at local public schools. A quasi-experimental design was used, with assignment to groups based on parental preference. Assessments were conducted by independent examiners for IQ (Bayley Scales of Infant Development or Wechsler Preschool and Primary Scales of Intelligence), language (Reynell Developmental Language Scales), nonverbal skill (Merrill-Palmer Scale of Mental Tests), and adaptive behavior (Vineland Adaptive Behavior Scales). Analyses of covariance, with baseline scores as covariates and Year 1-3 assessments as repeated measures, revealed that, with treatment, the EIBT group obtained significantly higher IQ (F = 5.21, p =.03) and adaptive behavior scores (F = 7.84, p =.01) than did the comparison group. No difference between groups was found in either language comprehension (F = 3.82, p =.06) or nonverbal skill. Six of the 21 EIBT children were fully included into regular education without assistance at Year 3, and 11 others were included with support; in contrast, only 1 comparison child was placed primarily in regular education. Although the study was limited by the nonrandom assignment to groups, it does provide evidence that EIBT can be successfully implemented in a community setting.