Early Intervention in Severe Autism: Positive Outcome Using Exchange and Development Therapy.
Early Intervention in Severe Autism: Positive Outcome Using Exchange and Development Therapy.
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重度自闭症的早期干预：运用交流与发展疗法取得积极成效
DOI：
10.3389/fped.2021.785762
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发表时间：
2021
影响因子：
2.6
通讯作者：
Malvy J
中科院分区：
文献类型：
--
作者：
Blanc R;Latinus M;Guidotti M;Adrien JL;Roux S;Dansart P;Barthélémy C;Rambault A;Bonnet-Brilhault F;Malvy J
早期干预计划积极影响自闭症谱系障碍（ASD）儿童的关键行为。然而，大多数这些计划不针对儿童与严重自闭症自闭症与智力残疾（ID）。本研究的目的是调查严重自闭症和ID儿童的心理和临床结果参加了定制和包容性计划自闭症之旅（TIPA-T）。TIPA-T的第一步是交流和发展疗法（EDT）：一种个体神经功能干预，包括在一个简化的环境中进行的儿童和治疗师之间的一对一交流。它旨在通过结构化的“社会游戏”序列，在社会交往的根源上恢复心理生理能力。认知和社会情感技能和一般发展进行了评估与社会认知评估量表和Brunet-Lézine量表修订版，分别在9个月的干预之前和之后，在32名ASD和ID的儿童。孤独症患者在5个时间点在一个子集的14名儿童，无论是在个人和团体设置的行为总结评估修订的规模进行了评估。在认知和社会情感技能方面发现了统计学上显着的干预后改善。除一名儿童外，所有儿童在至少一个社交领域都有所改善，78%的儿童在至少四个社交领域中获得了一个水平。29名儿童在认知领域有所改善，66%的儿童在至少三个认知领域有所改善。在一对一环境中评估的自闭症症状随着治疗显着减少;超过85%的儿童观察到这种减少。在小组环境中，自闭症儿童的患病率也下降了60%以上。总体发育年龄显著增加了3.8个月。TIPA-T，特别是EDT，提高了大多数ASD儿童的社会情感技能，减少了自闭症的发生，但结果却不均匀，这与ASD中观察到的特征的强烈异质性一致。在小组层面上，这项研究强调了TIPA-T对严重自闭症和相关ID儿童的益处。自闭症核心症状的评估显示，无论是一对一还是小组评估，社会互动都有所改善，证明了EDT期间学到的技能的普遍性。
Early intervention programs positively affect key behaviors for children with autism spectrum disorder (ASD). However, most of these programs do not target children with severe autistic symptomatology associated with intellectual disability (ID). This study aimed to investigate the psychological and clinical outcomes of children with severe autism and ID enrolled in the Tailored and Inclusive Program for Autism—Tours (TIPA-T). The first step of the TIPA-T is the Exchange and Development Therapy (EDT): an individual neurofunctional intervention consisting of one-to-one exchanges between a child and a therapist taking place in a pared-down environment. It aims to rehabilitate psychophysiological abilities at the roots of social communication through structured sequences of “social play.” Cognitive and socio-emotional skills and general development were evaluated with the Social Cognitive Evaluation Battery scale and the Brunet–Lézine Scale—Revised, respectively, before and after 9 months of intervention in 32 children with ASD and ID. Autistic symptomatology was evaluated with the Behavior Summarized Evaluation—Revised scale at five time-points in a subset of 14 children, both in individual and group settings. Statistically significant post-intervention improvements were found in cognitive and socio-emotional skills. All but one child showed improvements in at least one social domain, and 78% of children gained one level in at least four social domains. Twenty-nine children improved in cognitive domains, with 66% of children improving in at least three cognitive domains. Autistic symptomatology evaluated in one-to-one settings significantly decreased with therapy; this reduction was observed in more than 85% of children. In group settings, autistic symptomatology also decreased in more than 60% of children. Global developmental age significantly increased by 3.8 months. The TIPA-T, including EDT in particular, improves socio-emotional skills of most children with ASD and reduces autistic symptomatology, yet with heterogeneous outcomes profiles, in line with the strong heterogeneity of profiles observed in ASD. At the group level, this study highlights the benefits of the TIPA-T for children with severe autism and associated ID. Assessment of autistic core symptoms showed an improvement of social interaction, both in one-to-one and group evaluations, demonstrating the generalizability of the skills learned during the EDT.
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影响因子：
6.9
作者：
Charman, T.;Pickles, A.;Baird, G.
通讯作者：
Baird, G.
影响因子：
3.1
作者：
Adrien, Jean-Louis;Taupiac, Emmanuelle;Lacombe, Didier
通讯作者：
Lacombe, Didier
影响因子：
3.9
作者：
Goods KS;Ishijima E;Chang YC;Kasari C
通讯作者：
Kasari C
影响因子：
3.9
作者：
Barthelemy, C;Roux, S;Lelord, G
通讯作者：
Lelord, G
影响因子：
8
作者：
Gotham, Katherine;Pickles, Andrew;Lord, Catherine
通讯作者：
Lord, Catherine