Randomized controlled effectiveness trial of executive function intervention for children on the autism spectrum
Randomized controlled effectiveness trial of executive function intervention for children on the autism spectrum
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DOI：
10.1111/jcpp.12161
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发表时间：
2014-04-01
影响因子：
7.6
通讯作者：
Wallace, Gregory L.
中科院分区：
文献类型：
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作者：
Kenworthy, Lauren;Anthony, Laura Gutermuth;Wallace, Gregory L.
背景Unstuck and On Target（UOT）是一种针对自闭症谱系障碍（ASD）儿童的执行功能（EF）干预，通过自我调节脚本、引导/褪色练习和视觉/语言提示的认知行为程序，针对坚持一致性、灵活性、目标设定和计划。UOT是上下文为基础的，因为它是在学校和家庭中实施，在其中一个孩子使用EF skills.MethodsTo评估UOT的有效性相比，社会技能干预（SS），3 - 5年级ASD（平均智商=108; UOT n=47; SS n=20）收到的干预措施由学校工作人员在小组会议。学生们在性别、年龄、种族、智商、ASD遗传学、药物治疗状况和父母的教育程度方面进行了匹配。干预措施的剂量与培训相匹配。前后变化的措施包括课堂观察，家长/教师的报告，并直接儿童解决问题的措施，EF，和社会技能。学校进行了随机和评估，但不是家长或教师，是盲目的干预type.ResultsInterventions管理高保真。两组儿童的干预改善，但从干预前到干预后的平均变化分数表明UOT比SS组在解决问题，灵活性和规划/组织方面有更大的改善。此外，课堂观察显示，UOT的参与者比SS参与者在遵守规则，过渡和灵活性方面的能力有了更大的提高。在这两个群体中的儿童取得了相当的改善，在social skills.ConclusionsThese数据支持的有效性，第一个基于上下文的EF干预ASD的儿童。UOT改善了ASD儿童的课堂行为，灵活性和解决问题的能力。在ASD中具有可变背景/培训的个人成功地在主流教育环境中实施了UOT。
BackgroundUnstuck and On Target (UOT) is an executive function (EF) intervention for children with autism spectrum disorders (ASD) targeting insistence on sameness, flexibility, goal-setting, and planning through a cognitive-behavioral program of self-regulatory scripts, guided/faded practice, and visual/verbal cueing. UOT is contextually-based because it is implemented in school and at home, the contexts in which a child uses EF skills.MethodsTo evaluate the effectiveness of UOT compared with a social skills intervention (SS), 3rd-5th graders with ASD (mean IQ=108; UOT n=47; SS n=20) received interventions delivered by school staff in small group sessions. Students were matched for gender, age, race, IQ, ASD symptomotolgy, medication status, and parents' education. Interventions were matched for dose' of intervention and training. Measures of pre-post change included classroom observations, parent/teacher report, and direct child measures of problem-solving, EF, and social skills. Schools were randomized and evaluators, but not parents or teachers, were blinded to intervention type.ResultsInterventions were administered with high fidelity. Children in both groups improved with intervention, but mean change scores from pre- to postintervention indicated significantly greater improvements for UOT than SS groups in: problem-solving, flexibility, and planning/organizing. Also, classroom observations revealed that participants in UOT made greater improvements than SS participants in their ability to follow rules, make transitions, and be flexible. Children in both groups made equivalent improvements in social skills.ConclusionsThese data support the effectiveness of the first contextually-based EF intervention for children with ASD. UOT improved classroom behavior, flexibility, and problem-solving in children with ASD. Individuals with variable background/training in ASD successfully implemented UOT in mainstream educational settings.