Utility of the Autism Diagnostic Observation Schedule and the Brief Observation of Social and Communication Change for Measuring Outcomes for a Parent-Mediated Early Autism Intervention.
Utility of the Autism Diagnostic Observation Schedule and the Brief Observation of Social and Communication Change for Measuring Outcomes for a Parent-Mediated Early Autism Intervention.
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DOI：
10.1002/aur.2449
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
PACT Consortium
中科院分区：
文献类型：
--
作者：
Carruthers S;Charman T;El Hawi N;Kim YA;Randle R;Lord C;Pickles A;PACT Consortium
鉴于自闭症儿童在社交沟通干预后的变化具有异质性且可能很细微，衡量干预结果是一项持续的挑战。我们对社交沟通变化简要观察量表（BOSCC）、自闭症诊断观察量表（ADOS - 2）算法以及ADOS - 2校准严重程度分数（CSS）在学前自闭症沟通试验（PACT）中2 - 5岁自闭症儿童中的整体和条目层面的干预效果进行了测试和比较。BOSCC应用于ADOS第一模块评估（ADOS - BOSCC）。在117名使用单个词语或不使用词语的儿童（第一模块）中，ADOS - BOSCC、ADOS算法和ADOS CSS各自检测到较小的、不显著的干预效果。然而，在ADOS算法中，基线时“几乎不使用词语”的儿童有中等显著的干预效果，而“使用一些词语”的儿童干预效果甚微。对于整个PACT样本（包括ADOS第二模块，总数n = 152），ADOS指标显示出显著的小（CSS）和中等（算法）的整体干预效果。第一模块的条目层面干预效果均未达到显著水平，其中手势（ADOS - BOSCC和ADOS）、面部表情（ADOS）和语调（ADOS）的变化最大。在ADOS第二模块中，对于刻板行为和重复兴趣及刻板行为观察到显著的条目层面效果。尽管ADOS - BOSCC具有良好的心理测量特性，但在第一模块儿童中，它对行为变化的敏感度并不高于ADOS。我们的研究结果表明ADOS可以是一种敏感的结果测量工具。条目层面的干预效果图有可能表明干预“变化特征”，这一概念在未来的试验和系统综述中可能有用。
这项研究比较了一种家长介导疗法中的两种结果测量方法。两者没有明显的优劣之分；然而，对于开始时“几乎不使用词语”的儿童，自闭症诊断观察量表比社交沟通变化简要观察量表更能清晰地显示出改善的证据。我们探究了哪些特定行为与更大的改善相关。这些发现可以为研究人员在考虑如何最好地探究其干预的影响时提供参考。
Measuring outcomes for autistic children following social communication interventions is an ongoing challenge given the heterogeneous changes, which can be subtle. We tested and compared the overall and item‐level intervention effects of the Brief Observation of Social Communication Change (BOSCC), Autism Diagnostic Observation Schedule (ADOS‐2) algorithm, and ADOS‐2 Calibrated Severity Scores (CSS) with autistic children aged 2–5 years from the Preschool Autism Communication Trial (PACT). The BOSCC was applied to Module 1 ADOS assessments (ADOS‐BOSCC). Among the 117 children using single or no words (Module 1), the ADOS‐BOSCC, ADOS algorithm, and ADOS CSS each detected small non‐significant intervention effects. However, on the ADOS algorithm, there was a medium significant intervention effect for children with “few to no words” at baseline, while children with “some words” showed little intervention effect. For the full PACT sample (including ADOS Module 2, total n=152), ADOS metrics evidenced significant small (CSS) and medium (algorithm) overall intervention effects. None of the Module 1 item‐level intervention effects reached significance, with largest changes observed for Gesture (ADOS‐BOSCC and ADOS), Facial Expressions (ADOS), and Intonation (ADOS). Significant ADOS Module 2 item‐level effects were observed for Mannerisms and Repetitive Interests and Stereotyped Behaviors. Despite strong psychometric properties, the ADOS‐BOSCC was not more sensitive to behavioral changes than the ADOS among Module 1 children. Our results suggest the ADOS can be a sensitive outcome measure. Item‐level intervention effect plots have the potential to indicate intervention “signatures of change,” a concept that may be useful in future trials and systematic reviews. This study compares two outcome measures in a parent‐mediated therapy. Neither was clearly better or worse than the other; however, the Autism Diagnostic Observation Schedule produced somewhat clearer evidence than the Brief Observation of Social Communication Change of improvement among children who had use of “few to no” words at the start. We explore which particular behaviors are associated with greater improvement. These findings can inform researchers when they consider how best to explore the impact of their intervention.
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影响因子：
3.9
作者：
Gotham, Katherine;Pickles, Andrew;Lord, Catherine
通讯作者：
Lord, Catherine
自闭症诊断观察表： 提高诊断有效性的修订算法
影响因子：
3.9
作者：
Gotham, Katherine;Risi, Susan;Lord, Catherine
通讯作者：
Lord, Catherine
影响因子：
5.2
作者：
Fletcher-Watson, Sue;Petrou, Alexandra;McConachie, Helen
通讯作者：
McConachie, Helen
影响因子：
3.9
作者：
Hus, Vanessa;Lord, Catherine
通讯作者：
Lord, Catherine
DOI：
10.1111/j.1469-7610.2004.00338.x
发表时间：
2004-11-01
影响因子：
7.6
作者：
Aldred, C;Green, J;Adams, C
通讯作者：
Adams, C