Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model.
Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model.
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DOI：
10.1542/peds.2009-0958
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发表时间：
2010-01
期刊：
影响因子：
8
通讯作者：
Varley J
中科院分区：
文献类型：
--
作者：
Dawson G;Rogers S;Munson J;Smith M;Winter J;Greenson J;Donaldson A;Varley J
进行一项随机对照试验，以评估早期启动丹佛模型（ESDM）的有效性，ESDM是一种全面的发育行为干预措施，用于改善诊断为自闭症谱系障碍（ASD）的幼儿的结局。将48名年龄在18至30个月之间被诊断为ASD的儿童随机分配到两组中的一组：（1）ESDM干预，该干预基于发展和应用行为分析原则，由训练有素的治疗师和父母提供2年;或（2）转介到社区提供者进行社区常见的干预。与接受社区干预的儿童相比，接受ESDM的儿童在智商、适应行为和自闭症诊断方面表现出显着改善。进入干预后两年，ESDM组平均提高了17.6标准分（1 SD：15分），而对照组相对于基线评分平均提高了7.0分。与发育正常的儿童的标准样本相比，ESDM组保持了适应行为的增长速度。相比之下，在2年的时间里，对照组在适应行为方面表现出更大的延迟。接受ESDM的儿童也更有可能经历从自闭症到广泛性发育障碍的诊断变化，而不是其他特殊情况，比对照组。这是第一项随机对照试验，旨在证明ASD幼儿综合发育行为干预对改善认知和适应行为以及降低ASD诊断严重程度的有效性。这项研究的结果强调了早期发现和干预自闭症的重要性。
To conduct a randomized, controlled trial to evaluate the efficacy of the Early Start Denver Model (ESDM), a comprehensive developmental behavioral intervention, for improving outcomes of toddlers diagnosed with autism spectrum disorder (ASD). Forty-eight children diagnosed with ASD between 18 and 30 months of age were randomly assigned to 1 of 2 groups: (1) ESDM intervention, which is based on developmental and applied behavioral analytic principles and delivered by trained therapists and parents for 2 years; or (2) referral to community providers for intervention commonly available in the community. Compared with children who received community-intervention, children who received ESDM showed significant improvements in IQ, adaptive behavior, and autism diagnosis. Two years after entering intervention, the ESDM group on average improved 17.6 standard score points (1 SD:15 points) compared with 7.0 points in the comparison group relative to baseline scores. The ESDM group maintained its rate of grow thin adaptive behavior compared with a normative sample of typically developing children. In contrast, over the 2-year span, the comparison group showed greater delays in adaptive behavior. Children who received ESDM also were more likely to experience a change in diagnosis from autism to pervasive developmental disorder, not otherwise specified, than the comparison group. This is the first randomized, controlled trial to demonstrate the efficacy of a comprehensive developmental behavioral intervention for toddlers with ASD for improving cognitive and adaptive behavior and reducing severity of ASD diagnosis. Results of this study underscore the importance of early detection of and intervention in autism.