Mechanism of Developmental Change in the PLAY Project Home Consultation Program: Evidence from a Randomized Control Trial.
Mechanism of Developmental Change in the PLAY Project Home Consultation Program: Evidence from a Randomized Control Trial.
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PLAY 项目家庭咨询计划中的发育变化机制：来自随机对照试验的证据。
DOI：
10.1007/s10803-016-2720-x
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发表时间：
2016
影响因子：
3.9
通讯作者：
Solomon,Richard
中科院分区：
文献类型：
--
作者：
Mahoney,Gerald;Solomon,Richard
这项调查是对PLAY家庭咨询干预项目的随机对照试验数据的二次分析，该项目对112名患有自闭症谱系障碍的学龄前儿童及其父母进行了研究（Solomon et al. J Dev Behav pediatrics 35:47 - 485, 2014）。受试者被随机分配到社区标准（CS）治疗组或PLAY项目加CS治疗（PLAY）组。PLAY受试者每月接受为期一年的亲子干预，在此期间，父母学习如何使用发展、个体差异、基于关系（DIR）干预模型的基本原理和互动策略（格林斯潘和韦德在《特殊需要的孩子：鼓励智力和情感成长》一书中提到）。DeCapo Press, Cambridge， MA, 1998)与孩子进行更积极、更有情感、更少指令性的互动。本研究考察了PLAY干预对父母与孩子互动方式和儿童社会参与的影响是否介导了PLAY对儿童自闭症严重程度的影响。采用回归程序对中介进行检验。主要有两个发现。首先，玩耍对儿童社会参与的影响是通过玩耍促进的父母反应性和情感的增加来调节的。玩耍对儿童社会情感障碍严重程度的影响是通过父母反应性和情感的改变介导的；然而，这些变量对儿童社会参与的影响介导了反应/影响的影响。结果讨论了发展变化的当代模型，包括发展变化模型，发展变化模型是DIR的基础。
This investigation is a secondary analysis of data from a randomized control trial of the PLAY Home Consultation Intervention Program which was conducted with 112 preschool children with Autism Spectrum Disorders and their parents (Solomon et al. in J Dev Behav Pediatr 35:475–485, 2014). Subjects were randomly assigned to either a community standard (CS) treatment group or to the PLAY Project plus CS Treatment (PLAY). PLAY subjects received monthly parent–child intervention sessions for 1 year during which parents learned how to use the rationale and interactive strategies of the Developmental, Individual-differences, Relationship-based (DIR) intervention model (Greenspan and Weider in The child with special needs: encouraging intellectual and emotional growth. DeCapo Press, Cambridge, MA, 1998) to engage in more responsive, affective and less directive interactions with their children. This investigation examined whether PLAY intervention effects on parents’ style of interacting with their children as well as on children’s social engagement mediated the effects of PLAY on children’s autism severity as measured by ADOS calibrated severity scores. Regression procedures were used to test for mediation. There were two main findings. First the effects of PLAY on children’s social engagement were mediated by the increases in parental responsiveness and affect that were promoted by PLAY. Second, the effects of PLAY on the severity children’s Social Affect disorders were mediated by changes in parental responsiveness and affect; however, the effects of Responsive/Affect were mediated by the impact these variables had on children’s social engagement. Results are discussed in terms of contemporary models of developmental change including the developmental change model that is the foundation for DIR.
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