Intervention targeting development of socially synchronous engagement in toddlers with autism spectrum disorder: a randomized controlled trial.
Intervention targeting development of socially synchronous engagement in toddlers with autism spectrum disorder: a randomized controlled trial.
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DOI：
10.1111/j.1469-7610.2010.02288.x
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发表时间：
2011-01
期刊：
影响因子：
--
通讯作者：
Stuart EA
中科院分区：
文献类型：
--
作者：
Landa RJ;Holman KC;O'Neill AH;Stuart EA
社交和沟通障碍是自闭症的核心缺陷和预后指标。我们评估了以社会同步行为为目标的课程补充综合干预对自闭症谱系障碍（ASD）幼儿社会结果的影响。50名年龄在21到33个月之间的自闭症幼儿被随机分为人际同步和非人际同步两组。干预措施提供相同的强度（每周10小时课堂教学）、师生比例、时间表、以家庭为基础的家长培训（每月1.5小时）、家长教育（38小时）和教学策略，但人际同步条件提供了针对社会参与模仿、共同注意和影响分享的补充课程；这些指标是主要结果。评估在干预前、干预后立即进行，并在6个月随访时评估维持情况。随机效应模型被用来检验各组间随时间的差异。二次分析检查了在干预和随访期间表达性语言和非语言认知方面的收益以及时间效应。在社会参与模仿方面有显著的治疗效果（p=0.02），在干预后，人际同步组的模仿行为与目光接触的比例增加了一倍多（17%至42%）。这种技能被推广到不熟悉的环境中，并通过随访得以维持。在开始共同关注和共享积极影响方面也观察到类似的收益，但组间差异没有达到统计学意义。所有结果均存在显著的时间效应（p<0.001）；在干预期间发生了最大的变化，尤其是在人际同步组。这是第一个涉及幼儿的ASD随机试验，以确定增强社会参与模仿的有效成分。在干预措施中加入社会参与目标可以改善短期结果，而不增加干预措施的成本。我们的参与者在社交、语言和认知方面的进步为自闭症幼儿的这些发展系统的可塑性提供了证据。http://www.clinicaltrials.gov/ct2/show/NCT00106210?term=landa&rank=3
Social and communication impairments are core deficits and prognostic indicators of autism. We evaluated the impact of supplementing a comprehensive intervention with a curriculum targeting socially synchronous behavior on social outcomes of toddlers with autism spectrum disorders (ASD). Fifty toddlers with ASD, ages 21 to 33 months, were randomized to one of two 6-month interventions: Interpersonal Synchrony or Non-Interpersonal Synchrony. The interventions provided identical intensity (10 hours per week in classroom), student-to-teacher ratio, schedule, home-based parent training (1.5 hours per month), parent education (38 hours), and instructional strategies, except the Interpersonal Synchrony condition provided a supplementary curriculum targeting socially engaged imitation, joint attention, and affect sharing; measures of these were primary outcomes. Assessments were conducted pre-intervention, immediately post-intervention, and, to assess maintenance, at six-month follow-up. Random effects models were used to examine differences between groups over time. Secondary analyses examined gains in expressive language and nonverbal cognition, and time effects during the intervention and follow-up periods. A significant treatment effect was found for socially engaged imitation (p=0.02), with more than doubling (17% to 42%) of imitated acts paired with eye contact in the Interpersonal Synchrony group after the intervention. This skill was generalized to unfamiliar contexts and maintained through follow-up. Similar gains were observed for initiation of joint attention and shared positive affect, but between-group differences did not reach statistical significance. A significant time effect was found for all outcomes (p<0.001); greatest change occurred during the intervention period, particularly in the Interpersonal Synchrony group. This is the first ASD randomized trial involving toddlers to identify an active ingredient for enhancing socially engaged imitation. Adding social engagement targets to intervention improves short-term outcome at no additional cost to the intervention. The social, language, and cognitive gains in our participants provide evidence for plasticity of these developmental systems in toddlers with ASD. http://www.clinicaltrials.gov/ct2/show/NCT00106210?term=landa&rank=3
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影响因子：
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作者：
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DOI：
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