A Randomized, Controlled Trial of a Home-Based Intervention Program for Children with Autism and Developmental Delay
A Randomized, Controlled Trial of a Home-Based Intervention Program for Children with Autism and Developmental Delay
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针对自闭症和发育迟缓儿童的家庭干预计划的随机对照试验
DOI：
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发表时间：
2007
影响因子：
2.4
通讯作者：
D. Reddihough
中科院分区：
文献类型：
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作者：
A. Rickards;J. Walstab;R. A. Wright;J. Simpson;D. Reddihough
目的：本研究的目的是：（1）调查除了以中心为基础的方案之外，还提供以家庭为基础的方案是否能改善残疾幼儿的发展及其家庭的应对能力;（2）描述从干预中受益最多的儿童和家庭的特征。方法：59名3-5岁无脑性瘫痪的儿童参加了这项研究。一半的人被随机分配到家中接受额外的计划。一名特殊教育教师在12个月的时间里与这些家庭一起进行了40次访问，帮助将技能推广到家庭环境，并帮助解决他们的问题。在干预前后对所有儿童进行了评估，家庭在两种情况下都完成了评估家庭压力、支持和赋权的问卷。随着时间的推移，干预组和对照组之间的变化差异进行了分析，通过重复测量和儿童和家庭的特点之间的关联，通过多变量方差分析改善的结果。结果如下：随着时间的推移，认知发展和行为（在中心）的变化有利于接受额外干预的儿童（分别为p = .007和p = .007）。这些群体在任何家庭变化措施上都没有差异。多变量方差分析显示，干预组中来自高压力家庭的儿童比来自低压力家庭的儿童有更多的改善。结论：结果表明，需要每天加强在中心为基础的程序和参与家庭，特别是那些资源少，压力相对较高的重要性，学到的技能。
Objective: This study aimed to (1) investigate whether provision of a home-based program in addition to a center-based program improves development in young children with disabilities and coping abilities of their families and (2) describe the characteristics of children and families who benefit most from the intervention. Methods: Fifty-nine children, aged 3–5 years, with no cerebral palsy, participated in the study. Half of the group was randomized to receive an additional program in their homes. A special education teacher provided 40 visits over 12 months working with the families to help generalize skills to the home environment and assist with their concerns. All children were assessed before and after the intervention, and families completed questionnaires assessing family stress, support, and empowerment on both occasions. Differences in change over time and between the intervention and control group were analyzed by repeated measures and the association between characteristics of children and families with improved outcome by multivariate analysis of variance. Results: Change in cognitive development and behavior (in the centers) over time favored the children who received the extra intervention (p = .007 and p = .007, respectively). The groups did not differ on any of the family measures of change. Multivariate analysis of variance revealed more improvement for children in the intervention group from higher than lower stressed families. Conclusions: Results suggest the need for daily reinforcement of skills learned at the center-based program and the importance of involving families, especially those with few resources and relatively high stress.