A randomized controlled trial of Hanen's 'More Than Words' in toddlers with early autism symptoms
A randomized controlled trial of Hanen's 'More Than Words' in toddlers with early autism symptoms
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DOI：
10.1111/j.1469-7610.2011.02395.x
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发表时间：
2011-07-01
影响因子：
7.6
通讯作者：
Yoder, Paul
中科院分区：
文献类型：
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作者：
Carter, Alice S.;Messinger, Daniel S.;Yoder, Paul
背景：这项随机对照试验将哈宁的“多于言语”（HMTW）（一种由家长实施的干预措施）与“一切照旧”对照组进行了比较。方法：62 名符合自闭症谱系障碍 (ASD) 标准的儿童（51 名男孩和 11 名女孩；M 年龄 = 20 个月；SD = 2.6）及其父母参与了这项研究。 HMTW 干预持续了 3.5 个月。共有三个测量期：随机化之前（时间 1）以及入组后 5 个月和 9 个月（时间 2 和 3）。在每个时间点测量儿童的沟通和父母的反应度。儿童的物体兴趣（假定的调节因素）在时间 1 进行测量。结果：HMTW 干预对父母的反应性或儿童的沟通没有主要影响。然而，从第 1 次到第 2 次和第 3 次，对父母反应性残余增益的影响产生了显着的效应大小（Glass 的 Delta 分别 = 0.71、0.50）。相比之下，治疗对时间 3 儿童沟通增益的影响受到儿童时间 1 对象兴趣的调节。对“时间 1”对象兴趣水平较低的儿童表现出交流能力的提高；对物体兴趣较高的儿童表现出生长衰减。结论：HMTW 干预对儿童沟通表现出不同的影响，具体取决于基线儿童因素。 HMTW 促进了对时间 1 对象兴趣水平较低的儿童的交流。表现出较高物体兴趣的孩子的家长可能需要更多的支持来实施 HMTW 策略，或者可能需要与 HMTW 课程提供的策略不同的策略。
Background: This randomized controlled trial compared Hanen's 'More than Words' (HMTW), a parent-implemented intervention, to a 'business as usual' control group. Methods: Sixty-two children (51 boys and 11 girls; M age = 20 months; SD = 2.6) who met criteria for autism spectrum disorders (ASD) and their parents participated in the study. The HMTW intervention was provided over 3.5 months. There were three measurement periods: prior to randomization (Time 1) and at 5 and 9 months post enrollment (Times 2 and 3). Children's communication and parental responsivity were measured at each time point. Children's object interest, a putative moderator, was measured at Time 1. Results: There were no main effects of the HMTW intervention on either parental responsivity or children's communication. However, the effects on residualized gains in parental responsivity from Time 1 to both Times 2 and 3 yielded noteworthy effect sizes (Glass's Delta = .71, .50 respectively). In contrast, there were treatment effects on child communication gains to Time 3 that were moderated by children's Time 1 object interest. Children with lower levels of Time 1 object interest exhibited facilitated growth in communication; children with higher levels of object interest exhibited growth attenuation. Conclusions: The HMTW intervention showed differential effects on child communication depending on a baseline child factor. HMTW facilitated communication in children with lower levels of Time 1 object interest. Parents of children who evidence higher object interest may require greater support to implement the HMTW strategies, or may require different strategies than those provided by the HMTW curriculum.