Pre-school autism intervention and autism development: a longitudinal follow up of the Preschool Autism Communication Trial (PACT)

学前自闭症干预和自闭症发展：学前自闭症沟通试验（PACT）的纵向随访

• 批准号: MR/K005863/1
• 负责人: Jonathan Green
• 金额: $ 93.67万
• 依托单位: University of Manchester
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2012
• 资助国家: 英国
• 起止时间: 2012 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FK005863%2F1
• 关键词: Pre; autism; intervention; development; longitudinal

Autism is a severe and persistent developmental disorder, starting in childhood and often extending throughout life and affecting about 1% of children in the community. Autism is diagnosed from about 2 years of age onwards. Parents find adjustment to diagnosis and the management of their child with autism very challenging; use of health, social care, and specialist education resources increases progressively through the pre-school and early school years with costs of supporting children with autistic spectrum disorders in the UK estimated at £2.7 billion per year. However, the additional impact of autism on families is probably far higher than this in terms of intense parental involvement and stretching of resources to care for other children and to sustain employment. Rates of family breakdown are higher than the average. Early intervention is thought to be most beneficial and there is increasing evidence that programmes of appropriate advice and training improve child communication and behaviour. However, there has been a lack of research into the longer term effects of early intervention, if any, on the development and wellbeing of children with autism and also on family stress and family function.We have conducted the largest early intervention trial to date of a treatment with parents to help them communicate better with their child with autism. This study (Green et al 2010) showed that, parents who took part in the intervention, were successful in adapting their style of interacting with their child, and in turn the child communicated more with the parent. In spite of these improvements in parent-child communication, children who received the intervention did not improve more than those who had the usual services in how they interacted with adults outside the family, that is the communication improvements did not seem to generalize. However our initial follow up was only at the end of the 13 month intervention - a very short time in the context of development for a child with autism. Therefore in this current study we wish to follow-up the same children about 3 years further on to see how our early intervention has affected longer term developmental outcomes. We will be doing the follow-up in the early school years which is a key time in the development of a child with autism, when many associated difficulties of social integration, and mental health problems such as anxiety, come to the fore. We will be looking at the child's language and communication, other symptoms of autism and social integration. We will also look at parent perceptions of their child's functioning and family life. We are interested in whether parents who took part in the intervention feel more confident and optimistic than those who did not. This study will be to help us understand, for the first time, the impact of early intervention on later child communication, the presentation of autism in the early school years and family life, school adjustment and family need for services. This will help clarify how development proceeds into middle childhood, and give an indication of any necessary additional intervention required either in the pre-school years or later, to maximise the best developmental outcomes in autism. The findings will potentially impact the way early intervention and intervention in the pre-school and early school years is organised, ideally with the integration of medical, social care and education, and methods of supporting families as their children grow older. Green J. Charman, T,. McConachie, H. et al (2010). Parent-Mediated Communication-Focused Treatment for preschool children with Autism (PACT); a randomised controlled trial. The Lancet, 375(9732), 2152-2160.

自闭症是一种严重和持续的发育障碍，始于童年，往往贯穿一生，影响社区中约1%的儿童。自闭症是从大约2岁开始诊断的。家长发现调整诊断和自闭症儿童的管理非常具有挑战性;通过学前和早期教育，健康，社会关怀和专业教育资源的使用逐渐增加，英国支持自闭症谱系障碍儿童的费用估计为每年27亿英镑。然而，自闭症对家庭的额外影响可能远远超过这一点，因为父母的强烈参与以及照顾其他儿童和维持就业的资源紧张。家庭破裂率高于平均水平。早期干预被认为是最有益的，越来越多的证据表明，适当的咨询和培训方案可以改善儿童的沟通和行为。然而，早期干预对自闭症儿童的发展和健康以及对家庭压力和家庭功能的长期影响缺乏研究。我们进行了迄今为止最大规模的早期干预试验，帮助父母更好地与自闭症儿童沟通。这项研究（绿色等人，2010年）表明，参与干预的父母成功地调整了他们与孩子互动的方式，反过来，孩子与父母的沟通更多。尽管在亲子沟通方面有了这些改善，但接受干预的儿童在如何与家庭外的成年人互动方面并没有比接受常规服务的儿童改善得更多，也就是说，沟通改善似乎并不普遍。然而，我们最初的随访只是在13个月的干预结束时-对于自闭症儿童的发展来说，这是一个非常短的时间。因此，在目前的研究中，我们希望对这些儿童再进行3年的随访，以了解我们的早期干预如何影响长期的发展结果。我们将在早期学年进行随访，这是自闭症儿童发展的关键时期，此时许多相关的社会融合困难和焦虑等心理健康问题会凸显出来。我们将关注孩子的语言和交流，自闭症的其他症状和社会融合。我们还将研究父母对孩子的功能和家庭生活的看法。我们感兴趣的是，参加干预的父母是否比没有参加干预的父母更自信和乐观。这项研究将帮助我们了解，第一次，早期干预的影响，以后的儿童沟通，自闭症的表现在早期的学年和家庭生活，学校适应和家庭需要的服务。这将有助于澄清发展如何进入童年中期，并指出在学前阶段或以后需要的任何必要的额外干预，以最大限度地提高自闭症的最佳发展成果。研究结果可能会影响早期干预和学前和早期干预的组织方式，理想情况下，将医疗，社会护理和教育以及随着孩子长大支持家庭的方法相结合。绿色J.查曼，T，. McConachie，H.等（2010）。家长介导的沟通为重点的治疗学龄前儿童自闭症（PACT）：一项随机对照试验。The Lancet，375（9732），2152-2160.

项目成果

Depression and Anxiety Change from Adolescence to Adulthood in Individuals with and without Language Impairment.

• DOI: 10.1371/journal.pone.0156678
• 发表时间: 2016
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Botting N;Toseeb U;Pickles A;Durkin K;Conti-Ramsden G
• 通讯作者: Conti-Ramsden G

Emotional health, support, and self-efficacy in young adults with a history of language impairment.

• DOI: 10.1111/bjdp.12148
• 发表时间: 2016-11
• 期刊: The British journal of developmental psychology
• 作者: Botting N;Durkin K;Toseeb U;Pickles A;Conti-Ramsden G
• 通讯作者: Conti-Ramsden G

Additive effects of social and non-social attention during infancy relate to later autism spectrum disorder.

• DOI: 10.1111/desc.12139
• 发表时间: 2014-07
• 期刊: Developmental science
• 影响因子: 3.7
• 作者: Bedford R;Pickles A;Gliga T;Elsabbagh M;Charman T;Johnson MH;BASIS Team
• 通讯作者: BASIS Team

The preschool autism communication therapy - an evidence-based approach to enhancing early autistic development and empowering families

学前自闭症沟通疗法——一种促进自闭症早期发展并赋予家庭权力的循证方法

• DOI: 10.3917/enf2.191.0119
• 发表时间: 2019
• 期刊: Enfance
• 影响因子: 0.2
• 作者: Aldred C

Aberrant oscillatory activity in Neurofibromatosis Type 1: An EEG study of resting state and working memory

1 型神经纤维瘤病的异常振荡活动：静息状态和工作记忆的脑电图研究

• DOI: 10.1101/2022.08.24.22279165
• 发表时间: 2022
• 作者: Booth S