Sibling-mediated Social Communicative Intervention for Children with Autism Spect

描述（由申请人提供）：缺乏社交能力是自闭症的主要特征。对这些孩子来说，提高社交能力的干预措施很重要。大多数关注社会能力的干预都发生在课堂或诊所环境中。然而，自闭症儿童大部分时间是在家庭和社区环境中度过的。在这些环境中，兄弟姐妹很可能能够支持或加强自闭症儿童的社会沟通发展。很少有研究调查在自然环境中涉及兄弟姐妹及其兄弟姐妹的社会干预。因此，本项目的目的是发展和获得初步证据，证明一种以兄弟姐妹为中介的干预措施的有效性，该干预措施旨在改善患有自闭症谱系障碍（ASD）的幼儿的社会沟通技能。本研究试图回答以下问题：(1)兄弟姐妹介导的社会交往干预是否会改变幼儿ASD的社会交往行为？(2)如果干预使自闭症儿童与其正常发育的兄弟姐妹之间的整体互动（例如，社会启动/反应，社会交际行为）增加，一旦干预停止并推广到家庭以外的环境中，这种增加是否会在一段时间内保持？(3)干预的结果是否具有社会有效性？采用单受试者多基线设计对12对兄弟姐妹进行干预，以评估干预对ASD儿童社会交往行为的效果。单受试者设计（即单病例实验设计）被认为是开始测试干预措施并确定潜在疗效的适当策略，因为这种设计可以“产生证据，证明该技术对特定行为具有明确的、可复制的效果（Smith, Scahill, Dawson, Guthrie, Lord, Odom, Rogers, & Wagner, 2007, p. 356）”。将收集和分析定性（即访谈）和定量（即对社会沟通技能的观察和发展评价）数据。本研究将扩展以往的研究，在家庭环境（即自然环境）中进行研究，调查自闭症儿童的社会行为变化，并记录是否存在兄弟姐妹介导干预的跨环境泛化。最重要的是，本研究的结果将用于将干预技术整合到手册中，并推进更大规模的全面实施和评估（例如，随机临床试验）。

DESCRIPTION (provided by applicant): Lacking social competence is a primary feature of autism. For those children, interventions to improve social competence are important. Most interventions focusing on social competence have occurred in classroom or clinic settings. Children with autism, however, spend the majority of their time in home and community environments. Siblings in those settings might well be able to support or enhance social communicative development of children with autism. Little research has examined social intervention involving siblings and their brother or sister with autism in a natural environment. Therefore, the purpose of this project is to develop and obtain preliminary evidence of the efficacy of a sibling-mediated intervention designed to improve the social communicational skills of young children with autism spectrum disorder (ASD). The study seeks to answer the following questions (1) does a sibling-mediated social communicative intervention produce changes in social communicative behaviors of young children with ASD? (2) if the intervention produces an increase in overall interactions (e.g., social initiations/responses, social communicative behaviors) between children with ASD and their typically developing siblings, will this increase be maintained for a certain period of time once the intervention has stopped and generalize to a setting outside of home? (3) are the outcomes of the intervention socially valid? A single subject multiple-baseline design will be used with twelve sibling dyads to assess the efficacy of the intervention on the social communicative behaviors of children with ASD. Single subject design (i.e., single case experimental design) is regarded as an appropriate strategy to begin testing an intervention and establishing potential efficacy because this design can "yield evidence that the technique has a clear, replicable effect on a specific behavior (Smith, Scahill, Dawson, Guthrie, Lord, Odom, Rogers, & Wagner, 2007, p. 356)". Both qualitative (i.e., interview) and quantitative (i.e., observations and developmental evaluation on social communication skills) data will be collected and analyzed. This study will extend previous research by conducting the study at home settings (i.e., naturalistic environment), investigating the changes of social behaviors of children with ASD, and documenting the presence or absence of cross-setting generalization of sibling mediated intervention. Most importantly, the results of this study will be used to assemble intervention techniques into a manual and move forward for larger size full implementation and evaluation (e.g., randomized clinical trials). PUBLIC HEALTH RELEVANCE: The purpose of this project is to develop and obtain preliminary evidence of the efficacy of a sibling-mediated intervention designed to improve the social communicational skills of young children with autism spectrum disorder (ASD). The aim is to develop and test the sibling-mediated intervention for young children with confirmed or suspected autism spectrum disorders in terms of social communicative outcomes at home and community settings.