2/2-Effects of Parent-Implemented Intervention for Toddlers with Autism Spectrum

2/2-家长对自闭症谱系幼儿实施干预的效果

• 批准号: 7870965
• 负责人: Catherine Lord
• 金额: $ 17.5万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7870965
• 关键词: Adaptive Behaviors; Address; Age; Age-Months; American Psychological Association; Arbitration; Attention; Authorship; Autistic Disorder; Award; Child; Code; Codes of Ethics; Cognitive; Collaborations; Communication; Communities; Computers; Crossover Design; Data; Databases; Development; Diagnosis; Diagnostic; Documentation; Early identification; Early treatment; Education; Educational process of instructing; Effect Modifiers (Epidemiology); Effectiveness; Electronic Mail; Electronics; Elements; Ensure; Environment; Evaluation; Family Characteristics; Florida; Grant; Growth; Health; Hour; Housing; Individual; Internet; Intervention; Intervention Studies; Investigation; Joints; Life; Linear Models; Link; Mails; Measurement; Measures; Mediator of activation protein; Michigan; National Institute of Mental Health; National Research Council; Outcome; Outcome Measure; Outcome Study; Parents; Pattern; Procedures; Process; Property; Public Health; Publications; Randomized; Recruitment Activity; Regulation; Relative (related person); Research; Research Personnel; Resources; Rights; Role; Running; Sampling; Schedule; Screening procedure; Secure; Series; Severities; Site; Social Interaction; Staging; Support Groups; Symptoms; Technology; Telephone; Time; Toddler; Training; Universities; Update; Video Recording; Videotape; Work; Writing; autism spectrum disorder; base; compare effectiveness; cost; cost efficient; data sharing; design; digital; dissemination research; effective intervention; evidence base; experience; formycin triphosphate; improved; meetings; response; skills; social communication; symposium; web site

DESCRIPTION (provided by applicant): Previous research has suggested that earlier intervention may contribute to better outcomes in autism. Answering the question "how early?" has significant health and educational implications for age of screening for autism spectrum disorders (ASD) and age of entry into early intervention for children with ASD. With the increased number of young children identified with ASD, there is a pressing need for evidence-based, manualized intervention that is accessible to and implemented by parents within their natural environments. This project is collaborative with two identical, linked applications submitted by Dr. Amy Wetherby at FSU and Dr. Catherine Lord at UM. The major objective is to directly compare two parent intervention conditions for 9 months each: 1) an individualized parent-implemented intervention (PII) offered in 2-3 weekly sessions to teach parents how to embed strategies to support social communication skills for 25 hours a week within everyday routines, activities, and places; and 2) an information, education and support group (IES) offered twice monthly. Each site will recruit 36 new parent-child dyads at 18 months of age, who will be pooled with 18 dyads recruited for a preliminary ongoing study, totaling 54 dyads at each site, randomly assigned to either PII or IES as the first condition. Using a crossover design, all dyads will also receive the other condition beginning at 27 months of age, totaling 18 months of intervention. The specific aims of this investigation are: 1) to compare the effectiveness of PII and IES at 27 months; and 2) to compare the effectiveness of the combination of PII and IES at 36 months. Outcome measures of social communication and autism symptoms will be gathered bi-monthly from 18 to 36 months of age and measures of developmental levels and adaptive behavior will be gathered before treatment at 18 months of age, at the point of crossover at 27 months, and after the 2nd treatment condition at 36 months. Hierarchical linear modeling will be used on the combined sample of 108 dyads to estimate growth curves of the outcome measures and to examine differences in growth trajectories for children during the different treatment conditions and starting intensive treatment at different ages. The findings of this study will: 1) document improved outcomes for very young children with ASD receiving a manualized, community-based, cost efficient, appropriate, and effective intervention; and 2) substantiate that intensive intervention beginning by 18 months of age leads to better outcomes than intervention in the third year of life, providing evidence that autism screening for toddlers is crucial to effective early intervention.

描述(由申请人提供)：以前的研究表明，早期干预可能有助于改善自闭症的结果。回答“多早？”对自闭症谱系障碍(ASD)筛查年龄和自闭症儿童早期干预年龄具有重要的健康和教育意义。随着发现患有自闭症的幼儿人数增加，迫切需要以证据为基础、由父母在其自然环境中可获得和实施的手动干预措施。该项目与FSU的艾米·韦瑟比博士和密歇根大学的凯瑟琳·洛德博士提交的两份相同的、相互关联的申请进行了合作。主要目标是直接比较两种家长干预条件，每种情况各9个月：1)每周2-3次会议提供的个性化家长实施干预(PII)，教父母如何在日常生活、活动和场所中每周25小时嵌入支持社交技能的策略；2)每月提供两次信息、教育和支持小组(IES)。每个站点将在18个月大的时候招募36个新的亲子双体，他们将与18个双体集合在一起进行初步的正在进行的研究，每个站点总共54个双体，随机分配到PII或IES作为第一种情况。使用交叉设计，所有的双胞胎也将从27个月大开始接受另一种情况，总计18个月的干预。本研究的具体目的是：1)比较27个月时PII和IES的效果；2)比较36个月时PII和IES的联合效果。社会沟通和自闭症症状的结果测量将在18至36个月龄期间每两个月收集一次，发育水平和适应行为的测量将在18个月龄前收集，在27个月龄交叉时收集，并在第二次治疗条件后36个月收集。将对108个二元体的组合样本进行分层线性建模，以估计结果指标的生长曲线，并检查不同治疗条件和不同年龄开始强化治疗期间儿童生长轨迹的差异。这项研究的结果将：1)记录患有自闭症的非常年幼的儿童接受手动的、基于社区的、具有成本效益的、适当的和有效的干预的改善结果；以及2)证实从18个月开始的强化干预导致比第三年的干预更好的结果，提供证据表明对学步儿童的自闭症筛查对于有效的早期干预至关重要。