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）：先前的研究表明，早期干预可能有助于自闭症取得更好的结果。回答“多早？”的问题。对于自闭症谱系障碍 (ASD) 筛查年龄和对自闭症谱系障碍儿童进行早期干预的年龄具有重大的健康和教育意义。随着被诊断为自闭症谱系障碍的幼儿数量不断增加，迫切需要父母在自然环境中可以获取和实施的基于证据的手动干预措施。该项目与佛罗里达州立大学的艾米·韦瑟比博士和密歇根大学的凯瑟琳·洛德博士提交的两个相同的链接申请合作。主要目标是直接比较两种家长干预条件，各为期 9 个月：1) 每周 2-3 次的个性化家长实施干预 (PII)，教家长如何在日常生活、活动和场所中嵌入支持社交沟通技能的策略，每周 25 小时； 2) 每月两次的信息、教育和支持小组 (IES)。每个中心将招募 36 名 18 个月大的新亲子二人组，将其与招募的 18 名二人组进行初步持续研究，每个中心总共 54 名二人组，随机分配到 PII 或 IES 作为首要条件。采用交叉设计，所有二人组也将从 27 个月大时开始接受另一种情况，总共 18 个月的干预。本次调查的具体目的是： 1) 比较 PII 和 IES 在 27 个月时的有效性； 2) 比较 PII 和 IES 组合在 36 个月时的有效性。社交沟通和自闭症症状的结果测量将在 18 至 36 个月大时每两个月收集一次，发育水平和适应行为的测量将在 18 个月大治疗前、27 个月大交叉点和 36 个月大第二次治疗条件后收集。分层线性模型将用于 108 个二元组的组合样本，以估计结果测量的生长曲线，并检查儿童在不同治疗条件下以及在不同年龄开始强化治疗期间生长轨迹的差异。本研究的结果将： 1) 记录患有自闭症谱系障碍 (ASD) 的幼儿接受手动、基于社区、具有成本效益、适当且有效的干预措施后的改善结果； 2) 证实从 18 个月大开始的强化干预比三岁时的干预效果更好，这提供了证据表明幼儿自闭症筛查对于有效的早期干预至关重要。