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，较早的干预措施可能会导致自闭症的更好结果。回答“多早？”这个问题。对自闭症谱系疾病（ASD）的筛查年龄和ASD儿童的早期干预年龄的筛查年龄具有重大的健康和教育意义。随着ASD认同的幼儿数量增加，需要在其自然环境内由父母在其自然环境中使用和实施的基于证据的手动干预措施的迫切需求。该项目与FSU的Amy Wetherby博士和UM的Catherine Lord博士提交的两个相同的链接应用程序是合作的。主要目的是直接将两个父母干预条件直接比较9个月的两个父母干预条件：1）在每周2-3个会议中提供的个性化父母实施干预措施（PII），以教父母如何嵌入策略，以每周的日常工作，活动和地点在日常工作中每周25个小时支持社交交流技能； 2）每月两次提供信息，教育和支持小组（IES）。每个地点将在18个月大时招募36个新的亲子二元组，他们将与18个二元组合并进行初步研究，每个站点总共有54个二元组，随机分配给PII或IES作为第一个条件。使用跨界设计，所有二元组还将从27个月大时就可以接受其他条件，总共进行了18个月的干预。这项调查的具体目的是：1）比较27个月时PII和IE的有效性； 2）比较36个月时PII和IE组合的有效性。社交沟通和自闭症症状的结果度量将从18到36个月大的一个月中收集，发育水平和适应性行为的度量将在18个月大时，在27个月的跨界点和第二次治疗状态后的36个月后进行。分层线性建模将用于108个二元组的组合样本，以估计结果指标的生长曲线，并检查不同治疗条件下儿童生长轨迹的差异，并在不同年龄开始接受强化治疗。这项研究的结果将：1）记录ASD的非常小的孩子的结果改善，接受了手动，基于社区的，具有成本效益，适当和有效的干预措施； 2）证实，从18个月大的年龄开始，与三年级的干预相比，强化干预可以提高结果，提供证据表明，对幼儿的自闭症筛查对于有效的早期干预至关重要。