Long-Term Outcomes of Early Intervention in 6-Year-Old Children With Autism Spectrum Disorder.
Long-Term Outcomes of Early Intervention in 6-Year-Old Children With Autism Spectrum Disorder.
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DOI：
10.1016/j.jaac.2015.04.005
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发表时间：
2015-07
影响因子：
13.3
通讯作者：
Dawson, Geraldine
中科院分区：
文献类型：
--
作者：
Estes, Annette;Munson, Jeffrey;Rogers, Sally J.;Greenson, Jessica;Winter, Jamie;Dawson, Geraldine
我们前瞻性地研究了早期干预的持续效果的证据，该研究基于对39名ASD儿童的随访研究，这些儿童开始参与一项随机临床试验，测试早期开始丹佛模型（ESDM）在18-30个月时的有效性。在高强度的家庭中进行了2年的干预，在治疗后立即显示出疗效的证据。这组儿童在6岁时，即干预结束后两年内，由对先前干预组状态不了解的临床医生在多个功能领域进行评估。平均而言，ESDM组在2年的随访期内，在整体智力、适应行为、症状严重程度和挑战行为方面保持了早期干预的收益。治疗后立即发现核心自闭症症状没有组间差异;然而，两年后，与常规社区干预（COM）组相比，ESDM组表现出核心自闭症症状和适应行为的改善。两组在6岁时的智力功能方面没有显着差异。两组在最初的研究中接受了相同的干预时间，但ESDM组在随访期间接受的时间较少。这些结果提供了证据表明，早期强化干预的收益在2年后仍保持不变。值得注意的是，相对于COM组，ESDM组的核心自闭症症状在随访期间有所改善。这一改善发生在ESDM组接受的服务明显减少的同时。这是第一个研究早期ESDM行为干预在30个月以下的年龄开始在改变自闭症的长期发展过程中的作用。
We prospectively examine evidence for the sustained effects of early intervention based on a follow-up study of 39 children with ASD who began participation in a randomized clinical trial testing the effectiveness of the Early Start Denver Model (ESDM) at age 18–30 months. The intervention, conducted at a high level of intensity in-home for 2 years, showed evidence of efficacy immediately posttreatment. This group of children was assessed at age 6, two years after the intervention ended, across multiple domains of functioning by clinicians naïve to previous intervention group status. The ESDM group, on average, maintained gains made in early intervention during the 2-year follow-up period in overall intellectual ability, adaptive behavior, symptom severity, and challenging behavior. No group differences in core autism symptoms were found immediately posttreatment; however, two years later, the ESDM group demonstrated improved core autism symptoms and adaptive behavior as compared with the community-intervention-as-usual (COM) group. The two groups were not significantly different in terms of intellectual functioning at age 6. The two groups received equivalent intervention hours during the original study, but the ESDM group received fewer hours during the follow-up period. These results provide evidence that gains from early intensive intervention are maintained 2 years later. Notably, core autism symptoms improved in the ESDM group over the follow-up period relative to the COM group. This improvement occurred at the same time the ESDM group received significantly fewer services. This is the first study to examine the role of early ESDM behavioral intervention initiated below 30 months of age in altering the longer term developmental course of autism.
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影响因子：
3.9
作者：
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作者：
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DOI：
10.1016/j.jaac.2012.08.018
发表时间：
2012-11
影响因子：
13.3
作者：
Dawson G;Jones EJ;Merkle K;Venema K;Lowy R;Faja S;Kamara D;Murias M;Greenson J;Winter J;Smith M;Rogers SJ;Webb SJ
通讯作者：
Webb SJ