Preschool Autism Communication Trial (PACT)

自闭症是一种严重的慢性儿童残疾，从童年早期一直影响到整个家庭。已经有很多关于有效治疗自闭症的说法，但令人惊讶的是（考虑到这种疾病的重要性和在理解它方面取得的进展），几乎没有系统的研究证据支持有效的治疗方法。家庭和使用者团体一直在呼吁对治疗进行更多的研究，法定机构也受到越来越大的法律压力，通过教育法庭提供密集、昂贵但往往未经检验的干预措施。这项研究将为有效治疗提供有力的证据。它测试了一种治疗方法，旨在加强自闭症患者的亲子交流以及儿童的社交和语言发展。在6个月的时间里，每个家庭每两周参加一次治疗师的会议，以学习理解和与自闭症儿童沟通的新方法，在接下来的6个月里，每月进行一次强化会议。类似的治疗模式已应用于其他类型的沟通障碍，并取得了良好的效果。该研究将在英国三个代表性地点（曼彻斯特、纽卡斯尔和伦敦）随机分配144名儿童，其中一组在社区接受常规临床护理，另一组接受常规临床护理，但增加了这种交流干预。我们的试点研究在一个地点使用相同的设计，显示了在常规护理中增加这一额外成分的非常有希望的价值。我们还将研究这种治疗的成本效益。这种治疗不是太密集（每周约有1.5小时的治疗师时间和3.5小时的家长家庭作业时间），因此有可能将其实际扩展到地方保健服务。因为治疗有助于父母和孩子之间的沟通，我们发现它提高了父母的能力感和与孩子的参与感，以及孩子？年代的发展。这些是我们与家长的焦点小组确定的关键特征，这些特征是家庭对自闭症治疗的核心要求。在这项研究中，我们正在与全国自闭症协会合作，并与服务使用者进行焦点小组讨论，以确定衡量对家庭至关重要的治疗结果的最佳方法。我们将通过NAS、其他通讯和专业会议传播有关本研究及其结果的信息。

Autism is a severe and chronic childhood disability affecting families from early in childhood through the lifespan. Many claims have been made for effective treatments for autism, but surprisingly (given the importance of the disorder and the progress that has been made in understanding it), there has very little systematic research evidence to support effective treatments. Families and user groups have been vocal in calling for more research on treatment, and statutory agencies have been placed under escalating legal pressure through educational tribunals to provide intensive, costly but often quite untested interventions. This study would represent a significant enhancement of the evidence for effective treatment. It tests a treatment that is aims to enhance parent child communication in autism and the social and language development of the child. Families attend sessions with a therapist every two weeks for 6 months to learn new ways of understanding and communicating with their autistic child, with monthly booster sessions for a further 6 months. Similar treatment models have been applied to other kinds of communication disorder with good results. The study will randomly allocate 144 children in three representative sites across the UK (Manchester, Newcastle and London) to a group receiving routine clinical care in the community and another group receiving routine clinical care but with the addition of this communication intervention. Our pilot study using the same design on a single site has shown very promising value of adding this additional component to routine care. We will also study the cost effectiveness of the treatment. This treatment is not too intensive (with about 1.5 hours of therapist time and 3.5 hours of parent homework time weekly) and for this reason it would be possible to extend it practically into local health services. Because the treatment helps communication between parent and child, we find that it improves parental sense of competence and involvement with their child as well as the child?s development. These are key features identified in our focus groups with parents that are central to what families want from a treatment for Autism.We are collaborating with the National Autistic Society in this study and are conducting focus groups with service users to identify the best ways of measuring treatment outcomes that matter to families. We will disseminate information about this study and its results through the NAS, other newsletters and professional meetings.