PDF(Pubmed)
Abstract：
Many autistic children require support to meet their learning needs. Given the heterogeneity within the autism spectrum it is plausible that different types of support might be better suited to different children. However, knowledge on what interventions work best for which children is limited. We examined the outcomes of autistic preschool-aged children receiving one of two community early intervention approaches. Our main objective was to understand which baseline child characteristics might be associated with the degree of individual response to intervention-whether prognostically (i.e., irrespective of intervention received) or predictively (i.e., specifically in the context of one or other EI approach). Participants comprised two matched groups of preschool-aged autistic children receiving either Group-based Early Start Denver Model (G-ESDM; n = 42) delivered in a 1:3-4 staff:child ratio or an Early Intensive Behavioural Intervention (EIBI; n = 40) delivered in combination of 1:1 and 1:2 staff:child ratio. Over an approximate one-year follow-up period, children in both groups made significant gains in Developmental Quotient (DQ) scores, and trend-level gains in adaptive behaviour composite scores. Higher attention to a playful adult measured via an eye-tracking task was prognostically indicative of better verbal DQ and adaptive behaviour outcomes for the cohort overall. Moderation analyses indicated a single predictive effect-of pre-program sustained attention for subsequent NVDQ outcomes specific to those children receiving G-ESDM. These findings suggest that fine-grained measures of learning skills offer promise towards the selection and tailoring of intervention approaches to meet individual children\'s learning needs.
摘要：
许多自闭症儿童需要支持来满足他们的学习需求。鉴于自闭症谱系内的异质性，不同类型的支持可能更适合不同的儿童是合理的。然而,关于哪些干预措施对哪些儿童最有效的知识是有限的。我们检查了接受两种社区早期干预方法之一的自闭症学龄前儿童的结果。我们的主要目标是了解哪些基线儿童特征可能与个体对干预的反应程度相关-无论是预后性的(即，与接受的干预无关)或预测性(即，特别是在一种或其他EI方法的背景下)。参与者包括两组匹配的学龄前自闭症儿童，他们接受以1：3-4员工：儿童比例提供的基于团体的早期丹佛模型（G-ESDM；n=42）或以1：1和1：2员工：儿童比例提供的早期强化行为干预（EIBI；n=40）。在大约一年的随访期内，两组儿童在发育商（DQ）得分上都取得了显著的进步，和适应行为综合得分的趋势水平增益。通过眼动追踪任务测量的对嬉戏的成年人的更高注意力在预后上表明该队列总体上具有更好的言语DQ和适应性行为结果。适度分析表明，对于接受G-ESDM的儿童，计划前持续关注对随后的NVDQ结果具有单一的预测作用。这些发现表明，细粒度的学习技能措施为选择和定制干预方法以满足个别儿童的学习需求提供了希望。
