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Lancet:儿童自闭症束手无策?家长介导的社会沟通疗法治疗来分忧

2016-10-26 MedSci MedSci原创

目前还不知道早期干预是否可以改善长期自闭症症状的结果。

目前还不知道早期干预是否可以改善长期自闭症症状的结果。该研究的目的是随访学龄前自闭症沟通试验(PACT),调查PACT干预是否对自闭症症状有长期影响,以及对父母和孩子的社会交往是否会产生持续影响。

PACT是一项对2-4岁自闭症儿童进行父母介导的社会沟通干预的随机对照试验。 研究人员在英国(伦敦,曼彻斯特和纽卡斯尔)的三个专业临床服务中心进行随访确诊,从原始试验终点开始平均随访时间为5.75年(IQR 5.42-5.92)。 主要结果是自闭症诊断观察时间表(ADOS)的严重程度评分(CSS),双向沟通评估测量(DCMA)用来评估当与父母沟通时,儿童发起沟通的比例,以及表达接受的语言综合方面。所有分析都遵循意向治疗原则。

研究人员对152名试验参与者中的121名(80%)参与者(分配给PACT干预组77名参与者中的59名参与者[77%] vs 普通治疗组75名参与者中的62名[83%])进行了随访,在2013年7月至2014年9月期间进行评估,平均随访时间为10.5年(SD 0.8)。在治疗结束时,基于ADOS CSS的log-odds效应(ES)的PACT干预组的优势效应组间差异为0.64(95%CI0.07至1.20),在随访时为ES为0.70(95%CI -0.05至1.47),这表明在整个试验和随访期间症状严重程度总体降低(ES 0.55,95%CI 0.14至0.91,p=0.004)。在随访中的DCMA儿童发起沟通的组间差异表现为Cohen's d ES为0.29(95%CI -0.02至0.57),并且在研究过程中组间差异显著(ES 0.33,95%CI 0.11至0.57,p=0.004)。随访时的语言综合方面没有组间差异(ES 0.15,95%CI -0.23至0.53)。

这些结果第一次显示出自闭症谱系障碍经过早期干预后长期症状减轻。这些结果支持了PACT干预的临床价值,并对发展理论有一定影响。

原始出处:

Andrew Pickles,Ann Le Couteur,Kathy Leadbitter,et al.Parent-mediated social communication therapy for young children with autism (PACT),Lancet,2016.10.26


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    2017-04-29 howi
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    2016-11-05 ylzr123

    自闭症谱系障碍经过早期干预后长期症状减轻。结果支持了PACT干预的临床价值,并对发展理论有一定影响。

    0

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    2016-10-27 xiongke014
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