3/5-Randomized Trial of Parent Training for Young Children with Autism

自闭症幼儿家长培训的 3/5 随机试验

基本信息

批准号：
8680505
负责人：
TRISTRAM H SMITH
金额：
$ 6.56万
依托单位：
UNIVERSITY OF ROCHESTER
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-01-15 至 2014-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8680505
关键词：
7 year old Accountability Address Advocate Affect Aftercare Age Aggressive behavior Agreement Asperger Syndrome Attention Autistic Disorder Behavior Behavior Therapy Behavioral Blinded Child Child Behavior Childhood Clinical Communication Communities Data Development Effectiveness Enrollment Ensure Evidence based intervention Family Government Health Home environment Hour Indiana Institutional Review Boards Intervention Laboratories Left Life Measures Mental disorders Methods Monitor National Institute of Mental Health National Research Council Newly Diagnosed Nursery Schools Ohio Outcome Outcome Assessment Parent-Child Relations Parenting Education Parenting behavior Parents Pervasive Development Disorder Phase Population Positive Reinforcements Preschool Child Prevalence Procedures Psychopharmacology Public Health Questionnaires Randomized Recommendation Research Research Personnel Self-Injurious Behavior Services Severities Site Socialization Specific qualifier value Stress Structure Techniques Testing Time TimeLine Training Training Programs Training and Education Universities Variant Video Recording age group analog autism spectrum disorder base blind data management design developmental disease disability early childhood experience follow up assessment follow-up impression improved indexing interest non-compliance parental role primary outcome programs psychoeducation psychoeducational intervention psychosocial quality assurance randomized trial response skills social social communication statistical service teacher

项目摘要

DESCRIPTION (provided by applicant): Autism is a condition of early childhood onset marked by social delay, communication delay and repetitive behavior affecting 2 per 1,000 children (Fombonne, 2003). If the wider spectrum is included (PDD-NOS and Asperger's disorder), the prevalence is 67 per 1000 children (Autism and Developmental Disorders Monitoring Network, 2007). Given the severity and the prevalence, pervasive developmental disorders (PDDs) have enormous public health impact. There is general agreement that intervention in the preschool years can reduce the long-term disability of PDD, but the required components and optimal intensity of these programs remain unclear (National Research Council, 2001). In addition, recommended behavioral and educational treatments for young children with PDD are not available in all communities (Lord et al., 2005). Moreover, preschool interventions often focus on the child (Smith, 1999) leaving parents to manage the child's behavior on their own (Jacobson & Mulick, 2000). Thus, although the role of parents as partners in the treatment team is universally acknowledged, few studies have tested parent-based interventions and large-scale interventions are non-existent (Smith et al., 2007). In response to PA 07-092 (Collaborative R01s for Mental Disorders) and PA 07-085 (Research on Autism and Autism Spectrum Disorders), this application describes a five-site study to compare parent training to psychoeducation in 180 preschool-age children with PDD. Eligible subjects will be randomly assigned to receive either Parent Training (PT) or Psychoeducational Intervention (PEP) over 6 months. The primary outcomes are the change in the child's irritable and noncompliant behavior rated by the parent. Overall improvement and gains in adaptive functioning (social, communication and daily living skill domains) will be assessed by a rater who is blind to treatment assignment. Parent-child interaction will be assessed in a semi-structured lab sequence by blinded raters. The effects of PT on parental stress and the possible moderating effects of concurrent interventions will also be explored. Training and quality assurance services will be shared across sites; Yale University will provide data management and statistical services. This application is congruent with recommendations of an NIMH advisory council (Research in Psychosocial and Behavioral Interventions in Autism), which called for large-scale, randomized trials to evaluate the efficacy and promote the dissemination of psychosocial interventions in children with PDD (Lord et al., 2005; Smith et al., 2007). To conduct this study, we have assembled a consortium of experienced investigators from leading autism research programs including Yale, University of Rochester, University of Pittsburgh, Ohio State University, and Indiana University. These centers have extensive experience with conducting multisite trials (e.g., Research Units on Pediatric Psychopharmacology (RUPP) Autism Network) and with parenting training for children with autism.

描述（由申请人提供）：自闭症是幼儿发作的一种条件，其标志着社会延迟，沟通延迟和重复行为，影响每1000名儿童2个（FOMBONNE，2003年）。如果包括较宽的频谱（PDD-NOS和Asperger's障碍），则患病率为每1000名儿童67（自闭症和发育障碍监测网络，2007年）。鉴于严重性和患病率，普遍的发育障碍（PDD）具有巨大的公共卫生影响。人们普遍同意，干预学期可以减少PDD的长期残疾，但是这些计划所需的组成部分和最佳强度尚不清楚（国家研究委员会，2001年）。此外，所有社区都不提供针对PDD幼儿的推荐行为和教育治疗（Lord等，2005）。此外，学龄前的干预措施通常集中在孩子上（Smith，1999），使父母独自管理孩子的行为（Jacobson＆Mulick，2000年）。因此，尽管普遍认可父母作为治疗团队中伴侣的作用，但很少有研究测试了基于父母的干预措施和大规模干预措施（Smith等，2007）。为了回应PA 07-092（用于精神障碍的R01）和PA 07-085（自闭症和自闭症谱系障碍研究），该应用程序描述了一项五个站点的研究，将父母培训与PDD的180名学龄前儿童中的父母培训与心理教育进行了比较。合格的受试者将在6个月内随机分配接受父母培训（PT）或心理教育干预（PEP）。主要结果是父母评级的孩子的易怒和不合格行为的变化。自适应功能（社会，沟通和日常生活技能领域）的总体改进和增长将由视觉治疗分配的评估者评估。亲子的相互作用将在半结构化的实验室序列中通过盲人评估。还将探索PT对父母应力的影响以及并发干预措施的可能调节作用。培训和质量保证服务将在跨站点共享；耶鲁大学将提供数据管理和统计服务。该应用与NIMH咨询委员会的建议（自闭症的心理社会和行为干预研究）的建议是一致的，该建议呼吁进行大规模的随机试验，以评估疗效并促进PDD儿童的心理心理干预措施的传播（Lord et et al。，2005; Smith等，2007）。为了进行这项研究，我们组建了一个来自领先的自闭症研究计划的经验丰富的研究人员，包括耶鲁大学，罗切斯特大学，匹兹堡大学，俄亥俄州立大学和印第安纳大学。这些中心在进行多站点试验（例如，有关儿科心理药理学（RUPP）自闭症网络的研究单位）以及对自闭症儿童的育儿培训方面具有丰富的经验。