Pivotal Response Treatment Package for Young Children with Autism

自闭症幼儿关键应对治疗方案

• 批准号: 8623747
• 负责人: ANTONIO HARDAN
• 金额: $ 24.08万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-01-01 至 2015-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8623747
• 关键词: Abbreviations; Adaptive Behaviors; Age; Area; Attention; Autistic Disorder; Behavior; Behavior Therapy; Behavioral; Characteristics; Child; Clinical; Cognitive; Communication; Communities; Computer software; Development; Early Intervention; Educational process of instructing; Effectiveness; Environment; Equipment and supply inventories; Exhibits; Eye; Family; Functional disorder; Gender; Goals; Home environment; Hour; Intervention; Investigation; Laboratories; Language; Learning; Measures; Mediator of activation protein; Modeling; Monitor; Nursery Schools; Outcome Measure; Parent-Child Relations; Parenting behavior; Parents; Performance; Phase; Play; Procedures; Publishing; Randomized; Recruitment Activity; Relative (related person); Research; Research Personnel; Research Project Grants; Secondary to; Social Behavior; Socialization; Stress; Structure; Symptoms; Systems Analysis; Toy; Training; Treatment Effectiveness; Treatment Efficacy; Waiting Lists; autism spectrum disorder; base; blind; control trial; digital; effective intervention; effective therapy; empowered; empowerment; executive function; experience; improved; indexing; interest; intervention program; meetings; natural language; pilot trial; public health relevance; response; secondary outcome; skills; social; social communication; standardize measure; treatment as usual; treatment response; treatment strategy; vocalization

Over the last decade, considerable progress has been made to increase our understanding of the pathophysiology of autism spectrum disorder (ASD), but limited progress has been made in identifying effective interventions. The goal of this investigation is to build on our preliminary findings and conduct a randomized controlled 24-week pilot trial to examine the efficacy of a pivotal response treatment package (PRT-P) in improving language expression in young children with ASD. Pivotal response treatment (PRT) is a naturalistic behavioral intervention based on the principles of applied behavior analysis. While some evidence has emerged suggesting the effectiveness of PRT, no randomized well-controlled trials have been published to date examining the efficacy of this intervention in ASD. The proposed treatment model will focus on teaching parents PRT strategies in combination with in-home therapy for 24 weeks and will be compared to families in a delayed treatment group (DTG). To achieve these goals, 48 children with autism (age range: 2-5.11 years) with severe communication deficits will be recruited to participate in this study and will be stratified according to gender. Twenty-four children will be randomized to the PRT-P and 24 to the DTG. The PRT-P will consist of a combination of parent training sessions and in-home therapy for a total of 10 weekly treatment hours for the first 12 weeks, and 5 hours per week for the following 3 months. Standardized and video-taped assessments will be conducted at baseline, week 6, 12, and 24 and will be rated by a blind investigator. In addition, full-day audio recordings of the child's natural language environment will be analyzed using the Language ENvironment Analysis System (LENA), which involves digital language recording and software analysis. Finally, a social attention and word-learning eye tracking task will be used to monitor the effectiveness of treatment on social and communication deficits. This research will show that parents of children with autism can learn pivotal response training procedures and their children will benefit with improved language skills. Additionally, we are interested in exploring whether response to treatment will vary according to any clinical or cognitive factors at baseline (moderators). 1

在过去的十年中，我们在加深对 自闭症谱系障碍 (ASD) 的病理生理学，但在识别方面取得的进展有限 有效的干预措施。这项调查的目的是建立在我们的初步调查结果的基础上 进行一项为期 24 周的随机对照试点试验，以检验关键反应的有效性 治疗方案（PRT-P）可改善自闭症谱系障碍幼儿的语言表达。枢轴 反应治疗（PRT）是一种基于应用原理的自然行为干预 行为分析。虽然一些证据表明 PRT 的有效性，但没有证据表明 迄今为止，已经发表了随机对照试验，检验了这种方法的有效性 对 ASD 的干预。拟议的治疗模式将侧重于向家长教授 PRT 策略 与家庭治疗相结合，为期 24 周，并将与延迟治疗的家庭进行比较 治疗组（DTG）。为了实现这些目标，48名自闭症儿童（年龄范围：2-5.11岁） 将招募具有严重沟通缺陷的人参与本研究，并进行分层 根据性别。 24 名儿童将被随机分配至 PRT-P，24 名儿童将被随机分配至 DTG。这 PRT-P 将包括家长培训课程和家庭治疗，总共 10 前 12 周每周治疗小时，接下来 3 个月每周治疗 5 小时。 将在基线、第 6 周、第 12 周和第 24 周进行标准化和录像评估，并将 由盲人调查员进行评级。此外，孩子自然语言的全天录音 将使用语言环境分析系统（LENA）对环境进行分析，该系统 涉及数字语言记录和软件分析。最后，社会关注和单词学习 眼动追踪任务将用于监测治疗对社交和沟通的有效性 赤字。这项研究将表明自闭症儿童的父母可以学习关键的反应 培训程序及其孩子将受益于语言技能的提高。此外，我们还 有兴趣探索对治疗的反应是否会根据任何临床或认知而变化 基线因素（调节因素）。 1