研究证明Denver模式的干预对自闭症孩子的智力,沟通能力和社交技能有明显提高

自闭症教育 来源:用户投稿 收藏

Early Intervention For Toddlers With Autism Highly Effective, Study Finds

Significant gains seen in IQ, communication and social interaction

研究证明Denver模式的干预对自闭症孩子的智力,沟通能力和社交技能有明显提高

SEATTLE, WASH. (November 30, 2009) – A novel early intervention program for very young children with autism – some as young as 18 months – is effective for improving IQ, language ability, and social interaction, a comprehensive new study has found.
西雅图(2009年11月30日)- 一个新的针对幼儿自闭症的早期干预被证明对于提高幼儿的智商,语言能力和社交技能有明显的效果。(最小能用这个治疗方式的孩子是18个月大)。


"This is the first controlled study of an intensive early intervention that is appropriate for children with autism who are less than 2½ years of age. Given that the AmericanAcademy of Pediatrics recommends that all 18- and 24-month-old children be screened for autism, it is crucial that we can offer parents effective therapies for children in this age range," said Geraldine Dawson, Ph.D., chief science officer of Autism Speaks and the study's lead author. "By starting as soon as the toddler is diagnosed, we hope to maximize the positive impact of the intervention."
“这是第一个针对2岁半以下自闭症早期干预的对照研究。由于美国儿童协会建议给所有18到24个月大的孩子做自闭症的筛查,所以如果能同时提供给家长有效的治疗方式就变得非常重要” Geraldine Dawson, Ph.D., Autism Speaks 首席科学官员兼这个研究的作者说到。“如果在幼儿一被确诊就开始给予治疗,我们希望能把效果做到最好。”


The study, published online today in the journal Pediatrics, examined an intervention called the Early Start Denver Model, which combines applied behavioral analysis (ABA) teaching methods with developmental 'relationship-bas[NextPage]ed' approaches. This approach was novel because it blended the rigor of ABA with play-based routines that focused on building a relationship with the child. While the youngest children in the study were 18 months old, the intervention is designed to be appropriate for children with autism as young as 12 months of age. Although previous studies have found that early intervention can be helpful for preschool-aged children, interventions for children who are toddlers are just now being tested. Autism is a lifelong neurodevelopmental disorder characterized by repetitive behaviors and impairment in verbal communication and social interaction. It is reported to affect one in 100 children in the United States.
这个研究在“儿科学术期刊”发表。Early Start Denver Model (及早开始的丹佛模式-博主译),是集合应用行为治疗(ABA)和发展“关系为基础”的方法。这是一个全新的方法,因为它把严紧的ABA与以游戏为基础的程序混合,使它们帮助幼儿建立人际关系。 虽然这项研究最小的被试是18个月大,但是整个教学模式对于12个月大以上的孩子都是适用的。 早期的研究显示只要是学龄前的孩子,早期干预就可以有效地帮助他们,但是3岁前的研究这个是第一个。自闭症是一个终身的神经发展障碍,主要表现为重复性的行为,语言沟通和社会交流的缺失。在美国每100个孩子就有1个是自闭症。


"Infant brains are quite malleable so with this therapy we're trying to capitalize on the potential of learning that an infant brain has in order to limit autism's deleterious effects, to help children lead better lives," said Sally Rogers, a professor of psychiatry and behavioral sciences, a study co-author and a researcher at the UC Davis MIND Institute in Sacramento, Calif. Rogers and Dawson developed the intervention.
“婴儿的脑子是比较具有延展性的,所以用这个治疗我们可以尽量强化婴儿脑部的学习能力从而减低由于自闭症所带来的有害的影响,让孩子以后能生活得更好” Sall[NextPage]y Rogers,精神科和行为科学教授,UC Davis MIND Institute的研究员说到。


The five-year study took place at the University of Washington (UW) in Seattle and was led by Dawson, then a professor of psychology and director of the university's AutismCenter, in partnership with Rogers. It involved therapy for 48 diverse, 18- to 30-month-old children with autism and no other health problems. Milani Smith, who oversees the UW Autism Center's clinical programs, provided day-to-day oversight.
这个长达5年的研究在西雅图的华盛顿大学进行。它的治疗包括了48个18个月到30个月的健康自闭症幼儿。


The children were separated into two groups, one that received 20 hours a week of the intervention – two two-hour sessions five days a week – from UW specialists. They also received five hours a week of parent-delivered therapy. Children in the second group were referred to community-based programs for therapy. Both groups' progress was monitored by UW researchers. At the beginning of the study there was no substantial difference in functioning between the two groups.
幼儿被分成2个组,ESDM组接受每周20小时的治疗(每周5天,每天2节2小时的课),由大学的专家治疗,另外家长每周给幼儿提供5小时的治疗。对照组接受社会性为主的治疗。


At the conclusion of the study, the IQs of the children in the intervention group had improved by an average of approximately 18 points, compared to a little more than four points in the comparison group. The intervention group also had a nearly 18-point improvement in receptive language (listening and understanding) compared to approximately 10 points in the comparison group. Seven of the children in the intervention grou[NextPage]p had enough improvement in overall skills to warrant a change in diagnosis from autism to the milder condition known as 'pervasive developmental disorder not otherwise specified,' or PDD-NOS. Only one child in the community-based intervention group had an improved diagnosis.
研究的结论,在接受ESDM治疗的孩子在智力上平均提高了18分,对照组是4分多一点。ESDM组在接受性语言(聆听和理解)提高了18分,对照组为10分。ESDM组里有7个孩子再接受诊断时已经从自闭症转为广泛性发展障碍非特定型或一般所称的「非典型自闭症」,而对照组只有1个。


"We believe that the ESDM group made much more progress because it involved carefully structured teaching and a relationship-based approach to learning with many, many learning opportunities embedded in the play," Rogers said.
“我们相信ESDM组之所以得到更多的进步是因为它包含了非常认真有系统的教学和以关系发展为基础的学习模式,让孩子在玩的时候充满的学习的机会”Rogers 说。


"Parental involvement and use of these strategies at home during routine and daily activities are likely important ingredients of the success of the outcomes and their child's progress. The study strongly affirms the positive outcomes of early intervention and the need for the earliest possible start," Dawson said.
“家长的参与和把相关的步骤用在家里和日常生活上也是一个非常重要的成功原因。这个研究证明了早期干预的效果和重要性。”Dawson 说。


In this study, the intervention was provided in a toddler's natural environment (their home) and delivered by trained therapists and parents who received instruction and training as part of the model.
这个研究,治疗是在幼儿熟悉的环境中(家里)进行,而提供治疗的是受过专业训练的治疗师和家长。


"Parents and therapists both carried out the intervention toward individualized goals for each child, and worked collaboratively to improve how the child[NextPage]ren were responding socially, playing with toys, and communicating," said Milani Smith, associate director of the UW Autism Center and a study co-author. "Parents are taught strategies for capturing their children's attention and promoting communication. By using these strategies throughout the day, the children were offered many opportunities to learn to interact with others."
“家长和治疗师同时给幼儿进行个别学习计划的内容,他们共同帮助孩子提高社交能力,游戏技巧和沟通能力” Milani Smith ,华盛顿大学自闭症中心的副主任。“家长接受如何抓住孩子的注意力和促进沟通的步骤和技巧。通过这些技巧,全天应用在孩子的身上,能让他们有更多的机会学习如何与他人互动。”


Other study authors include Jeffrey Munson, Jamie Winter, Jessica Greenson, and Jennifer Varley, all of UW Autism Center or the department of psychiatry and behavioral sciences, and Amy Donaldson of the department of speech and hearing science, Portland State University, Portland, Ore.

The study was funded by a grant from the National Institute of Mental Health (NIMH). NIMH has also funded a multi-site trial of the Early Start Denver Model which is currently being conducted at the University of Washington, the UC Davis MIND Institute and the University of Michigan.

"Randomized, Controlled Trial of an Intervention for Toddlers With Autism: The Early Start Denver Model."
Geraldine Dawson, Sally Rogers, Jeffrey Munson, Milani Smith, Jamie Winter, Jessica Greenson, Amy Donaldson, and Jennifer Varley.
Pediatrics, Nov 2009.
DOI:10.1542/peds.2009-0958

(文章来自Autism Speaks, 博主译)


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