Promoting emotional and behavioral interventions in ASD treatment: Evidence from EPIGRAM, A naturalistic, prospective and longitudinal study

IF 2.9 2区 医学 Q1 EDUCATION, SPECIAL
Carlotta Bettencourt , Nicole Garret-Gloanec , Hugues Pellerin , PereMorgane Péré , Giulio Bertamini , Maria Squillante , Fabienne Roos-Weil , Léa Ferrand , Anne-Sophie Pernel , Gisèle Apter , Mohamed Chetouani , Samuele Cortese , David Cohen
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引用次数: 0

Abstract

Background

Prognostic factors from naturalistic treatment studies of children with Autism Spectrum Disorder (ASD) remain largely unknown. We aimed to identify baseline and treatment-related prognostic predictors at 1-year follow-up after Integrative Care Practices (ICPs).

Methods

Eighty-nine preschool children with severe ASD were given ICP combining nine therapeutic workshops based on children’s needs. Participants were assessed at baseline and during 12 months follow-up with the Psycho-educational Profile-3-R, Children Autism Rating Scale, Parental Global Impression, and the Autistic Behaviors Scale. We assessed prognostic predictors using multivariable regression models and explored treatment ingredients influencing outcome using Classification and Regression Trees (CART).

Results

Multivariable models showed that being a child from first generation immigrant parents predicted increased maladaptive behaviors, whereas play activities had an opposite effect; severity of ASD symptoms and impaired cognitive functions predicted worse autism severity at follow-up; and lower play activities predicted worse parent impression. Regarding treatment effects, more emotion/behavioral interventions predicted better outcomes, and more communication interventions predicted lower autism severity, whereas more education and cognitive interventions had an opposite effect. CART confirmed that more hours of intervention in the emotion/behavioral domain helped classifying cases with better outcomes. More parental support was associated with decreased maladaptive behaviors. Sensorimotor and education interventions also significantly contributed to classifying cases according to outcomes but defined subgroups with opposite prognosis.

Conclusion

Children who exhibited the best prognosis following ICPs had less autism severity, better cognition, and non-immigrant parents at baseline. Emotion/behavior interventions appeared key across all outcomes and should be promoted.

促进 ASD 治疗中的情绪和行为干预:来自 EPIGRAM 的证据,一项自然、前瞻性和纵向研究
背景自闭症谱系障碍(ASD)儿童自然治疗研究的预后因素在很大程度上仍不为人所知。我们旨在确定基线和治疗相关的预后预测因素,并在综合护理实践(ICP)后进行为期一年的随访。在基线和 12 个月的随访期间,对参与者进行了心理教育档案-3-R、儿童自闭症评定量表、家长总体印象和自闭症行为量表的评估。我们使用多元回归模型评估了预后预测因素,并使用分类和回归树(CART)探索了影响治疗结果的治疗成分。结果多元回归模型显示,作为来自第一代移民父母的孩子,预示着适应不良行为的增加,而游戏活动则具有相反的效果;自闭症症状的严重程度和认知功能受损预示着随访时自闭症严重程度的恶化;较低的游戏活动预示着较差的家长印象。在治疗效果方面,更多的情绪/行为干预预示着更好的结果,更多的沟通干预预示着更低的自闭症严重程度,而更多的教育和认知干预则具有相反的效果。CART 证实,在情绪/行为领域进行更多小时的干预有助于对结果更好的病例进行分类。父母支持越多,适应不良行为越少。感知运动干预和教育干预也有助于根据结果对病例进行分类,但却界定了预后相反的亚组。情感/行为干预似乎是所有结果的关键,应加以推广。
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来源期刊
CiteScore
5.50
自引率
6.50%
发文量
178
期刊介绍: Research In Developmental Disabilities is aimed at publishing original research of an interdisciplinary nature that has a direct bearing on the remediation of problems associated with developmental disabilities. Manuscripts will be solicited throughout the world. Articles will be primarily empirical studies, although an occasional position paper or review will be accepted. The aim of the journal will be to publish articles on all aspects of research with the developmentally disabled, with any methodologically sound approach being acceptable.
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