多学科干预对印度孟买自闭症谱系障碍儿童临床结局的影响

S. Dalwai, Deepti Kanade Modak, A. Bondre, Sajeda Ansari, Danial Siddiqui, Diksha Gajria
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引用次数: 7

摘要

目的:分析自闭症谱系障碍(ASD)儿童在接受多学科发展干预计划前后的功能改变的临床结果。方法:2014-2015年,在印度孟买的5个儿童发展中心对每个儿童进行个性化的结构化目标导向的多学科干预。对年龄2.1 ~ 6.1岁的38例ASD患儿进行二次资料分析。所有儿童都接受了职业治疗和语言治疗,并进行了父母咨询。职业治疗的平均干预次数为48-72次(每周2 - 3次),言语治疗的平均干预次数为24-48次(每周1 - 2次),父母辅导的平均干预次数为5-6次(每月1次)。干预前后分别采用儿童自闭症评定量表(CARS)和Vineland社会成熟度量表(VSMS)进行评估。结果:配对t检验CARS总分平均阳性差异为4.18 (p < 0.0001)。在大多数子量表(与人有关;对象使用;视觉反应;语言和非语言交流;味觉、嗅觉和触觉的反应和运用;智力反应和总体印象的水平和一致性)。配对t检验也显示,除社会化外,所有VSMS子量表均有显著的正变化。结论:在一个对发育障碍认识有限的地区,这种多学科干预所使用的模型,以及对其方案的遵守,有可能提高自闭症儿童的功能能力(或儿童对他/她的状况的适应能力)。局限性:由于亚分析的样本量不足,无法检测干预外因素的单独影响。结果还需要通过不依赖于父母报告的测试(例如,CARS和VSMS)来验证,而是评估儿童的表现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of Multidisciplinary Intervention on Clinical Outcomes of Children with Autism Spectrum Disorder in Mumbai, India
Purpose: To analyse clinical outcomes in terms of functional changes in children with Autism Spectrum Disorder (ASD), before and after receiving a multidisciplinary developmental intervention programme. Methods: Structured goal-oriented multidisciplinary intervention, individualised to each child, was implemented through 5 child development centres in Mumbai, India, in 2014-2015. Secondary data analysis of 38 children diagnosed with ASD, in the age group of 2.1 - 6.1 years, was conducted.  All children received occupational therapy and speech therapy, and parental counselling was also done. The average number of intervention sessions were 48-72 for occupational therapy (twice or thrice a week), 24-48 for speech therapy (once or twice a week) and 5-6 for parental counselling (once a month). Childhood Autism Rating Scale (CARS) and Vineland Social Maturity Scale (VSMS) were used for assessment, before and after intervention. Results: Mean positive difference in CARS total scores through paired t-test was 4.18 (p < 0.0001). Significant positive changes in functional ability were observed in most of the sub-scales (relating to people; object use; visual response; verbal and non-verbal communication; taste, smell and touch response and use; level and consistency of intellectual response and general impression). Paired t-test also showed significant positive changes on all VSMS sub-scales, except Socialisation. Conclusions:  The model used in this multidisciplinary intervention, and adherence to its protocols, has the potential to improve functional ability (or the child’s adaptation to his/her condition) in children with ASD, in a region with limited awareness of developmental disabilities. Limitations:  Separate effects of factors outside the intervention could not be tested due to inadequate sample sizes for sub-analyses. Results also need to be validated by tests that do not depend on parental reporting (e.g., CARS and VSMS) but assess the performance of the child instead.
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