Background Several studies have shown the effectiveness of the Early Start Denver Model(ESDM),but few studies have explored the long-term efficacy of ESDM.This study aimed to explore the efficacy and moderating factor...Background Several studies have shown the effectiveness of the Early Start Denver Model(ESDM),but few studies have explored the long-term efficacy of ESDM.This study aimed to explore the efficacy and moderating factors of ESDM in Chinese toddlers with autism spectrum disorder(ASD)in a longitudinal way.Methods A total of 60 toddlers with ASD were recruited and randomly divided into two groups:ESDM group all received 24 weeks intervention;Control group were waiting for intervention.Baseline assessment(T0)was conducted before intervention,including Gesell Developmental Scale(GDS)and Psycho-educational Profile-3rd Edition(PEP-3).All toddlers with ASD were examined in the first assessment(T1)at 6 months and in the second assessment(T2)at 12 months.Results In T1 assessment,the increments in speech and personal communication development quotient in GDS were significantly larger in the ESDM group than in the control group(P=0.010,0.047).In T2 assessment,the ESDM group had higher elevation in cognitive verbal/preverbal(CVP),social reciprocity and characteristic verbal behaviors assessed by PEP-3(P=0.021,0.046,0.014).In addition,the severity of stereotyped behavior was negatively associated with improvement in CVP.Family income was positively associated with improvement in speech and CVP(all P<0.05).Conclusions ESDM can effectively improve speech and communication in toddlers with ASD after 24-week intervention.More importantly,ESDM can promote cognition and social interaction and can reduce stereotyped verbal behavior in toddlers with ASD in longitudinal observation.The severity of stereotyped behavior and family ecological factors may be considered as affecting the efficacy of ESDM.展开更多
目的:采用meta分析的方法评估早期介入丹佛模式(ESDM)对孤独症(ASD)患儿认知能力、适应行为以及核心症状的干预效果。方法:计算机检索从建库至2019年2月21日期间EMBASE、Cochrane Library、PubMed、Web of Science、PsycINFO、ScienceDi...目的:采用meta分析的方法评估早期介入丹佛模式(ESDM)对孤独症(ASD)患儿认知能力、适应行为以及核心症状的干预效果。方法:计算机检索从建库至2019年2月21日期间EMBASE、Cochrane Library、PubMed、Web of Science、PsycINFO、ScienceDirect、ProQuest、中国生物医学数据库(CBM)、中国知网(CNKI)以及万方数据库中有关ESDM在5岁及以下ASD患儿中应用效果的随机对照试验和非随机对照试验,由2名研究者对纳入文献的质量进行评价和资料提取。结果:最终纳入文献12篇,共631名ASD患儿。Meta分析结果显示,与干预前相比,ESDM干预后患儿的认知能力(SMD=0.74,95%CI:0.42~1.05,P <0.001)和适应行为(WMD=1.82,95%CI:0.34~3.30,P <0.05)提高,核心症状的严重程度降低(SMD=-0.29,95%CI:-0.54^-0.03,P <0.05)。结论:早期介入丹佛模式可改善孤独症患儿的认知能力、适应行为及核心症状。展开更多
基金This study was supported by grants from the Scientific Research project of National Health Commission(No:201302002)National Natural Science Foundation of China(No:81873801)+1 种基金Technology Program of Guangzhou,China(No:201903010040)Science and Technology Program of Guangzhou(202007030011).
文摘Background Several studies have shown the effectiveness of the Early Start Denver Model(ESDM),but few studies have explored the long-term efficacy of ESDM.This study aimed to explore the efficacy and moderating factors of ESDM in Chinese toddlers with autism spectrum disorder(ASD)in a longitudinal way.Methods A total of 60 toddlers with ASD were recruited and randomly divided into two groups:ESDM group all received 24 weeks intervention;Control group were waiting for intervention.Baseline assessment(T0)was conducted before intervention,including Gesell Developmental Scale(GDS)and Psycho-educational Profile-3rd Edition(PEP-3).All toddlers with ASD were examined in the first assessment(T1)at 6 months and in the second assessment(T2)at 12 months.Results In T1 assessment,the increments in speech and personal communication development quotient in GDS were significantly larger in the ESDM group than in the control group(P=0.010,0.047).In T2 assessment,the ESDM group had higher elevation in cognitive verbal/preverbal(CVP),social reciprocity and characteristic verbal behaviors assessed by PEP-3(P=0.021,0.046,0.014).In addition,the severity of stereotyped behavior was negatively associated with improvement in CVP.Family income was positively associated with improvement in speech and CVP(all P<0.05).Conclusions ESDM can effectively improve speech and communication in toddlers with ASD after 24-week intervention.More importantly,ESDM can promote cognition and social interaction and can reduce stereotyped verbal behavior in toddlers with ASD in longitudinal observation.The severity of stereotyped behavior and family ecological factors may be considered as affecting the efficacy of ESDM.
