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Objective@#Children with autism spectrum disorder(ASD) who participated in the " Play-based Communication and Behavior Intervention(PCBI)" were studied in order to evaluate the impact of caregiver factors on the efficacy of the PCBI very early intervention model systematically.@*Methods@#Seventy-six children with ASD aged 8-30 months were recruited in this study at Brain Hospital Affiliated to Nanjing Medical University form December 2017 to June 2018, and they were trained for PCBI very early intervention.The Autism Treatment Evaluation Checklist (ATEC) and the Gesell Developmental Schedules were used to evaluate the efficacy of the PCBI very early intervention.Parenting Stress Index Short Form, General Self-Efficacy Scale and the self-developed Caregiver Training Course Evaluation Scale and the Homework Completion Level Scale were used to assess the level of parental stress, self-efficacy, curriculum satisfaction and acceptance.A pair of sample t-test was used to analyze the ASD symptoms, developmental level and caregiver factors of ASD children before and after intervention.Multivariate regression analysis was used to analyze the caregiver factors and the effects of PCBI very early intervention.@*Results@#(1) At the end of 12 weeks of PCBI very early intervention, the score of the ATEC (17.36±15.98) was lower than that before intervention (78.43±22.84), and the difference was statistically significant(P<0.05); the adaptive developmental quotient(5.90±15.45), the fine action developmental quotient(5.13±19.89), the language developmental quotient (12.43±20.60) and the personal social developmental quotient(4.79±16.02) scores of the Gesell Developmental Schedules were higher than those before intervention (73.08±20.54, 77.33±23.63, 52.24±19.12, 71.79±20.81), and the differences were statistically significant (all P<0.05). (2) At the end of PCBI very early intervention, there was a significant decrease in the scores of Parenting Stress Index Short Form, and the differences were statistically significant (4.84±14.69 vs.94.05±29.67, P<0.05). (3) Acceptance of the intervention model, and mastery of the skills in the caregiver factors had a positive predictive effect on the effect of PCBI very early intervention (t=3.068, 10.468, all P<0.05).@*Conclusions@#PCBI very early intervention can effectively reduce the parenting pressure of the caregivers, and in the PCBI very early intervention, the better the mastery of skills and the completion of homework, the better the efficacy of intervention.
RESUMEN
Objective Children with autism spectrum disorder(ASD) who participated in the " Play-based Communication and Behavior Intervention(PCBI) " were studied in order to evaluate the impact of caregiver factors on the efficacy of the PCBI very early intervention model systematically.Methods Seventy-six children with ASD aged 8-30 months were recruited in this study at Brain Hospital Affiliated to Nanjing Medical University form December 2017 to June 2018,and they were trained for PCBI very early intervention.The Autism Treatment Evaluation Checklist (ATEC) and the Gesell Developmental Schedules were used to evaluate the efficacy of the PCBI very early intervention.Parenting Stress Index Short Form,General Self-Efficacy Scale and the self-developed Caregiver Training Course Evaluation Scale and the Homework Completion Level Scale were used to assess the level of parental stress,self-efficacy,curriculum satisfaction and acceptance.A pair of sample t-test was used to analyze the ASD symptoms,developmental level and caregiver factors of ASD children before and after intervention.Multivariate regression analysis was used to analyze the caregiver factors and the effects of PCBI very early intervention.Results (1) At the end of 12 weeks of PCBI very early intervention,the score of the ATEC (17.36 ± 15.98) was lower than that before intervention (78.43± 22.84),and the difference was statistically significant (P ＜ 0.05);the adaptive developmental quotient (5.90 ± 15.45),the fine action developmental quotient (5.13 ± 19.89),the language developmental quotient (12.43 ± 20.60) and the personal social developmental quotient (4.79 ± 16.02) scores of the Gesell Developmental Schedules were higher than those before intervention (73.08 ± 20.54,77.33 ± 23.63,52.24 ± 19.12,71.79 ± 20.81),and the differences were statistically significant (all P ＜ 0.05).(2) At the end of PCBI very early intervention,there was a significant decrease in the scores of Parenting Stress Index Short Form,and the differences were statistically significant (4.84 ± 14.69 vs.94.05 ± 29.67,P ＜ 0.05).(3) Acceptance of the intervention model,and mastery of the skills in the caregiver factors had a positive predictive effect on the effect of PCBI very early intervention (t =3.068,10.468,all P ＜ 0.05).Conclusions PCBI very early intervention can effectively reduce the parenting pressure of the caregivers,and in the PCBI very early intervention,the better the mastery of skills and the completion of homework,the better the efficacy of intervention.
RESUMEN
Objective To compare and analyze the short-term effect of play-based communication and behavior intervention (PCBI) and applied behavioral analysis (ABA) on the treatment of toddlers with autism spectrum disorder (ASD).Methods Seventy-four ASD toddlers aged from 19 to 30 months were recruited in Nanjing Brain Hospital Affiliated to Nanjing Medical University from November 2017 to May 2018.The toddlers who participated in this study were randomly assigned into PCBI group and ABA group,then they were intervened weekly by PCBI or ABA for a total of 12 weeks.Portage Early Development Checklist and autism treatment evaluation checklist (ATEC) were used to estimate the toddlers' developmental level and the treatment efficacy respectively.The t-test was used to reveal whether there was significant difference between the 2 groups before and after intervention.Results (1) Compared with the ABA group,there was a significant increase in cognitive scores (△PCBI =9.03 scores,△ABA =4.27 scores,t =3.997) and a significant decrease in social behavior scores (△PCBI =8.87 scores,△ABA =16.91 scores,t =-4.022) of the Portage Early Development Checklist after 12 weeks of intervention in the PCBI group,and there were statistically significant differences(all P ＜ 0.001);while the total score and the scores of language,movement,and self-care subscale of Portage Early Development Checklist were also increased after PCBI intervention but without significant differences (all P ＞ 0.05).(2)Compared with the ABA group,after 12 weeks of PC BI intervention,the scores of social contact,perception,behavior of ATEC were decreased,but the difference was not significant (P ＞ 0.05);the total score of ATEC scale(△PCBI total =14.89 scores,△ABA total =22.22 scores,t =2.209)and the scores of language subscale(△PCBI language =2.89 scores,△ ABA language =6.43 scores,t =2.515) were decreased significantly,and there were statistically significant differences (all P ＜ 0.05).Conclusions After 12 weeks of the very early intervention of PCBI,the ASD toddlers all improved in clinical symptoms and developmental level.Compared with ABA intervention,PCBI very early intervention with parental guidance was comparable in short term efficacy,and PCBI was not taking up as much medical rehabilitation resources as ABA.