学龄前期孤独症谱系障碍儿童团体干预效果Meta分析

Effect of group intervention in preschool children with autism spectrum disorder:a Meta-analysis

目的:系统评价团体干预措施对学龄前期孤独症谱系障碍(ASD)患儿干预效果,以期找到合适学龄前期ASD患儿康复训练方法提供参考依据。方法:采Revman 5.2软件,对2000年1月1日—2020年3月2日国内外发表的有关团体干预措施对学龄前期ASD患儿干预的临床随机对照试验研究进行Meta分析,根据异质性检验结果选择固定效应模型或随机效应模型,选择SMD计算合并效应值及95%CI。结果:最终纳入12篇,累计576例研究对象。合并效应量结果显示,团体干预措施可提高学龄前期ASD患儿适应行为(SMD=-0.96,95%CI:0.51~1.41,P<0.0001),能改善其临床核心症状严重程度(SMD=-3.89,95%CI:-6.40,-1.39,P=0.002),但对学龄前期ASD患儿的言语功能和父母育儿压力干预效果不显著,其SMD及95%CI分别为(SMD=-0.26,95%CI:-0.75,0.22,P=0.29)和(SMD=0.12,95%CI:-0.20,0.44,P=0.46)。结论:团体干预措施能够改善学龄前期ASD患儿的临床核心症状严重程度及提升其适应行为。但无法降低父母育儿压力及改善学龄前期ASD患儿的言语功能。因此,今后应该采用多样化干预措施来提升学龄前期ASD患儿语言、社交、智商等总体能力,以期ASD儿童更好地适应今后社会活动,独立自主生活。

Objective:To systematically evaluate the effect of group interventions on preschool children with autism spectrum disorder(ASD),so as to provide reference for suitable rehabilitation training methods for preschool children with ASD.Methods:Randomized controlled trial studieson the effect of group interventions for preschool children with ASDpublished in China and abroad from January 1,2000,to March 2,2020,were conducted a meta-analysis using Revman 5.2 software.According to the heterogeneity test results,the fixed-effects or random-effects models were selected,and SMD calculated the combined effect value and 95%CI.Results:A total of 12 articles were finally included,involving 576 subjects.The combined effect size results showed that group interventions could improve the adaptive behavior of preschool children with ASD(SMD=-0.96,95%CI:0.51 to 1.41,P<0.001)and improve the severity of their clinical core symptoms(SMD=-3.89,95%CI:-6.40,-1.39,P=0.002);but the effect of the intervention on the speech function(SMD=-0.26,95%CI:-0.75,0.22,P=0.29)and parental stress(SMD=0.12,95%CI:-0.20,0.44,P=0.46)of preschool children with ASD was not significant.Conclusions:Group intervention could improve the severity of clinical core symptoms and the adaptive behaviors of preschool children with ASD.It could not reduce the pressure of parenting and improve the speech function of preschool children with ASD.Therefore,diversified interventions should be used in the future to improve the overall abilities of preschool children with ASD,such as language,social interaction,and IQ,so that ASD children can better adapt to the future social activities and live independently.