2~9岁孤独症谱系障碍儿童WHO-CST干预中国实施方案

WHO-CST intervention for children with autism spectrum disorders aged 2 to 9 years in China

目的探讨在国内社区医疗保健框架下制定世界卫生组织(WHO)照顾者养育技能培训项目(CST)对孤独症谱系障碍干预实施有效性和可行性的研究方案。方法2020—2022年采用随机平行对照进行干预性研究,通过WHO-CST的培训和督导框架,由中山大学附属第三医院和南京脑科医院具备培训资质的团队培训非专业人员成为引导师,通过形成“专业人员-非专业人员-照顾者-孤独症儿童”的技能传递链条,将基于循证医学证据的干预策略传授给孤独症儿童的主要照顾者以开展家庭干预。结果主要结局指标包括实施干预后目标行为的变化、儿童参与度以及在亲子互动中共同参与的能力水平。次要结局指标包括孤独症的核心症状变化、照顾者的知识技能、照顾者能力感与家庭赋能,以及对不良事件的应对方式等。结论WHO-CST干预中国实施方案是国内首次针对孤独症儿童及照顾者实施CST干预的大样本随机对照临床试验,以此获得在中国本土实施的有效性数据,并最终为全球以及国内推动CST项目的实施提供新证据,具有比较重要的研究价值和意义。

Objective To explore the effectiveness and feasibility of the WHO Caregiver Skills Training(CST)program for children with autism spectrum disorder(ASD)within the domestic community healthcare framework.Methods This study is a randomized,parallel-controlled intervention trial using the WHO-CST program training and supervision framework through the pathway of"professional-nonprofessional-caregivers-children with ASD"to deliver evidence-based intervention strategies to caregivers of ASD children.The training is conducted and supervised by certified master trainers from the Third Affiliated Hospital of Sun Yat-Sen University and Nanjing Brain Hospital.Results The primary outcomes included target problem behavior management,engagement improvement and engagement severity changes and joint-engagement rating.Additionally,preliminary outcomes of overall child participation,ASD symptom severity measurement,caregiver knowledge and skills,parent's sense of competence,family empowerment,stigma,and caregiver coping skills in adverse events will be provided.Conclusions This study is the first large-sample randomized controlled trial(RCT)to implement CST for ASD children in China's Mainland.The effectiveness and feasibility data will be obtained to provide evidence for promoting CST implementation.