ABSTRACT

For families with children with autism that engage in severe behavior, the American Academy of Pediatrics recommends that functional assessment and management of environmental variables contributing to severe behavior occur prior to the prescription of psychopharmacologic treatment. Despite the inclusion of this recommendation in guidance articles published in pediatric journals for more than a decade, access to such services may not be feasible, in particular for families living in rural and geographically isolated communities. Given that families often view pediatricians as their first line of professional guidance for addressing challenges surrounding child development, the inaccessibility of appropriate services for managing healthcare is a concern for many pediatricians. To address this issue, a brief family-centered service provision model was developed through a collaboration between healthcare providers at a university-based hospital and Applied Behavior Analysis program faculty of the affiliated university. The hospital served many families living in rural areas of the state; therefore, the model utilized research-based practices with evidence of ecological validity for providing function-based assessment and treatment services. Within this manuscript we present a description of the model and its current implementation at a university-based hospital. For a data-based evaluation of the clinic and model, we refer readers to https://osf.io/qx8ak.

摘要

对于患有严重行为的自闭症儿童的家庭，美国儿科学会建议在进行心理药物治疗之前应进行功能评估和对导致严重行为的环境变量进行管理。尽管十多年来在儿科杂志上发表的指导文章中都包含了该建议，但获得此类服务可能并不可行，特别是对于生活在农村和地理上偏远社区的家庭而言。鉴于家庭经常将儿科医生视为应对儿童发育挑战的第一专业指导，因此许多儿科医生都无法获得适当的医疗保健服务。为了解决这个问题，通过基于大学的医院的医疗保健提供者与所属大学的“应用行为分析”计划系之间的协作，开发了一个简短的以家庭为中心的服务提供模型。医院为许多居住在该州农村地区的家庭提供了服务；因此，该模型利用具有生态有效性证据的基于研究的实践来提供基于功能的评估和处理服务。在本手稿中，我们介绍了该模型及其在一家大学医院中的当前实施情况。对于诊所和模型的基于数据的评估，我们将读者推荐给https://osf.io/qx8ak。医院为许多居住在该州农村地区的家庭提供了服务；因此，该模型利用了具有生态有效性证据的基于研究的实践来提供基于功能的评估和处理服务。在本手稿中，我们介绍了该模型及其在一家大学医院中的当前实施情况。对于诊所和模型的基于数据的评估，我们将读者推荐给https://osf.io/qx8ak。医院为许多居住在该州农村地区的家庭提供了服务；因此，该模型利用具有生态有效性证据的基于研究的实践来提供基于功能的评估和处理服务。在本手稿中，我们介绍了该模型及其在一家大学医院中的当前实施情况。对于诊所和模型的基于数据的评估，我们将读者推荐给https://osf.io/qx8ak。