ABSTRACT

Objective

The heterogeneous symptom presentation of autism spectrum disorder (ASD) requires clinicians to consider each child’s unique constellation of symptoms and tailor intervention accordingly. Treatment moderators, though necessary to guide evidence-based treatment decisions, are significantly under-studied. This brief report aims to expand on previous literature by providing an overview of characteristics which may influence treatment outcome and specifying future directions to build on this preliminary evidence base.

Method

A subset of treatment modalities was identified from the National Clearinghouse on Autism Evidence and Practice Review Team’s most recent report including discrete trial early intensive behaviorally based treatment, social skills training, and cognitive behavioral interventions. Within these treatment modalities, individual interventions with significant support were specifically discussed. Due to the lack of research on treatment moderators, a discussion of significant predictors of treatment outcome is also included.

Results

Preliminary evidence suggests that overall, treatment intensity, duration, and parent involvement are the most consistently identified predictors (and in some studies, moderators) of treatment outcome; sessions which occur more frequently, continue for longer periods of time, and include parent training or coaching may yield the best outcomes. Other characteristics, including age and IQ, have been widely debated, with differing results found across treatment modalities.

Conclusions

The sparsity of research demonstrates a clear need for continued research on moderators to guide clinical judgment. Future studies that recruit larger samples targeting specific ASD symptoms at specific ages may be more adequately powered to detect these moderating effects.

中文翻译：

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自闭症谱系障碍儿童和青少年治疗效果的预测因子和调节因子

摘要

客观的

自闭症谱系障碍 (ASD) 的异质症状表现要求临床医生考虑每个孩子独特的症状群并相应地调整干预措施。治疗调节剂虽然对指导循证治疗决策是必要的，但研究不足。这份简短的报告旨在通过提供可能影响治疗结果的特征的概述并在此初步证据基础上指定未来的方向来扩展先前的文献。

方法

从国家自闭症证据和实践审查小组的最新报告中确定了一部分治疗方式，包括离散试验早期强化行为治疗、社交技能培训和认知行为干预。在这些治疗方式中，特别讨论了具有重要支持的个体干预措施。由于缺乏对治疗调节剂的研究，还包括对治疗结果的重要预测因素的讨论。

结果

初步证据表明，总体而言，治疗强度、持续时间和父母参与是治疗结果最一致确定的预测因素（在一些研究中，是调节因素）；发生更频繁、持续时间更长、包括家长培训或辅导的课程可能会产生最佳结果。其他特征，包括年龄和智商，已被广泛讨论，不同的治疗方式发现了不同的结果。

结论

研究的稀少性表明显然需要继续研究调节剂以指导临床判断。未来招募针对特定年龄特定 ASD 症状的更大样本的研究可能更有能力检测这些调节作用。