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Developmental social pragmatic interventions for preschoolers with autism spectrum disorder: A systematic review
Autism & Developmental Language Impairments Pub Date : 2019-01-01 , DOI: 10.1177/2396941518824497
Amanda V Binns 1 , Janis Oram Cardy 1
Affiliation  

Background and aims Developmental social pragmatic interventions are one treatment option for supporting the social communication and language skills of preschool children with autism spectrum disorder. Our first aim was to differentiate interventions using a developmental social pragmatic model from other developmental or naturalistic behavioral approaches. We applied explicit criteria outlining core features of developmental social pragmatic interventions to identify programs that use these core features. We then systematically reviewed studies examining the impact of developmental social pragmatic interventions in supporting (a) foundational social communication and language skills of preschool children with autism spectrum disorder and (b) caregiver interaction style. Additionally, we reviewed results exploring mediators and potential factors influencing children’s response to developmental social pragmatic interventions. Methods A multistep comprehensive search strategy was used to identify developmental social pragmatic treatments and studies examining their effectiveness for preschool children with autism spectrum disorder. The characteristics of each study and their outcomes were then reviewed, and a modified Critical Appraisal Skills Programme tool was used to evaluate rigor. Main contribution/Results Six interventions that met criteria to be classified as developmental social pragmatic are examined within this review. Ten studies of varying methodological rigor met criteria for inclusion and collectively reported on the outcomes of 716 preschool-aged children with autism spectrum disorder. All of the studies examined foundational communication outcomes and all but one reported positive outcomes for at least one of the measures. Seven studies examined language outcomes. While results were positive for language use within natural contexts, they were mixed for overall, receptive, and expressive language. Parents’ interaction styles significantly changed postintervention, namely in terms of increased responsiveness, synchronous behavior, use of affect, and decreased directiveness. Only two studies conducted formal mediation analysis and found that parent responsiveness and synchronous behavior were related to children’s positive response to treatment. Conclusions This review suggests that developmental social pragmatic treatments positively impact children’s foundational communication capacities (i.e. attention, social referencing, joint attention, initiation, reciprocity). Positive findings were not consistently found for supporting children’s language. Further, methodologically rigorous studies are needed to draw definitive conclusions. Additional research exploring components of developmental social pragmatic treatments that might mediate response to treatment is needed. Implications This review provides synthesized information for clinicians, families, and researchers on the effectiveness of developmental social pragmatic interventions for improving children’s foundational communication. It also suggests directions for future research and provides ideas for enhancing methodological rigor and promoting more homogeneity among treatment implementation and outcome assessments.

中文翻译:

自闭症谱系学龄前儿童的发展性社会实用干预:系统评价

背景和目的发展性社会实用干预是支持自闭症谱系学龄前儿童社交和语言技能的一种治疗选择。我们的首要目标是使用发展性社会实用模型将干预措施与其他发展性或自然主义行为方法区分开来。我们应用了明确的标准来概述发展性社会实用干预的核心特征,以识别使用这些核心特征的程序。然后,我们系统地回顾了研究,探讨了发展性社会实用干预在支持(a)自闭症谱系障碍学龄前儿童的基本社交和语言技能以及(b)照顾者互动方式方面的影响。另外,我们回顾了探索调解人的结果以及影响儿童对发展性社会实用干预的反应的潜在因素。方法采用多步骤综合搜索策略确定发展性社会实用疗法,并研究其对学龄前儿童自闭症谱系障碍的有效性。然后审查每个研究的特征及其结果,并使用改良的“关键评估技能计划”工具评估严谨性。主要贡献/结果本次审查对符合标准的六项干预措施进行了分类,这些干预措施被归类为发展性社会实用主义。十项方法严格程度不同的研究符合纳入标准,并集体报告了716名学龄前自闭症谱系障碍儿童的结局。所有研究均检查了基本的交流结果,除一项报告外,其他均报告了至少一项措施的积极结果。七项研究检查了语言结果。虽然在自然语境下使用语言取得了积极的成果,但对于整体,接受和表达语言而言,结果却参差不齐。父母的互动方式显着改变了干预后的行为,即在增加响应能力,同步行为,使用情感和降低指导性方面。只有两项研究进行了正式的调解分析,发现父母的反应能力和同步行为与孩子对治疗的积极反应有关。结论这项评价表明,发展性社会实用主义治疗对儿童的基本沟通能力(即注意力,社会参照,共同注意,主动,互惠)。不能始终如一地发现支持儿童语言的积极发现。此外,需要进行严格的方法学研究得出明确的结论。需要进行其他研究,探讨可能介导对治疗的反应的发展性社会实用治疗的组成部分。启示这篇综述为临床医生,家庭和研究人员提供了有关发展性社会实用干预措施对改善儿童基础沟通的有效性的综合信息。它还为将来的研究提供了方向,并为提高方法的严谨性和促进治疗实施和结果评估之间的同质化提供了思路。不能始终如一地发现支持儿童语言的积极发现。此外,需要进行严格的方法学研究得出明确的结论。需要进行其他研究,探讨可能介导对治疗的反应的发展性社会实用治疗的组成部分。启示这篇综述为临床医生,家庭和研究人员提供了有关发展性社会实用干预措施对改善儿童基础沟通的有效性的综合信息。它还为将来的研究提供了方向,并为提高方法的严谨性和促进治疗实施和结果评估之间的同质化提供了思路。不能始终如一地发现支持儿童语言的积极发现。此外,需要进行严格的方法学研究得出明确的结论。需要进行其他研究,探讨可能介导对治疗的反应的发展性社会实用治疗的组成部分。启示这篇综述为临床医生,家庭和研究人员提供了有关发展性社会实用干预措施对改善儿童基础沟通的有效性的综合信息。它还为将来的研究提供了方向,并为提高方法的严谨性和促进治疗实施和结果评估之间的同质化提供了思路。需要进行其他研究,探讨可能介导对治疗的反应的发展性社会实用治疗的组成部分。启示这篇综述为临床医生,家庭和研究人员提供了有关发展性社会实用干预措施对改善儿童基础沟通的有效性的综合信息。它还为将来的研究提供了方向,并为提高方法的严谨性和促进治疗实施和结果评估之间的同质化提供了思路。需要进行其他研究,探讨可能介导对治疗的反应的发展性社会实用治疗的组成部分。启示这篇综述为临床医生,家庭和研究人员提供了有关发展性社会实用干预措施对改善儿童基础沟通的有效性的综合信息。它还为将来的研究提供了方向,并为提高方法的严谨性和促进治疗实施和结果评估之间的同质化提供了思路。研究人员研究了发展性社会实用干预措施对改善儿童基础沟通的有效性。它还为将来的研究提供了方向,并为提高方法的严谨性和促进治疗实施和结果评估之间的同质化提供了思路。研究人员研究了发展性社会实用干预措施对改善儿童基础沟通的有效性。它还为将来的研究提供了方向,并为提高方法的严谨性和促进治疗实施和结果评估之间的同质化提供了思路。
更新日期:2019-01-01
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