Traduction: G.M.
J Child Psychol Psychiatry. 2013 Nov 21. doi: 10.1111/jcpp.12161.
Essai randomisé contrôlé l'efficacité de l'intervention de la fonction exécutive pour enfants dans le spectre de l'autisme
Kenworthy L, Anthony LG, Naiman DQ, Cannon L, Wills MC, Luong-Tran C, Werner MA, Alexander KC, Strang J, Bal E, Sokoloff JL, Wallace GL.
Source
Children's National Medical Center, Center for Autism Spectrum Disorders, Rockville, MD, USA; The George Washington University School of Medicine, Washington, DC, USA.Résumé
CONTEXTE
Débloquer et sur la cible ( UOT ) est une intervention sur la fonction exécutive ( EF ) pour les enfants avec des troubles du spectre autistique (TSA ) ciblant l'insistance sur la similitude , la flexibilité , l'établissement d'objectifs et la planification grâce à un programme cognitivo-comportemental d'auto- régulation, pratique guidée /atténuée, et de repérage visuel / verbal .UOT est contextuel, car il est mis en œuvre à l'école et à la maison , les contextes dans lesquels un enfant utilise les compétences en EF .
MÉTHODES
To evaluate the effectiveness of UOT compared with a social skills intervention (SS), 3rd-5th graders with ASD (mean IQ = 108; UOT n = 47; SS n = 20) received interventions delivered by school staff in small group sessions. Students were matched for gender, age, race, IQ, ASD symptomotolgy, medication status, and parents' education. Interventions were matched for 'dose' of intervention and training. Measures of pre-post change included classroom observations, parent/teacher report, and direct child measures of problem-solving, EF, and social skills. Schools were randomized and evaluators, but not parents or teachers, were blinded to intervention type.
RÉSULTATS
Les interventions ont été administrés avec une grande fidélité . Les enfants dans les deux groupes se sont améliorés avec l'intervention , mais les faibles changements de score entre pré- et post-intervention indiquent une amélioration significativement plus marquée pour le groupe UOT que pour le groupe de compétences sociales CS dans : la résolution de problèmes , la flexibilité et la planification / organisation .En outre, les observations en classe ont révélé que les participants UOT ont de plus grandes améliorations que les participants SS dans leur capacité à suivre les règles , faire des transitions , et être flexible .
Les enfants des deux groupes ont montré des améliorations équivalentes dans les compétences sociales .
CONCLUSIONS
Ces données confirment l'efficacité de la première intervention contextuelles de EF pour les enfants avec TSA .L'UOT améliore le comportement en classe , la flexibilité et la résolution de problèmes chez les enfants avec TSA .
Les personnes avec une formation de base sur les TSA mettent en œuvre avec succès l'UOT dans les établissements scolaires ordinaires.© 2013 les auteurs. Journal of Child Psychology and Psychiatry © 2013 Association pour la santé des mentale des enfants et adolescents .
PMID: 24256459
Abstract
BACKGROUND:
Unstuck and On Target (UOT) is an executive function (EF) intervention for children with autism spectrum disorders (ASD) targeting insistence on sameness, flexibility, goal-setting, and planning through a cognitive-behavioral program of self-regulatory scripts, guided/faded practice, and visual/verbal cueing. UOT is contextually-based because it is implemented in school and at home, the contexts in which a child uses EF skills.METHODS:
To evaluate the effectiveness of UOT compared with a social skills intervention (SS), 3rd-5th graders with ASD (mean IQ = 108; UOT n = 47; SS n = 20) received interventions delivered by school staff in small group sessions. Students were matched for gender, age, race, IQ, ASD symptomotolgy, medication status, and parents' education. Interventions were matched for 'dose' of intervention and training. Measures of pre-post change included classroom observations, parent/teacher report, and direct child measures of problem-solving, EF, and social skills. Schools were randomized and evaluators, but not parents or teachers, were blinded to intervention type.RESULTS:
Interventions were administered with high fidelity. Children in both groups improved with intervention, but mean change scores from pre- to postintervention indicated significantly greater improvements for UOT than SS groups in: problem-solving, flexibility, and planning/organizing. Also, classroom observations revealed that participants in UOT made greater improvements than SS participants in their ability to follow rules, make transitions, and be flexible. Children in both groups made equivalent improvements in social skills.CONCLUSIONS:
These data support the effectiveness of the first contextually-based EF intervention for children with ASD. UOT improved classroom behavior, flexibility, and problem-solving in children with ASD. Individuals with variable background/training in ASD successfully implemented UOT in mainstream educational settings.© 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.
