创新团队成果专栏

孤独症谱系障碍ImPACT干预方案的改编及适应性调查

  • 吴丹萍 ,
  • 任芳 ,
  • 沈理笑 ,
  • 薛敏波 ,
  • 王俊丽 ,
  • 李斐 ,
  • 徐明玉
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  • 上海交通大学医学院附属新华医院发育行为儿童保健科,环境与儿童健康教育部重点实验室,上海 200092
吴丹萍(1992—),女,心理治疗师,硕士;电子信箱:whuwdp@163.com
李 斐,电子信箱:feili@shsmu.edu.cn
徐明玉,电子信箱:xumingyu@xinhuamed.com

收稿日期: 2022-05-24

  录用日期: 2022-08-21

  网络出版日期: 2022-09-28

基金资助

上海市公共卫生体系建设三年行动计划(GWV-10.1-XK07);上海市卫生健康委员会先进适宜技术推广项目(2019SY068);上海市高水平地方高校创新团队(SHSMU-ZDCX20211100)

Adaptation and adaptability investigation of Improving Parents as Communication Teachers (ImPACT) program for autism spectrum disorder

  • Danping WU ,
  • Fang REN ,
  • Lixiao SHEN ,
  • Minbo XUE ,
  • Junli WANG ,
  • Fei LI ,
  • Mingyu XU
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  • Department of Child Health Care, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine; MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai 200092, China
LI Fei, E-mail: feili@shsmu.edu.cn.
XU Mingyu, E-mail: xumingyu@xinhuamed.com

Received date: 2022-05-24

  Accepted date: 2022-08-21

  Online published: 2022-09-28

Supported by

Three-Year Construction Plan of Shanghai Municipal Health Commission(GWV-10.1-XK07);Project of Shanghai Municipal Health Commission(2019SY068);Innovative Research Team of High-level Local Universities in Shanghai(SHSMU-ZDCX20211100)

摘要

目的·对孤独症谱系障碍(autism spectrum disorder,ASD)家长介导干预项目“让家长成为孩子沟通训练的老师(Improving Parents as Communication Teachers,ImPACT)”进行中国文化背景下的改编和适应性调查。方法·改编过程按4个步骤进行:信息收集、初步改编设计、初步改编测试、进一步调整。信息收集部分邀请8位专家(6位儿科专家、2位心理治疗师)进行6次专家焦点小组讨论,并根据专家意见从语言、干预形式、方案结构、文化习俗等方面对ImPACT进行初步改编。然后招募16位ASD患儿家长,分成2批参加初步改编后的ImPACT团体治疗,并在初步改编测试阶段同步进行适应性调查。结果·初步改编方案的适应性调查结果显示:所有家长均认为“上课进度节奏把握得当,能跟着老师节奏完成课堂内容学习”,66.67%的家长认为“课程准备充分、讲解清晰、目标明确”,33.34%的家长则认为学习过程“提供了丰富例子,帮助理解干预技巧”。关于每次学习后的技能练习作业,83.33%的家长认为“轻松完成,能帮助自己更好地学习干预技巧”,且所有家长均认为“点评及时,点评的内容能帮助自己答疑解惑”。而针对家长反馈的难点,即第7次(塑造互动)、第6次(教授新的模仿和游戏技能)、第5次(教授新的沟通技能)干预,与专家小组讨论后,进行进一步调整,使得最终方案能更方便家长学习掌握。结论·经过改编和适应性调查,形成了更适合中国ASD儿童家庭的家长介导干预的ImPACT项目。

本文引用格式

吴丹萍 , 任芳 , 沈理笑 , 薛敏波 , 王俊丽 , 李斐 , 徐明玉 . 孤独症谱系障碍ImPACT干预方案的改编及适应性调查[J]. 上海交通大学学报(医学版), 2022 , 42(9) : 1239 -1246 . DOI: 10.3969/j.issn.1674-8115.2022.09.010

Abstract

Objective ·To adapt and investigate the adaptability of the parent-mediated intervention program “Improving Parents as Communication Teachers (ImPACT)” for autism spectrum disorder (ASD) under the background of Chinese culture. Methods ·There were 4 procedures of adaptation: information gathering, preliminary adaptation design, preliminary adaptation test, and adaptation refinement. In the information collection part, 8 experts (6 pediatrics and 2 psychotherapists) were invited to have 6 focus group discussions, and preliminary adaptation was made in the aspects of language, intervention form, program structure, cultural customs, etc., according to expert suggestions. Then 16 ASD parents were recruited to participate in the ImPACT program after the preliminary adaptation. Adaptative investigation of ImPACT was carried out simultaneously in the preliminary adaptation test stage. Results ·The adaptability investigation results of preliminary adaptation program showed that all parents believed that “the pace of the program was well controlled, and they could follow the rhythm of the therapist to complete the learning of skills”. Among these parents, 66.67% believed that “the course was fully prepared, the explanation was clear, and the goal was clear”, and 33.34% believed that “rich examples were provided to help understand intervention skills” in the learning process. As for the feedback of skill practice homework after each session, 83.33% of parents believed that “homework could be easily completed, and help them better learn intervention skills”, and all parents believed that “comments were timely, and the content of comments could help them answer questions and solve doubts”. The difficulties in mastering, i.e., the 7th session (shaping the interaction), the 6th session (teaching new imitation and play skills), and the 5th session (teaching new communication skills) were further adjusted after discussion with the expert group to make the final plan more convenient for parents to master. Conclusion ·After adaptation and adaptability investigation, a parent-mediated intervention program ImPACT which is more suitable for the families of ASD children in China has been formed.

参考文献

1 FRANCESMONNERIS A, PINCUS H, FIRST M. Diagnostic and statistical manual of mental disorders: DSM-V[M]. 5th ed. Arlington: American Psychiatric Association, 2013.
2 SCHREIBMAN L, DAWSON G, STAHMER A C, et al. Naturalistic developmental behavioral interventions: empirically validated treatments for autism spectrum disorder[J]. J Autism Dev Disord, 2015, 45(8): 2411-2428.
3 ZHOU B, XU Q, LI H, et al. Effects of parent-implemented early start Denver model intervention on Chinese toddlers with autism spectrum disorder: a non-randomized controlled trial[J]. Autism Res, 2018, 11(4): 654-666.
4 斯蒂芬·冯·特茨纳, 苏雪云, 肖非. 儿童期自闭谱系障碍的发展、评估与干预: 国际和中国视角[M]. 北京: 光明日报出版社, 2021.
4 STEPHEN V T, SU X Y, XIAO F. Development, assessment and intervention of autism spectrum disorders in childhood: international and Chinese perspective[M]. Beijing: Guangming Daily Press, 2021.
5 INGERSOLL B, DVORTCSAK A. Teaching social communication to children with autism: a practitioner′s guide to parent training and a manual for parents[M]. 2nd ed. New York: Guilford Press, 2010.
6 INGERSOLL B, DVORTCSAK A. Including parent training in the early childhood special education curriculum for children with autism spectrum disorders[J]. Top in Early Child Spec Educ, 2006, 26(3): 179-187.
7 INGERSOLL B, WAINER A. Initial efficacy of project ImPACT: a parent-mediated social communication intervention for young children with ASD[J]. J Autism Dev Disord, 2013, 43(12): 2943-2952.
8 INGERSOLL B R, WAINER A L. Pilot study of a school-based parent training program for preschoolers with ASD[J]. Autism, 2013, 17(4): 434-448.
9 BEJARANO-MARTíN á, CANAL-BEDIA R, MAGáN-MAGANTO M, et al. Effect of a focused social and communication intervention on preterm children with ASD: a pilot study[J]. J Autism Dev Disord, 2022, 52(4): 1725-1740.
10 SENGUPTA K, MAHADIK S, KAPOOR G. Glocalizing project ImPACT: feasibility, acceptability and preliminary outcomes of a parent-mediated social communication intervention for autism adapted to the Indian context[J]. Res Autism Spectr Disord, 2020, 76(1): 101585.
11 BARRERA M, CASTRO F G. A heuristic framework for the cultural adaptation of interventions[J]. Clin Psychol, 2006, 13(4): 311-316.
12 WONG R S, TUNG K T S, CHAN B N K, et al. Early-life activities mediate the association between family socioeconomic status in early childhood and physical fitness in early adolescence[J]. Sci Rep, 2022, 12(1): 81.
13 NARZISI A. Phase 2 and later of COVID-19 lockdown: is it possible to perform remote diagnosis and intervention for autism spectrum disorder? An online-mediated approach[J]. J Clin Med, 2020, 9(6): E1850.
14 ILIAS K, CORNISH K, PARK S A, et al. Risk and resilience among mothers and fathers of primary school age children with ASD in Malaysia: a qualitative constructive grounded theory approach[J]. Front Psychol, 2019, 9: 2275.
15 李莉. 上海市自闭症儿童家庭生活质量研究[D]. 上海: 华东师范大学, 2016.
15 LI L. Study on the quality of family life of autistic children in Shanghai[D]. Shanghai: East China Normal University, 2016.
16 GHANOUNI P, HOOD G. Stress, coping, and resiliency among families of individuals with autism: a systematic review[J]. Rev J Autism Dev Disord, 2021, 8(3): 389-402.
17 贺成华. 自闭症儿童母亲压力体验的质性研究[D]. 上海: 华东理工大学, 2018.
17 HE C H. A qualitative study on the stress experience of mothers of autistic children[D]. Shanghai: East China University of science and technology, 2018.
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