第22屆 疑似自閉症幼兒預防性早期介入時間序列個案分析研究

疑似自閉症幼兒預防性早期介入個案分析研究

A Time Series Study of Young Children Suspected with ASD Receiving Preventive Early Intervention

林初穗¹*(通訊作者)、陳韻如²、余映潔³(報告者)、黃美越⁴(報告者)

ChuSui Lin¹*, Yun-Ru Chen², Ying-Chieh Yu³, Mei-Yueh Huang⁴

^1,3,4中原大學特殊兒童家庭支持研究中心、²中原大學心理系

^1,3,4Center for Supporting Families of Children with Special needs, Chung-Yuan Christian University, ²Department of Psychology, Chung-Yuan Christian University

Background：This study wants to examine the effectiveness of an innovative model of preventive early intervention for young children suspected of autism spectrum disorder. The model includes early screening and intervention. During the first phase of early screening, a total of 702 infants aged 6 to 24 months were screened using the Infant and Toddler Checklist of the Communication and Symbolic Behavior Scales Developmental Profile (CSBS-DP).  Over three years, 227 infants and toddlers were identified as suspected of autism spectrum disorder. Thirty-four of them (aged 12 to 24 months) agreed to proceed to the phase of behavior sampling based on the CSBS-DP. A total of 25 cases who completed the phase-two screening went on to participate in the group intervention. Thirteen red flag behaviors of the Systematic Observation of Red Flags (SORF) measure were used to further screen for the risk of autism spectrum disorder among these 25 cases. The SORF test found 13 cases suspected of autism spectrum disorder who met the criteria in at least five behavioral items in the social communication (SC) domain and at least one item in the restricted repetitive behaviors (RRB) domain.  Eleven of these 13 cases participated in the phase 1 and phase 2 group preventive early intervention for approximately 12 to 24 months during the study.

Methods：A time series analysis (T1 ~ T3) was conducted among these 11 young children. Both pre- and post- quantitative and qualitative measures were used to examine the changes over times among these children. Among these 11 young children, five were later diagnosed as ASD by psychiatrist.

Results：We found that all children, except two, most showed significant developmental progress as measured by the scales used in this study, especially in verbal communication and social interaction. However, not every child developed at the same rate. Some showed significant improvement starting at T2 (6 months), while others, not until T3 (12 months). Interestingly, five of the nine children who showed improvement found their autism-suspected behaviors gradually disappearing. For instance, some children started out by pulling people with their hands and later replaced that behavior with gestures like "pointing" or even with “vocalization”. Other children began demonstrating pivotal behaviors such as “joint attention” which in turn spurred development in other domains. On the other hand, four young children retained their ASD characteristics, although they did show some improvement as measured by the scales.     

Conclusion：This preventive early intervention model has yielded a rich set of data, including the different developmental trajectory changes over times associated with each case and between-group comparisons. This results of this study may lead to the implications to the future practices of preventive early intervention in Taiwan.

Keywords：preventive early intervention、family support、early intervention