学前孤独症幼儿社交能力培养的实践研究

目的 探讨关键反应训练（pivotal response treatment，PRT）提高孤独症儿童主动提问技能的成效及使用策略。 方法 采用个案研究法，选取1名7岁1个月学前孤独症儿童作为研究对象，以针对物品主动提问“这是什么”为干预内容。研究过程包括基线期、干预期、维持期、第二维持期，干预期共持续2周。 结果 在干预期个案主动提问技能维持正向、稳定发展，正确率逐渐上升；维持期个案在结构化环境下主动提问的正确率保持稳定状态，具有较好的维持效果；第二维持期个案在自然情境下主动提问的正确率虽有所下降，但总体保持稳定状态；家长与教师均肯定关键反应训练干预成效。 结论 关键反应训练对孤独症儿童主动提问技能具有积极的干预成效，对未直接干预的其他领域具有积极的连带促进作用。

基于应用行为分析（ABA）的干预是孤独症谱系障碍（ASD）儿童的主流干预手段之一，虽有大量循证证据支持其有效性，然而在实践中也引发了一些讨论。本文梳理了ABA在国内外ASD儿童干预领域的研究进展，重点围绕干预策略结构化程度、惩罚手段使用、技能泛化及家庭投入负荷等问题进行了澄清与探讨。文章进一步引入神经多样性视角，分析其对ABA伦理实践的启示。在此基础上，从技术优化、家庭支持、专业能力及公众信任建设等方面提出对我国ABA干预服务优化的建议。本文旨在为ASD儿童行为干预的本土化发展与科学实践提供理性讨论与思考。

在传统的生物医学模型的引领下, 多数将孤独症社交沟通问题归咎于其自身的不足, 而双重共情问题(double empathy problem)是以社会沟通本质的双向性为基点, 认为孤独症难以融入社会环境不仅由于其自身无法理解典型发展人群, 典型发展人群亦难以理解孤独症, 由于双方之间感知和理解的不匹配, 信息的双向脱节, 从而导致双方的互动困难。一系列相关研究证实双重共情问题的存在, 其内部机制包括行为表达方式的不同和污名化现象, 可通过共同阅读模式、同伴支持和人际同步性方式进行干预。未来研究需关注更多年龄层面的孤独症间社交沟通情况, 研究评估需考虑孤独症特殊的共情表达, 深入研究双方互动过程, 并鼓励扩展更多有效的干预方法。

共同注意与行为调节能力是儿童社会性发展的重要基础，对儿童的社会互动与沟通具有关键作用，而孤独症儿童的共同注意和行为调节能力普遍存在缺陷，严重影响其社会适应能力的发展。共同注意、象征性游戏、参与和调节干预模式作为一种循证支持的自然主义发展行为干预，在提升孤独症儿童的语言、共同注意和象征性游戏能力方面效果显著。本文通过梳理JASPER干预模式的理论基础、核心框架及实施方法，并基于实证研究分析其干预成效，以期为我国孤独症儿童教育领域的研究和实践提供参考。

The deficit in social communication and interaction is one of the core symptoms of children with autism spectrum disorder (ASD).The preschool years are crucial for children with ASD laying the groundwork for social integration and mainstream school entry.Inclusive education is cornerstone of this educational and rehabilitative process.Due to the significant individual differences and functional impairments in social interaction among children with ASD,a tiered intervention model has been proposed to better support their integration into school learning and group life in preschool settings.This model addresses the heterogeneity and individualized needs of children with ASD and the corresponding need for individualized education.It involves implementing targeted social skills training based on comprehensive assessments of each child's abilities and needs.Furthermore,to effectively promote and implement this intervention model,several recommendations are proposed:developing social goals according to the level of support required by the child;applying applied behavior analysis-based intervention approaches;facilitating the involvement of typically developing children in peer support;enhancing teachers' expertise and skills related to ASD;and increasing parents' awareness and understanding of ASD.

… autism, and adaptive functioning to the variability in language and communication skills in 129 preschool … repetitive behaviors and the VABS Soc reflects the social skill deficit of autism. …

… program was designed for elementary-age students, no modifications were made to adapt the program for the preschool-age children included in this study. At the beginning of each ses…

… of social communication skills for children with autism spectrum disorder in inclusive preschools were identi… In a meta-analysis on social validity ratings for social skill interventions for …

Inclusion in “regular” schools has become a considerable option for children with autism only in recent years, but we are still far from having a global appreciation of the needs that arise upon the inclusion of children with such a severe disability. The main purpose of the present study was to identify empirically supported procedures that may improve the social interactions of children with autism upon their inclusion in the “regular” preschool. The identification of the needs of preschoolers with autism in Greek schools, as well as the specific skills that would be taught, were based on normative data collected and analysed in a series of prior studies. A long‐lasting controversy has been going on between professionals who either advocate for “schools for all children,” or stress the importance of making individualized decisions based on each child's needs during the inclusion process. The present study demonstrated that social reinforcement in combination with prompting procedures, provided by a shad...

The aim of this study was to examine the effect of motor intervention program (MIP) on autistic index, pre-academic skills, motor skills and social skills of children with Autism Spectrum Disorder (ASD). The research group consisted of a total of 34 participants between the ages of 3–6, 17 in the control group (CG) and 17 in the experimental group (EG). EG participated in the motor intervention program for 60 min a day, 2 days a week for 12 weeks. In the study, the Gilliam Autistic Disorder Rating Scale-2-Turkish Version (GARS-2 TV), Peabody Motor Development Scale-2 (PMDS-2), Pre-Academic Skills Evaluation Form (PASAF) and Social Skills Evaluation System Preschool Teacher Form (SSRS-PTF) were used. The increase in all subtests and total scores of PASAF and posttest scores obtained from PMDS-2 were found to be higher in favor of the experimental group (p < 0.05). The decrease in the stereotype and social interaction scores of GARS-2 TV and the change in the cooperation, self-control and externalization sub-dimensions of SSRS-PTF were found to be statistically significant in favor of the EG group (p < 0.05). In conclusion, it was found that MIP applied to autistic children was effective on the development of motor skills, academic skills and social skills and decreased the level of autistic index. This result shows that MIP is an effective practice that provides a favorable environment for autistic young children to develop multiple skills.

… Second, this study highlights the need for training general preschool teachers to implement social skills intervention in inclusive settings. Baseline observations revealed that teachers …

… social skills training for a preschooler diagnosed with autism. The goal of the training was to increase the rate of reciprocal social … and that these changes were socially valid (a) as …

… In the current study, the parent-report form was used with the preschool norms. The Social Skills domain encompasses prosocial behaviors reflecting communication, cooperation, …

… with autism such as preschool friendships. This study examined friendships in preschool children with autism … ,” there are already social skill deficits that are apparent in school settings. …

… available social skills training program plus classroom reinforcement for use with preschoolers … The combination of social skills training plus classroom reinforcement of target behaviors …

… The classroom is one of countless social contexts where individuals develop and practice these social skills. Before beginning conversational exchanges, at the preschool age (ie, 3–5 …

… Social reciprocity deficits are a core feature of the autism spectrum disorders (ASD). This review summarizes the state of research in group-based social skills … or preschoolers with ASD …

… preschool age population, and we sought to further explore the IQ-adaptive functioning gap in preschool … domains of adaptive skills, namely, conceptual skills, social skills, and practical …

… procedures applied to children with autism are reviewed, … expand the communication repertoires of children with autism. … behaviors and to promote social and scripted interactions. The …

… behaviors of young autistic children and their relation to social communication skills may aid in deepening our understanding of how autistic children learn from their social environment (…

Caregiver-mediated interventions are widely used to support social communication development in young autistic children. While many such interventions are evidence-informed, limited information exists about their shared and unique elements, making it challenging for caregivers and clinicians to tailor program selection to individual needs and preferences-an essential part of personalized care in autism. This scoping review with content analysis examined 18 commercially available, caregiver-mediated social communication interventions to identify similarities and differences in child skills targeted and caregiver-coached strategies. Data were extracted from program manuals, fidelity tools, published literature, and program websites for eight developmental social pragmatic (DSP) programs and 10 naturalistic developmental behavioral interventions (NDBIs). Programs varied in scope, with some supporting a broad range of child skills and others focusing on specific areas. Across all programs, 70 caregiver-coached strategies were identified, and then thematically grouped into eight categories aligned with the developmental skills the strategies aim to support. Although some strategies were common across all programs, some unique strategies were also identified. In addition, there were notable differences in how these strategies were operationalized despite using similar terminology, underscoring the need for more precise, clearly defined fidelity measures to enable accurate assessment of caregiver implementation and meaningful comparisons across programs. This study lays the groundwork for future research to identify active ingredients of interventions and supports more informed, individualized decision-making in clinical practice.Lay AbstractYoung autistic children may engage with others and communicate in ways that differ from non-autistic peers, and may need support to develop skills to communicate with, and navigate interactions with others. Many programs have been developed for this purpose, with a growing number of programs including caregivers in this process. In programs where caregivers play a primary role, professionals coach them to use certain techniques that can support social communication. Although many such programs exist, we still lack clarity on how these programs are similar or different, making it tough for families to choose among them. To address this gap, we reviewed 18 well-known caregiver-led programs to compare the skills they aim to support children with, and the specific techniques they teach caregivers. We gathered information from program resource materials, published research, and official program websites. We found that some programs focused on supporting a wide range of skills, whereas others targeted only certain developmental areas. In total, we identified 70 distinct caregiver-coached techniques, which we organized into eight categories. Many techniques were common across all programs, but others were unique to specific programs. Even among the shared techniques, there were differences in the way they were practiced, despite using the same strategy name. For example, a technique like "following the child's lead" could look quite different depending on the program. These findings show that having descriptions of how techniques should be used is important to understanding and comparing different programs. Overall, these findings provide families with information about program ingredients and can be used to guide clinicians toward programs that match individuals' needs and wants. This work also paves way for future research exploring how these social communication programs work, and evaluating which techniques are most effective for specific groups of children and families.

Interventions based upon applied behaviour analysis (ABA) have been shown to be best practice for children with autism spectrum disorder. However, in many parts of the world there is a shortage of appropriately trained behaviour analysts. Telehealth is a potential solution to increasing access to ABA. Our study assessed the use of telehealth to provide parent training in naturalistic teaching strategies designed to increase child communication skills. Five parent child dyads took part in the training, utilising didactic training and synchronous coaching. Parents could be trained to a high level of fidelity and viewed the training favourably. Children showed variable gains in communication and improved positive affect. The project was cost effective in comparison with traditional training models.

… tion in language skills of autistic children. Given this variation… effects on the ability of autistic children to communicate (… specific language skills of autistic children in specific contexts …

… Children with autistic disorder had the highest scores, followed by children with Asperger's disorder … the close link between social interactions and communication behaviors in autism. …

Social communication interventions to support autistic people are primarily developed and tested in Western countries with predominantly White, English-speaking participants. Although numerous frameworks have been developed to adapt these interventions for diverse ethnocultural groups, the quality of these adaptations is not well understood. This review used the Cultural Adaptation Checklist (CAC) to appraise the quality of cultural adaptations of social communication interventions for autistic children and adolescents. Searches across eight databases identified 16 studies involving 474 participants. Included studies reflected seven different culturally adapted interventions delivered across 12 countries in 11 languages. The methodological quality of the studies was assessed using QualSyst, and data were analyzed through narrative synthesis. All studies demonstrated at least adequate methodological quality, but only three reported using a specific framework to guide their cultural adaptations. The extent of adaptations varied, with fulfillment of CAC items across studies ranging from 44% to 91%. This review highlights the need for more comprehensively reported cultural adaptations to best support the global autistic community. The CAC offers a useful framework that researchers can use to facilitate this process. Future research should examine to what extent cultural adaptations are needed and which types of adaptations best support desired intervention outcomes. Lay Abstract Many programs have been designed in Western countries to support social communication skills such as understanding others, making friends, and building relationships in autistic people. Those who participate in these programs have mainly been English-speaking participants, so the suitability of these programs to other language, cultural, and ethnic backgrounds remains unknown. To make programs more culturally and linguistically relevant, researchers have adapted them in several ways. This study looked at how well programs for autistic children and adolescents have been adapted for various communities. Using the Cultural Adaptation Checklist (CAC), we examined 16 studies and found that the amount of adaptations varied widely. Only three studies mentioned using a framework that guided their adaptations. Our findings show that although all studies described some level of cultural adaptation, very few reported on ensuring stronger community involvement or making the programs more accessible for all. Using tools like the CAC can help researchers and clinicians make programs more inclusive and relevant for autistic individuals and their families worldwide.

… s, was associated with better social communication abilities in children with ASD, in addition … child with ASD to experience social interactions with children and to acquire communication …

… picture of the nature of social deficits presented by children diagnosed as autistic. The data … significant feature of the social skills deficits exhibited by young autistic children. These data, …

Effective support for autistic individuals is lacking in Brazil. Few centres offer services and those that do are limited in therapeutic options and geographical location. Paediatric Autism Communication Therapy is a low-intensity, evidence-based parent-mediated social-communication intervention that may be useful for this scenario. This implementation study aimed to assess the acceptability and feasibility of Paediatric Autism Communication Therapy for young autistic children (aged 2–10 years) in Brazil. Parents (n = 18) of 2- to 10-year-old autistic children and clinicians (n = 20) who work with autistic children in Brazil were interviewed and the data analysed using thematic analysis to explore their perceptions concerning the acceptability and feasibility of Paediatric Autism Communication Therapy. In addition, Paediatric Autism Communication Therapy was delivered to a case series of 15 further parent–child dyads; these parents were interviewed at the end of the therapy, and the data were analysed using thematic analysis. All parents and clinicians had favourable opinions about the acceptability, feasibility and perceived effectiveness of a parent-mediated intervention conducted mainly in the home. However, they also highlighted obstacles concerning the implementation of Paediatric Autism Communication Therapy in Brazil, especially related to engaging Brazilian parents in a parent-mediated model of therapy. Based on these data, minor adaptations were made to the original Paediatric Autism Communication Therapy protocol to facilitate the implementation of the intervention in Brazil. Lay abstract Parents of autistic children and health professionals who work with autistic children in Brazil had positive views about introducing Paediatric Autism Communication Therapy as a therapy for autistic children in Brazil. The parents and clinicians also mentioned some difficulties about using Paediatric Autism Communication Therapy in Brazil. We made adaptations to Paediatric Autism Communication Therapy to address these difficulties. Paediatric Autism Communication Therapy is a therapy to support the development of social and communication skills for autistic children aged 2–10 years. The therapy is conducted with the autistic child’s parent. Paediatric Autism Communication Therapy has not been used in Brazil before. There are few therapy options available for autistic children in Brazil and we believed that Paediatric Autism Communication Therapy may be useful. We asked three groups of people in Brazil about their views of Paediatric Autism Communication Therapy, after explaining how the therapy works. Group 1 included 18 parents of autistic children aged 2–10 years. Group 2 included 20 health professionals such as psychologists who work with autistic children. Group 3 included 15 parents of autistic children aged 2–7 years who received the Paediatric Autism Communication Therapy. We learned that parents and clinicians felt that Paediatric Autism Communication Therapy would be a beneficial therapy for autistic children in Brazil. We also found out about the challenges of using Paediatric Autism Communication Therapy in Brazil. We used these findings to make small cultural adaptations to Paediatric Autism Communication Therapy to make it more suitable for Brazil.

… This review involved a systematic analysis of studies that focused on the use of peer-mediated interventions (PMI) in the treatment of individuals with autism spectrum disorders (ASD). …

… with children with autism, and to more opportunities for learning. This article will review the research on peer-mediated social skills training strategies used with children with autism. The …

… peer-mediated interventions (PMI) to improve the social interaction skills of students with autism … the characteristics and components of peer-mediated social interaction interventions, (b) …

… This study investigated the effects of a peer-mediated intervention on the social interaction of five triads comprised of preschoolers with autism and their typical peers. Strategies thought …

Background Peer mediated intervention (PMI) is a promising practice used to increase social skills in children with autism spectrum disorder (ASD). PMIs engage typically developing peers as social models to improve social initiations, responses, and interactions. Method The current study is a systematic review examining PMIs for children and adolescents with ASD conducted using group designs. Five studies met the pre-specified review inclusion criteria: four randomized controlled trials and one pre- and post-test design. Results Four of the studies were conducted in school settings, whereas one study was conducted in a camp setting. The studies all reported that participants improved in social skills (e.g., social initiations, social responses, social communication) post intervention. Additionally, sustainment, generalization, and fidelity of implementation were examined. Conclusion PMI is a promising approach to address social skills in children with ASD, and this approach can be conducted in meaningful real-word contexts, such as schools. Limitations of the studies as well as future directions are discussed.

… Peer-mediated instruction and intervention is based on principles of behaviorism and social learning theory. In this intervention approach, developing peers … youth with autism spectrum …

Children with ASD face enormous challenges in the area of social functioning. Research has shown that impairments in social functioning distinguish this population from both typically developing children and children with disabilities. This study incorporated several evidence-based social skills-teaching procedures (i.e., direct instruction, priming, prompting, peer-mediation, contingent reinforcement, and token economies) directly in the recess setting to increase appropriate social behaviors for four children with ASD (ages 6–8). Elements of Peer Networks and Pivotal Response Training (two types of social skills intervention packages in the literature) were included. Results showed significant increases in social communication between focus children and their peers, as well as generalization of skills to non-intervention recesses.

This meta-analysis investigated the efficacy of peer-mediated interventions for promoting social interactions among children from birth to eight years of age diagnosed with ASD. Forty-five single-subject design studies were analyzed and the effect sizes were calculated by the regression model developed by Allison and Gorman (1993). The overall effect sizes suggest that peer-mediated interventions were highly effective. Further categorical comparisons suggest that these interventions were more effective in enhancing social responses in younger boys, when older male siblings served as interventionists, when the interventions took place in the home, when peer modeling was used, and when consideration was given to maintenance and generalization across participants, behaviors and activities, and in involving collaboration among all researchers, peers/siblings, school staff, and parents/families.