ISSN 1671-3710
CN 11-4766/R
主办:中国科学院心理研究所
出版:科学出版社

心理科学进展 ›› 2023, Vol. 31 ›› Issue (12): 2350-2367.doi: 10.3724/SP.J.1042.2023.02350

• 研究前沿 • 上一篇    下一篇

自然发展行为干预在孤独症早期干预中的应用

肖石花1,2, 李晶1,2()   

  1. 1中国科学院心理研究所 中国科学院行为科学重点实验室, 北京 100101
    2中国科学院大学心理学系, 北京 100049
  • 收稿日期:2022-10-28 出版日期:2023-12-15 发布日期:2023-09-11
  • 通讯作者: 李晶, Email: lij@psych.ac.cn.
  • 基金资助:
    国家自然科学基金项目(31971009);中国科学院青年创新促进会资助

Implementation of Naturalistic Developmental Behavioral Interventions: An early intervention program for children with autism spectrum disorder

XIAO Shihua1,2, LI Jing1,2()   

  1. 1CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
    2Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
  • Received:2022-10-28 Online:2023-12-15 Published:2023-09-11

摘要:

孤独症患病率的不断上升, 加剧了对早期干预的需求, 但传统行为干预有其局限性。自然发展行为干预(Naturalistic Developmental Behavioral Interventions, NDBI)是一类结合了行为原则和发展理论, 并在自然情境中实施的孤独症早期干预方法。近年来, NDBI在国际范围内受到广泛关注, 实证研究基础持续扩大。NDBI代表性干预方法包括:共同关注、象征性游戏、参与和调节, 强化式情境教学, 社交沟通−情绪调节−交往支持模式, 关键反应训练, 早期介入丹佛模式和教导父母成为社交教练等, 这些方法具有共同的核心要素和特征, 但目标领域和效果特点各有侧重。NDBI在促进孤独症儿童社交、语言、认知等领域的发展, 以及降低家庭经济成本和提高儿童主动性等方面具有突出优势, 在我国有广阔的应用前景。未来应围绕提高干预效果和扩展应用范围进行深入研究, 包括厘清影响干预效果的预测因素与调节变量、探索有效的家长培训方法、探索不同干预方法和工具的结合等, 同时在我国文化背景下推动NDBI的本土化研究和实践。

关键词: 自然发展行为干预, 孤独症, 早期干预

Abstract:

Naturalistic Developmental Behavioral Interventions (NDBI) are a class of early intervention methods for autism spectrum disorder (ASD) that combine the principles of applied behavior analysis and developmental psychology, emphasizing naturalistic teaching. In recent years, NDBI have gained international attention, with a continuously expanding empirical research base. This systematic analysis examines the application and effectiveness of six representative NDBI methods in early intervention for ASD. The findings highlight the outstanding advantages of NDBI in promoting the development of social, language, cognitive, and other domains in children with ASD, reducing family costs, and fostering children's initiative. Additionally, the study discusses the application prospects and existing problems of NDBI in China and proposes future research directions. These include clarifying predictive factors and moderating variables that affect intervention effects, exploring effective parent training methods, investigating the combination of different intervention methods and tools, and promoting the localization research and practice of NDBI within China's cultural context. This comprehensive analysis provides valuable reference and inspiration for early intervention in ASD.

The six representative NDBI methods introduced in the study are: Joint Attention, Symbolic Play, Engagement and Regulation (JASPER), Enhanced Milieu Teaching (EMT), Social Communication, Emotional Regulation, and Transactional Support (SCERTS), Pivotal Response Training (PRT), Early Start Denver Model (ESDM), and Parent-Implemented Social Coaching (PIT). These methods share core elements and characteristics of NDBI but have different focuses on target domains and effectiveness.

JASPER primarily targets the core deficits of children with autism in the nonverbal communication domain, enhancing their abilities in joint attention, symbolic play, and shared engagement while also promoting language development. EMT focuses on the language domain, effectively improving the language and verbal communication abilities of children with autism while fostering overall social communication development. SCERTS addresses the core deficits of children with autism in social communication and emotional regulation, building a cross-environmental support system that enhances their social interaction, particularly active participation in social engagement. PRT, as a comprehensive intervention method, targets four “pivotal areas” with a particular emphasis on the role of motivation in the overall development of children with autism, demonstrating favorable outcomes in social interaction and language communication domains. ESDM provides a comprehensive and systematic teaching system to promote the overall development and improvement of core symptoms in children with autism, particularly showing significant effects in cognition, language, and social participation. PIT involves parent training in teaching strategies, enabling parents to implement interventions to improve the social communication abilities of their children with autism while also facilitating the creation of a supportive family environment conducive to their development.

This study presents a comprehensive overview of six representative Naturalistic Developmental Behavioral Interventions (NDBI) methods, examining their concepts, characteristics, applications, and effectiveness. It summarizes empirical evidence supporting the effectiveness of these NDBI methods in improving various developmental domains of children with Autism Spectrum Disorder (ASD), including social interaction, joint attention, play skills, language communication, cognition, adaptive behavior, and executive function. By integrating findings from multiple studies, the study compares the advantages and disadvantages of different NDBI methods.

Furthermore, it discusses the prospects and challenges of implementing NDBI in China from a cultural perspective. The study emphasizes the broad application prospects of NDBI in China while acknowledging the challenges and difficulties hindering its implementation, such as the lack of qualified professionals, training resources, and localized research. To address these issues, the study proposes future research directions, including clarifying predictive factors and moderating variables that influence intervention effects, exploring effective parent training methods, and investigating interventions that combine different approaches or incorporate cutting-edge technologies. Additionally, the study provides insightful pathways for promoting the localization research and practice of NDBI in the cultural context of China.

Key words: Naturalistic Developmental Behavioral Interventions (NDBI), autism spectrum disorder (ASD), early intervention

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