The Efficacy Of Very Early Intervention PCBI On Toddlers With Autism Spectrum Disorder

[Objective]A self-control study and a randomized controlled trial were respectively used to explore the short-term treatment effects of “Play-based Communication and Behavior Intervention”(PCBI)and relevant factors of treatment on toddlers with autism spectrum disorder.[Methods]Study 1: Enrolled 104 ASD toddlers aged 8 to 30 months,treated in Child Mental Health Research Center,Nanjing Brain Hospital from November 2016 to May 2018 and their parents as objects,and in total 12 weeks of intervention by PCBI.Portage Early Development Checklist,Autism Treatment Evaluation Checklist(ATEC)and Parenting Stress Index-Short Form(PSI-SF)were used to estimate toddlers' developmental level,treatment efficacy and parenting stress before and after training respectively.T test and analysis of variance were used to contrast the difference before and after training.Furthermore,we analyze factors such as gender,parents' educational level and family economic status which may influence the effect of PCBI intervention.Study 2: Seventy-four ASD toddlers aged from 19 to 30 months were recruit in this study.Toddlers who participate in this study were randomly assigned to PCBI group and ABA(Applied Behavior Analysis,ABA)group,then intervened weekly by PCBI or ABA in total 12 weeks.Portage Early Development Checklist and Autism Treatment Evaluation Checklist(ATEC)were used to estimate toddlers' developmental level and the treatment efficacy respectively.The t-test was used to reveal whether there were significant difference between two groups before and after interventions.[Results]Study 1:(1)After 12 weeks,there were significant difference in Portage Early Developmental Checklist and ATEC(P<0.05)in 104 ASD toddlers.(2)After 12 weeks,104 ASD toddlers' parents reported that the total score and the parent-child dysfunctional interaction score of PSI-SF were decreased significantly(P<0.05).(3)Divided 104 ASD toddlers into groups by sex,before and after the intervention the Portage Early Development Checklist score difference and ATEC score difference were no significant difference between two groups(P>0.05).(4)Divided 104 ASD toddlers into groups by parents' educational level,before and after the intervention the Portage Early Development Checklist score difference,ATEC score difference and PSI-SF score difference were no significant difference among four groups(P>0.05).(5)Divided104 ASD toddlers into groups by annual family economic status,before and after the intervention the social subscale of ATEC score difference and PSI-SF score difference were significant among five groups(P<0.05).Study 2:(1)Compared to the ABA group,there was a significant increase in cognitive scores((35)PCBI=9.03,(35)ABA=4.27,t=3.997)and a significant decrease in social behavior scores((35)PCBI=8.87,(35)ABA=16.91,t=-4.022)of the Porter's Early Development Checklist after 12 weeks of intervention in the PCBI group(P<0.001);while the total score and the scores of language,movement,and self-care subscale of Portage Early Development Checklist were also increased after PCBI intervention but not significant(P>0.05).(2)Compared to the ABA group,after 12 weeks of PCBI intervention,the scores of social,perception,behavior of ATEC was decreased,but difference was not significant(P>0.05);while the total score of ATEC scale and the scores of language subscale was decreased significantly(P<0.05).[Conclusion](1)After 12 weeks of the very early intervention PCBI,the ASD toddlers all improved in clinical symptoms and developmental level,while effectively decreasing parenting stress.(2)Compared with ABA intervention,the treatment efficacy of parenting-direct PCBI very early intervention was comparable in same 12 weeks,and the PCBI was not taking up as much medical rehabilitation resources as ABA.