1. NCCU Academic Hub
  2. 學術產出
  3. College of Science
  4. Theses
  5. Item

學術產出-Theses

Article View/Open

Publication Export

Google ScholarTM

政大圖書館

Citation Infomation

  • No doi shows Citation Infomation
題名 自閉症幼童的遠距家長訓練方案：兒童療效探討
Telehealth Parent-mediated Intervention for Young Children with Autism Spectrum Disorder: Children`s Outcome
作者 陳庭萱
Chen, Ting-Hsuan
貢獻者 姜忠信
陳庭萱
Chen, Ting-Hsuan
關鍵詞 自閉症類群障礙症
丹佛早療模式
讓家長成為孩子溝通訓練的老師
遠距醫療
由家長引導的介入
兒童療效
Autism spectrum disorder
Early Start Denver Model
Improving Parents As Communication Teachers
Telehealth
Parent-mediated intervention
Children`s outcome
日期 2023
上傳時間 6-Jul-2023 16:57:50 (UTC+8)
摘要 研究目的：本研究融合丹佛早療模式（ESDM）及讓家長成為孩子的溝通老師（ImPACT）方案，發展台灣本土自閉症類群障礙（Autism Spectrum Disorder, ASD）兒童之遠距家長訓練方案。本研究旨在探討自學網站及加入教練協助的兩種遠距家長訓練模式，針對ASD兒童之介入效果及介入後3個月的短期維持效果，並進一步探討家長學習成效與兒童療效間之關聯性。
研究方法：本研究採取隨機對照試驗（randomized controlled trial, RCT）設計，共納入28名生理年齡18-48個月大之ASD兒童及其家長，並隨機分為教練協助組及家長自助組（各14名）。介入期間共計13週，兩組家長需每週觀看本研究設計之線上課程，而教練協助組家長需額外接受每週一次、一次一小時的教練指導視訊會議。本研究於介入前（時間點一）、後（時間點二），針對兒童的社交溝通能力、適應行為及問題行為進行評估，並於時間點二後間隔三個月，再次進行時間點三評估作為追蹤。本研究原採取現場評估方式， 2021/5月後，受到台灣COVID-19疫情升溫之影響，因此將研究參與方式改為遠距形式，取消部分實驗室測量作業，並透過線上會議及問卷代替原先評估內容。
研究結果：研究結果顯示，（1）兩組受試兒童於介入後，主要在社交溝通能力有顯著正向的進展，由家長報告的社交溝通能力（社交參與、表達性語言、接受性語言及模仿/遊戲能力）、總詞彙量、平均句長，及親子互動中的溝通頻率、高層次共享式參與狀態比例，皆顯著提升。兩組受試兒童的外化行為亦明顯減少，但適應行為表現未有顯著變化。（2）追蹤時，兩組受試兒童能維持多數社交溝通之進展，但問題行為及適應行為表現相較介入前皆未有顯著變化。（3）相較於家長自助組，教練協助組家長於 ESDM介入真確度方面有更顯著之進展。然而，兩組兒童各項指標進展並未有顯著組間差異。若比較效果量及組內進展，教練協助組兒童於介入後的表達性語言、語言及非語言溝通頻率、非工具性溝通頻率，及高層次共享式參與狀態等指標之進展有優於家長自助組的趨勢。（4）整體而言，家長親子互動技巧改善幅度，與兒童表達性語言及高層次共享式參與狀態比例之進展間，相關性達顯著。
結論：研究結果初步指出遠距家長介入模式之有效性，無論是否加入額外的教練協助，皆能有效提升ASD兒童的社交溝通能力，且短期內可維持進展。本研究亦發現家長進展與兒童的表達性語言及社交互動參與進展之關聯性。未來宜持續累積更多樣本、納入一般社區介入組、加入更多客觀指標，並嘗試進一步釐清影響兒童及家長進展之各項因素。最終目標是發展兼具有效性及可及性之台灣本土遠距家長訓練方案。
Objectives: Based on the Early Start Denver Model (ESDM) and the Improving Parents As Communication Teachers (ImPACT) project, this study developed a telehealth-based parent-mediated intervention (PMI) for children with autism spectrum disorder (ASD) in Taiwan. This study aimed to examine the post-treatment and 3-month-follow-up effect of children’s outcomes between self-directed and coach-assisted group, and further explored the relationship between parents’ and children`s outcomes.
Methods: A randomized controlled trial (RCT) was conducted. A total of 28 parents and their children with ASD (aged between 18-48 months) were recruited and randomized into coach-assisted (N =14) and self-directed groups (N =14). We delivered the intervention for 13 weeks. Parents in both groups were asked to finish online courses weekly, while parents in the coach-assisted group also received an additional 1-hour coaching session through videoconference. Children outcome measures were administered pre­ (time 1) and post­intervention (time 2), comprising social communication skills, adaptive behaviors and problem behaviors. Follow-up (time 3) evaluation also conducted, 3 months after time 2 evaluation. On-site assessment was carried out at first. However, due to the impact of the COVID-19 epidemic, we changed to a remote form after May 2021, some laboratory measurements were canceled, and online meetings and questionnaires were used to replace the original assessments.
Results: The results indicated that: (1) Children in both groups significantly improved in social communication skills, including parent-reported social engagement, expressive language, receptive language, imitation/play skills, vocabulary production and mean length of utterances, as well as the frequency of communication and higher order joint engagement during parent-child interaction. They also significantly reduced externalizing problem behaviors but showed no significant change in the adaptive behaviors. (2) During the follow-up, children in both groups were able to maintain most of the progress of social communication skills but showed no significant change in problem behaviors and adaptive behaviors. (3) Coach-assisted group had greater gains in parent fidelity; however, children’s outcomes did not significantly differ by group. If the effect size and progress within the group were considered, there’s a trend towards greater gains for the coach-assisted group in children’s expressive language, and the frequency of verbal and non-verbal communication, non-instrumental communication and higher order joint engagement. (4) We found a significant relationship between degree of change in parental interaction skill and rate of children’s improvement on expressive language and higher order joint engagement.
Conclusions: The results preliminarily suggested a potential role for both self-directed and coach-assisted programs for improving social communication skills of children with ASD, and the progress can be maintained in a short term. We also found an association between parents’ progress and children`s progress in expressive language and social engagement. In future, a larger sample size, comparing to usual community treatment group, and adding other objective indicators are needed. Also, it’s important to further exploring the factors that may affect the progress of children and parents. The ultimate goal is to develop an effective and accessible localized telehealth-based PMI for parents in Taiwan.
參考文獻 林容蒂、吳進欽、姜忠信、周文君與侯育銘（2015）。自閉症類疾患兒童模仿表現與相關因素。中華心理學刊，57(1)，45-66。https://doi.org/10.6129/CJP.20140411a
吳進欽、朱慶琳、侯育銘、姚淑芬（2014）。克氏行為量表篩檢 4 歲以下自閉症類疾患兒童效度探究。中華心理衛生學刊，27(1)，131-161。https://doi.org/10.30074/FJMH.201403_27(1).0005
吳進欽、姜忠信、侯育銘（2005）。自閉症兒童的立即模仿與延遲模仿之研究。中華心理衛生學刊，18(2)，1-24。https://doi.org/10.30074/FJMH.200506_18(2).0001
柯慧貞、朱倍毅、陸偉明、高振傑、龔毅珊、邱郁雯、方曉喻、林木芬、胡崇元 （2008）。更新學齡前兒童行為發展量表的常模。測驗學刊，55(2)，313-340。https://doi.org/10.7108/PT.200808.0313
徐澄清、蘇喜、蕭淑貞、林家青、宋維村、張珏（1978）。學齡前兒童行爲發展量表之修訂及初步常模之建立。Acta Paediatrica Sinica，19(2)，142-157。
張正芬、陳心怡、邱春瑜（2020）。文蘭適應行為量表第3版（中文版）。中國行為科學社。
陳怡群、黃惠玲、趙家琛（2009）。阿肯巴克實證衡鑑系統。心理出版社。
陳孟筳、何淑賢、吳欣治、姜忠信（2020）。訓練家長成為自閉症兒童介入方案的執行者：從現場教學到遠距教學的回顧與前瞻。中華心理衛生學刊，33(3)，219-245。https://doi.org/10.30074/FJMH.202009_33(3).0001
劉惠美、曹峰銘（2010）。華語嬰幼兒溝通發展量表（台灣版）。心理出版社。
衛生福利部統計處（2022）。身心障礙者人數按年齡及類別分。https://dep.mohw.gov.tw/dos/cp-5224-62359-113.html
謝清芬、宋維村、徐澄清（1983）。自閉症: 克氏行為量表的效度研究。中華民國神經精神學會會刊，9(1)，17-27。
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596
Bellomo, T. R., Prasad, S., Munzer, T., & Laventhal, N. (2020). The impact of the COVID-19 pandemic on children with autism spectrum disorders. Journal of Pediatric Rehabilitation Medicine, 13(3), 349-354. https://doi.org/10.3233/PRM-200740
Bearss K., Johnson C., Smith T., Lecavalier L., Swiezy N., Aman M., McAdam D. B., Butter E., Stillitano C., Minshawi N., Sukhodolsky D. G., Mruzek D. W., Turner K., Neal T., Hallett V., Mulick J. A., Green B., Handen B., Deng Y., …, Scahill L. (2015). Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder: A randomized clinical trial. Jama, 313(15), 1524-1533. https://doi.org/10.1001/jama.2015.3150
Bottema-Beutel, K., Yoder, P. J., Hochman, J. M., & Watson, L. R. (2014). The role of supported joint engagement and parent utterances in language and social communication development in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 44, 2162-2174. https://doi.org/10.1007/s10803-014-2092-z
Breitenstein, S. M., Gross, D., & Christophersen, R. (2014). Digital delivery methods of parenting training interventions: a systematic review. Worldviews on Evidence‐Based Nursing, 11(3), 168-176. https://doi.org/10.1111/wvn.12040
Bruinsma, Y. E., Minjarez, M. B., Schreibman, L., & Stahmer, A. C. (2020). Naturalistic Developmental Behavioral Interventions for Autism Spectrum Disorder. ERIC.
Carr, E. G., & Kologinsky, E. (1983). Acquisition of sign language by autistic children II: Spontaneity and generalization effects. Journal of Applied Behavior Analysis, 16(3), 297-314. https://doi.org/10.1901/jaba.1983.16-297
Carta, J. J., Greenwood, C. R., Walker, D., & Buzhardt, J. (2010). Using IGDIs: Monitoring Progress and Improving Intervention for Infants and Young Children. Brookes Publishing Company.
Chaturvedi, S., & Shweta, R. (2015). Evaluation of inter-rater agreement and inter-rater reliability for observational data: an overview of concepts and methods. Journal of the Indian Academy of Applied Psychology, 41(3), 20-27.
Chiang, C.H., Chu, C.L., & Lee, T.C. (2016). Efficacy of caregiver-mediated joint engagement intervention for young children with autism spectrum disorders. Autism, 20(2), 172-182. https://doi.org/10.1177/1362361315575725
Chiang, C.H., Lin, T.L., Lin, H.Y., Ho, S.Y., Wong, C.C., & Wu, H.C. (2022). Short-term low-intensity Early Start Denver Model program implemented in regional hospitals in Northern Taiwan. Autism, 27(3), 778-787. https://doi.org/10.1177/13623613221117444
Clark, M. L. E., Vinen, Z., Barbaro, J., & Dissanayake, C. (2018). School age outcomes of children diagnosed early and later with autism spectrum disorder. Journal of Autism and Developmental Disorders, 48(1), 92-102. https://doi.org/10.1007/s10803-017-3279-x
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Routledge. https://doi.org/10.4324/9780203771587
Council, N. R. (2001). Educating children with autism. National Academies Press.
Crank, J. E., Sandbank, M., Dunham, K., Crowley, S., Bottema‐Beutel, K., Feldman, J., & Woynaroski, T. G. (2021). Understanding the effects of naturalistic developmental behavioral interventions: a project AIM meta‐analysis. Autism Research, 14(4), 817-834. https://doi.org/10.1002/aur.2471
Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., Donaldson, A., & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23. https://doi.org/10.1542/peds.2009-0958
de Nocker, Y. L., & Toolan, C. K. (2021). Using telehealth to provide interventions for children with ASD: A systematic review. Review Journal of Autism and Developmental Disorders, 1-31. https://doi.org/10.1007/s40489-021-00278-3
Farmer, C., Adedipe, D., Bal, V., Chlebowski, C., & Thurm, A. (2020). Concordance of the Vineland Adaptive Behavior Scales, second and third editions. Journal of Intellectual Disability Research, 64(1), 18-26. https://doi.org/10.1111/jir.12691
Fenske, E. C., Zalenski, S., Krantz, P. J., & McClannahan, L. E. (1985). Age at intervention and treatment outcome for autistic children in a comprehensive intervention program. Analysis and Intervention in Developmental Disabilities, 5(1-2), 49-58. https://doi.org/10.1016/S0270-4684(85)80005-7
Fenson, L., Dale, P., Reznick, J., Thal, D., Bates, E., Hartung, J., & Reilly, J. (1993). The MacArthur communicative development inventory: Words and sentences. San Diego, CA: Singular.
Frazier, T. W., Klingemier, E. W., Anderson, C. J., Gengoux, G. W., Youngstrom, E. A., & Hardan, A. Y. (2021). A longitudinal study of language trajectories and treatment outcomes of early intensive behavioral intervention for autism. Journal of Autism and Developmental Disorders, 51(12), 4534-4550. https://doi.org/10.1007/s10803-021-04900-5
Gengoux, G. W., Berquist, K. L., Salzman, E., Schapp, S., Phillips, J. M., Frazier, T. W., Minjarez, M. B., & Hardan, A. Y. (2015). Pivotal response treatment parent training for autism: Findings from a 3-month follow-up evaluation. Journal of Autism and Developmental Disorders, 45, 2889-2898. https://doi.org/10.1007/s10803-015-2452-3
Green, V. A., Pituch, K. A., Itchon, J., Choi, A., O’Reilly, M., & Sigafoos, J. (2006). Internet survey of treatments used by parents of children with autism. Research in Developmental Disabilities, 27(1), 70-84. https://doi.org/10.1016/j.ridd.2004.12.002
Greenspan, S., & Wieder, S. (2008). DIR®/Floortime™ Model. The International Council on Developmental and Learning Disorders.
Greenwood, C. R., Walker, D., & Buzhardt, J. (2010). The early communication indicator for infants and toddlers: Early Head Start growth norms from two states. Journal of Early Intervention, 32(5), 310-334. https://doi.org/10.1177/1053815110392335
Guthrie, W., Swineford, L. B., Nottke, C., & Wetherby, A. M. (2013). Early diagnosis of autism spectrum disorder: stability and change in clinical diagnosis and symptom presentation. Journal of Child Psychology and Psychiatry, 54(5), 582-590. https://doi.org/10.1111/jcpp.12008
Hardan, A. Y., Gengoux, G. W., Berquist, K. L., Libove, R. A., Ardel, C. M., Phillips, J., Frazier, T. W., & Minjarez, M. B. (2015). A randomized controlled trial of Pivotal Response Treatment Group for parents of children with autism. Journal of Child Psychology and Psychiatry, 56(8), 884-892.
https://doi.org/10.1111/jcpp.12354
Ingersoll, B. (2010). Brief report: Pilot randomized controlled trial of reciprocal imitation training for teaching elicited and spontaneous imitation to children with autism. Journal of Autism and Developmental Disorders, 40(9), 1154-1160. https://doi.org/10.1007/s10803-010-0966-2
Ingersoll, B., & Dvortcsak, A. (2009). Teaching social communication to children with autism: A practitioner`s guide to parent training and a manual for parents. Guilford Press.
Ingersoll, B., & Dvortcsak, A. (2010). Teaching social communication: A practitioner’s guide to parent training for children with autism. New York: Guilford Press.
Ingersoll, B., & Dvortcsak, A. (2020a)。教導自閉症幼兒社會溝通能力：家長手冊
（第二版）（姜忠信、陳孟筳、倪子洛、陳思臻、蔡曉薇譯）。洪葉文化。（原著出版於2019年）
Ingersoll, B., & Dvortcsak, A. (2020b)。教導自閉症幼兒社會溝通能力（第二
版）：教練手冊（姜忠信、陳孟筳、倪子洛、江淑蓉、陳思臻、蔡曉薇、
呂幸芳譯）。洪葉文化。（原著出版於2019年）
Ingersoll, B., & Schreibman, L. (2006). Teaching reciprocal imitation skills to young children with autism using a naturalistic behavioral approach: Effects on language, pretend play, and joint attention. Journal of Autism and Developmental Disorders, 36(4), 487. https://doi.org/10.1007/s10803-006-0089-y
Ingersoll, B., Shannon, K., Berger, N., Pickard, K., & Holtz, B. (2017). Self-directed telehealth parent-mediated intervention for children with autism spectrum disorder: Examination of the potential reach and utilization in community settings. Journal of Medical Internet Research, 19(7), e248.
Ingersoll, B., & Wainer, A. (2013). Initial efficacy of Project ImPACT: A parent-mediated social communication intervention for young children with ASD. Journal of Autism and Developmental Disorders, 43(12), 2943-2952. https://doi.org/10.1007/s10803-013-1840-9
Ingersoll, B., Wainer, A. L., Berger, N. I., Pickard, K. E., & Bonter, N. (2016). Comparison of a self-directed and therapist-assisted telehealth parent-mediated intervention for children with ASD: A pilot RCT. Journal of Autism and Developmental Disorders, 46(7), 2275-2284. https://doi.org/10.1007/s10803-016-2755-z
Kanne, S. M., Mazurek, M. O., Sikora, D., Bellando, J., Branum-Martin, L., Handen, B., Katz, T., Freedman, B., Powell, M. P., & Warren, Z. (2014). The Autism Impact Measure (AIM): initial development of a new tool for treatment outcome measurement. Journal of Autism and Developmental Disorders, 44(1), 168-179. https://doi.org/10.1007/s10803-013-1862-3
Kasari, C., Freeman, S., & Paparella, T. (2006). Joint attention and symbolic play in young children with autism: A randomized controlled intervention study. Journal of Child Psychology and Psychiatry, 47(6), 611-620. https://doi.org/10.1111/j.1469-7610.2005.01567.x
Koegel, R. L., Bimbela, A., & Schreibman, L. (1996). Collateral effects of parent training on family interactions. Journal of Autism and Developmental Disorders, 26(3), 347-359. https://doi.org/10.1007/BF02172479
Koegel, R. L., Koegel, L. K., & Carter, C. M. (1999). Pivotal teaching interactions for children with autism. School Psychology Review, 28(4), 576-594. https://doi.org/10.1080/02796015.1999.12085986
Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 159-174. https://doi.org/10.2307/2529310
Liljequist, D., Elfving, B., & Skavberg Roaldsen, K. (2019). Intraclass correlation–A discussion and demonstration of basic features. PloS one, 14(7), e0219854. https://doi.org/10.1371/journal.pone.0219854
Lin, T.-L., Chiang, C.-H., Ho, S. Y., Wu, H.-C., & Wong, C.-C. (2020). Preliminary clinical outcomes of a short-term low-intensity Early Start Denver Model implemented in the Taiwanese public health system. Autism, 24(5), 1300-1306. https://doi.org/10.1177/1362361319897179
Lindgren, S., Wacker, D., Suess, A., Schieltz, K., Pelzel, K., Kopelman, T., Lee, J., Romani, P., & Waldron, D. (2016). Telehealth and autism: Treating challenging behavior at lower cost. Pediatrics, 137(Supplement 2), S167-S175. https://doi.org/10.1542/peds.2015-2851O
Liu, Q., Hsieh, W.-Y., & Chen, G. (2020). A systematic review and meta-analysis of parent-mediated intervention for children and adolescents with autism spectrum disorder in mainland China, Hong Kong, and Taiwan. Autism, 24(8), 1960-1979. https://doi.org/10.1177/1362361320943380
Lord, C., Rutter, M., DiLavore, P., & Risi, S. (2002). Autism diagnostic observation (ADOS) manual. Los Angeles: Western Psychological Services.
Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3. https://doi.org/10.1037//0022-006x.55.1.3
Maenner, M. J., Warren, Z., Williams, A. R., Amoakohene, E., Bakian, A. V., Bilder, D. A., Durkin M. S., Fitzgerald R. T., Furnier S. M., Hughes M. M., Ladd-Acosta C. M., McArthur D., Pas E. T., Salinas A., Vehorn A., Williams S., Esler A., Grzybowski A., Hall-Lande J., ... & Shaw, K. A. (2023). Prevalence and characteristics of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2020. MMWR Surveillance Summaries, 72(2), 1. http://doi.org/10.15585/mmwr.ss7202a1
Magiati, I., Tay, X. W., & Howlin, P. (2014). Cognitive, language, social and behavioural outcomes in adults with autism spectrum disorders: A systematic review of longitudinal follow-up studies in adulthood. Clinical Psychology Review, 34(1), 73-86. https://doi.org/10.1016/j.cpr.2013.11.002
McEachin, J. J., Smith, T., & Ivar Lovaas, O. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. American Journal of Mental Retardation, 97(4), 359-359. https://www.ncbi.nlm.nih.gov/pubmed/8427693
McGarry, E., Vernon, T., & Baktha, A. (2020). Brief report: A pilot online pivotal response treatment training program for parents of toddlers with autism spectrum disorder. Journal of Autism and Developmental Disorders, 50, 3424-3431. https://doi.org/10.1007/s10803-019-04100-2
McGee, G. G., Krantz, P. J., Mason, D., & McClannahan, L. E. (1983). A modified incidental‐teaching procedure for autistic youth: Acquisition and generalization of receptive object labels. Journal of Applied Behavior Analysis, 16(3), 329-338. https://doi.org/10.1901/jaba.1983.16-329
Meadan, H., Ostrosky, M. M., Zaghlawan, H. Y., & Yu, S. (2009). Promoting the social and communicative behavior of young children with autism spectrum disorders: A review of parent-implemented intervention studies. Topics in Early Childhood Special Education, 29(2), 90-104. https://doi.org/10.1177/0271121409337950
Mercer, J. (2017). Examining DIR/Floortime™ as a treatment for children with autism spectrum disorders: A review of research and theory. Research on Social Work Practice, 27(5), 625-635. https://doi.org/10.1177/1049731515583062
Mullen, E. M. (1995). Mullen scales of early learning. AGS Circle Pines, MN.
Nevill, R. E., Lecavalier, L., & Stratis, E. A. (2018). Meta-analysis of parent-mediated interventions for young children with autism spectrum disorder. Autism, 22(2), 84-98. https://doi.org/10.1177/1362361316677838
Parsons, D., Cordier, R., Vaz, S., & Lee, H. C. (2017). Parent-mediated intervention training delivered remotely for children with autism spectrum disorder living outside of urban areas: Systematic review. Journal of Medical Internet Research, 19(8), e198. https://doi.org/10.2196/jmir.6651
Prizant, B. M., Wetherby, A. M., Rubin, E., & Laurent, A. C. (2003). The SCERTS model: A transactional, family-centered approach to enhancing communication and socioemotional abilities of children with autism spectrum disorder. Infants & Young Children, 16(4), 296-316.
Reese, R. M., Jamison, R., Wendland, M., Fleming, K., Braun, M. J., Schuttler, J. O., & Turek, J. (2013). Evaluating interactive videoconferencing for assessing symptoms of autism. Telemedicine and e-Health, 19(9), 671-677. https://doi.org/10.1089/tmj.2012.0312
Risi, S., Lord, C., Gotham, K., Corsello, C., Chrysler, C., Szatmari, P., Cook E. H., Leventhal B. L., & Pickles, A. (2006). Combining information from multiple sources in the diagnosis of autism spectrum disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 45(9), 1094-1103. https://doi.org/10.1097/01.chi.0000227880.42780.0e
Rogers, S., Dawson, G., Zierhut, C., Winter, J., McCormick, C., & Holly, E. (2013). The PATH curriculum checklist for young children with autism. unpublished document.
Rogers, S. J., & Dawson, G. (2010). Early Start Denver Model for young children with autism. New York, NY: Guilford.
Rogers, S. J., & Dawson, G. (2014) 。丹佛早療模式：促進自閉症兒童的語言、學
習及參與能力（姜忠信、劉瓊瑛及朱思穎譯）。洪葉文化。（原著出版於
2010年）
Rogers, S. J., Dawson, G., & Vismara, L. A. (2016) 。穩步‧慢行：自閉症孩子的生活、溝通、學習（張美惠、姜忠信譯）。洪葉文化。（原著出版於2012年）
Rogers, S. J., Estes, A., Lord, C., Munson, J., Rocha, M., Winter, J., Greenson, J., Colombi, C., Dawson, G., & Vismara, L. A. (2019). A multisite randomized controlled two-phase trial of the Early Start Denver Model compared to treatment as usual. Journal of the American Academy of Child & Adolescent Psychiatry, 58(9), 853-865. https://doi.org/10.1016/j.jaac.2019.01.004
Rogers, S. J., Estes, A., Lord, C., Vismara, L., Winter, J., Fitzpatrick, A., Guo, M., & Dawson, G. (2012). Effects of a brief Early Start Denver Model (ESDM)–based parent intervention on toddlers at risk for autism spectrum disorders: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 51(10), 1052-1065. https://doi.org/10.1016/j.jaac.2012.08.003
Rogers, S. J., Estes, A., Vismara, L., Munson, J., Zierhut, C., Greenson, J., Dawson, G., Rocha, M., Sugar, C., & Senturk, D. (2019). Enhancing low-intensity coaching in parent implemented Early Start Denver Model intervention for early autism: A randomized comparison treatment trial. Journal of Autism and Developmental Disorders, 49(2), 632-646. https://doi.org/10.1007/s10803-018-3740-5
Rogers, S. J., Hepburn, S. L., Stackhouse, T., & Wehner, E. (2003). Imitation performance in toddlers with autism and those with other developmental disorders. Journal of Child Psychology and Psychiatry, 44(5), 763-781. https://doi.org/10.1111/1469-7610.00162
Rogers, S. J., Herbison, J. M., Lewis, H. C., Pantone, J., & Reis, K. (1986). An approach for enhancing the symbolic, communicative, and interpersonal functioning of young children with autism or severe emotional handicaps. Journal of the Division for Early Childhood, 10(2), 135-148. https://doi.org/10.1177/105381518601000205
Rogers, S. J., & Pennington, B. F. (1991). A theoretical approach to the deficits in infantile autism. Development and Psychopathology, 3(2), 137-162. https://doi.org/10.1017/S0954579400000043
Rogers, S. J., Vismara, L. A., & Dawson, G. (2021). Coaching parents of young children with autism: Promoting connection, communication, and learning. Guilford Publications.
Rooks-Ellis, D., Howorth, S. K., Kunze, M., Boulette, S., & Sulinski, E. (2020). Effects of a parent training using telehealth: Equity and access to early intervention for rural families. Journal of Childhood, Education & Society, 1(2), 141-166. https://doi.org/10.37291/2717638X.20201242
Rutter, M., Le Couteur, A., & Lord, C. (2003). Autism diagnostic interview-revised. Los Angeles, CA: Western Psychological Services, 29(2003), 30.
Sandbank, M., Bottema-Beutel, K., Crowley, S., Cassidy, M., Dunham, K., Feldman, J. I., Crank, J., Albarran, S. A., Raj, S., & Mahbub, P. (2020). Project AIM: Autism intervention meta-analysis for studies of young children. Psychological Bulletin, 146(1), 1. https://doi.org/10.1037/bul0000215
Schopler, E., Mesibov, G. B., & Hearsey, K. (1995). Structured teaching in the TEACCH system. In Learning and cognition in autism (pp. 243-268). Springer. https://doi.org/10.1007/978-1-4899-1286-2_13
Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., Kasari, C., Ingersoll, B., Kaiser, A. P., & Bruinsma, Y. (2015). Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(8), 2411-2428. https://doi.org/10.1007/s10803-015-2407-8
Shalev, R. A., Lavine, C., & Di Martino, A. (2020). A systematic review of the role of parent characteristics in parent-mediated interventions for children with autism spectrum disorder. Journal of Developmental and Physical Disabilities, 32, 1-21. https://doi.org/10.1007/s10882-018-9641-x
Simacek, J., Elmquist, M., Dimian, A. F., & Reichle, J. (2021). Current trends in telehealth applications to deliver social communication interventions for young children with or at risk for autism spectrum disorder. Current Developmental Disorders Reports, 8, 15-23. https://doi.org/10.1007/s40474-020-00214-w
Sparrow, S. S., Balla, D. A., & Cicchetti, D. V. (2005). Vineland-II adaptive behavior scales. AGS Publishing.
Stahmer, A. C., Rieth, S. R., Dickson, K. S., Feder, J., Burgeson, M., Searcy, K., & Brookman-Frazee, L. (2020). Project ImPACT for toddlers: pilot outcomes of a community adaptation of an intervention for autism risk. Autism, 24(3), 617-632. https://doi.org/10.1177/1362361319878080
Stone, W. L., Ousley, O. Y., & Littleford, C. D. (1997). Motor imitation in young children with autism: What`s the object? Journal of Abnormal Child Psychology, 25(6), 475-485. https://doi.org/10.1023/a:1022685731726
Symon, J. B. (2005). Expanding interventions for children with autism: Parents as trainers. Journal of Positive Behavior Interventions, 7(3), 159-173. https://doi.org/10.1177/10983007050070030501
Tamm, L., Day, H. A., & Duncan, A. (2022). Comparison of adaptive functioning measures in adolescents with autism spectrum disorder without intellectual disability. Journal of Autism and Developmental Disorders, 52(3), 1247-1256. https://doi.org/10.1007/s10803-021-05013-9
Virues-Ortega, J., Julio, F. M., & Pastor-Barriuso, R. (2013). The TEACCH program for children and adults with autism: A meta-analysis of intervention studies. Clinical Psychology Review, 33(8), 940-953. https://doi.org/10.1016/j.cpr.2013.07.005
Vismara, L. A., McCormick, C., Young, G. S., Nadhan, A., & Monlux, K. (2013). Preliminary findings of a telehealth approach to parent training in autism. Journal of Autism and Developmental Disorders, 43(12), 2953-2969. https://doi.org/10.1007/s10803-013-1841-8
Vismara, L. A., McCormick, C. E., Wagner, A. L., Monlux, K., Nadhan, A., & Young, G. S. (2018). Telehealth parent training in the Early Start Denver Model: Results from a randomized controlled study. Focus on Autism and Other Developmental Disabilities, 33(2), 67-79. https://doi.org/10.1177/1088357616651064
Vygotsky, L. S. (1978). Socio-cultural theory. Mind in society, 52-58.
Wainer, A. L., Berger, N. I., & Ingersoll, B. R. (2017). Brief report: The preliminary psychometric properties of the Social Communication Checklist. Journal of Autism and Developmental Disorders, 47(4), 1231-1238. https://doi.org/10.1007/s10803-016-3026-8
Waizbard‐Bartov, E., Ferrer, E., Heath, B., Rogers, S. J., Nordahl, C. W., Solomon, M., & Amaral, D. G. (2022). Identifying autism symptom severity trajectories across childhood. Autism Research, 15(4), 687-701. https://doi.org/10.1002/aur.2674
Zhou, B., Xu, Q., Li, H., Zhang, Y., Wang, Y., Rogers, S. J., & Xu, X. (2018). Effects of parent‐implemented Early Start Denver Model intervention on Chinese Toddlers with autism spectrum disorder: A non‐randomized controlled trial. Autism Research, 11(4), 654-666. https://doi.org/10.1002/aur.1917
描述 碩士
國立政治大學
心理學系
108752005
資料來源 http://thesis.lib.nccu.edu.tw/record/#G0108752005
資料類型 thesis
dc.contributor.advisor 姜忠信zh_TW
dc.contributor.author (Authors) 陳庭萱zh_TW
dc.contributor.author (Authors) Chen, Ting-Hsuanen_US
dc.creator (作者) 陳庭萱zh_TW
dc.creator (作者) Chen, Ting-Hsuanen_US
dc.date (日期) 2023en_US
dc.date.accessioned 6-Jul-2023 16:57:50 (UTC+8)-
dc.date.available 6-Jul-2023 16:57:50 (UTC+8)-
dc.date.issued (上傳時間) 6-Jul-2023 16:57:50 (UTC+8)-
dc.identifier (Other Identifiers) G0108752005en_US
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/145910-
dc.description (描述) 碩士zh_TW
dc.description (描述) 國立政治大學zh_TW
dc.description (描述) 心理學系zh_TW
dc.description (描述) 108752005zh_TW
dc.description.abstract (摘要) 研究目的：本研究融合丹佛早療模式（ESDM）及讓家長成為孩子的溝通老師（ImPACT）方案，發展台灣本土自閉症類群障礙（Autism Spectrum Disorder, ASD）兒童之遠距家長訓練方案。本研究旨在探討自學網站及加入教練協助的兩種遠距家長訓練模式，針對ASD兒童之介入效果及介入後3個月的短期維持效果，並進一步探討家長學習成效與兒童療效間之關聯性。
研究方法：本研究採取隨機對照試驗（randomized controlled trial, RCT）設計，共納入28名生理年齡18-48個月大之ASD兒童及其家長，並隨機分為教練協助組及家長自助組（各14名）。介入期間共計13週，兩組家長需每週觀看本研究設計之線上課程，而教練協助組家長需額外接受每週一次、一次一小時的教練指導視訊會議。本研究於介入前（時間點一）、後（時間點二），針對兒童的社交溝通能力、適應行為及問題行為進行評估，並於時間點二後間隔三個月，再次進行時間點三評估作為追蹤。本研究原採取現場評估方式， 2021/5月後，受到台灣COVID-19疫情升溫之影響，因此將研究參與方式改為遠距形式，取消部分實驗室測量作業，並透過線上會議及問卷代替原先評估內容。
研究結果：研究結果顯示，（1）兩組受試兒童於介入後，主要在社交溝通能力有顯著正向的進展，由家長報告的社交溝通能力（社交參與、表達性語言、接受性語言及模仿/遊戲能力）、總詞彙量、平均句長，及親子互動中的溝通頻率、高層次共享式參與狀態比例，皆顯著提升。兩組受試兒童的外化行為亦明顯減少，但適應行為表現未有顯著變化。（2）追蹤時，兩組受試兒童能維持多數社交溝通之進展，但問題行為及適應行為表現相較介入前皆未有顯著變化。（3）相較於家長自助組，教練協助組家長於 ESDM介入真確度方面有更顯著之進展。然而，兩組兒童各項指標進展並未有顯著組間差異。若比較效果量及組內進展，教練協助組兒童於介入後的表達性語言、語言及非語言溝通頻率、非工具性溝通頻率，及高層次共享式參與狀態等指標之進展有優於家長自助組的趨勢。（4）整體而言，家長親子互動技巧改善幅度，與兒童表達性語言及高層次共享式參與狀態比例之進展間，相關性達顯著。
結論：研究結果初步指出遠距家長介入模式之有效性，無論是否加入額外的教練協助，皆能有效提升ASD兒童的社交溝通能力，且短期內可維持進展。本研究亦發現家長進展與兒童的表達性語言及社交互動參與進展之關聯性。未來宜持續累積更多樣本、納入一般社區介入組、加入更多客觀指標，並嘗試進一步釐清影響兒童及家長進展之各項因素。最終目標是發展兼具有效性及可及性之台灣本土遠距家長訓練方案。		zh_TW
dc.description.abstract (摘要) Objectives: Based on the Early Start Denver Model (ESDM) and the Improving Parents As Communication Teachers (ImPACT) project, this study developed a telehealth-based parent-mediated intervention (PMI) for children with autism spectrum disorder (ASD) in Taiwan. This study aimed to examine the post-treatment and 3-month-follow-up effect of children’s outcomes between self-directed and coach-assisted group, and further explored the relationship between parents’ and children`s outcomes.
Methods: A randomized controlled trial (RCT) was conducted. A total of 28 parents and their children with ASD (aged between 18-48 months) were recruited and randomized into coach-assisted (N =14) and self-directed groups (N =14). We delivered the intervention for 13 weeks. Parents in both groups were asked to finish online courses weekly, while parents in the coach-assisted group also received an additional 1-hour coaching session through videoconference. Children outcome measures were administered pre­ (time 1) and post­intervention (time 2), comprising social communication skills, adaptive behaviors and problem behaviors. Follow-up (time 3) evaluation also conducted, 3 months after time 2 evaluation. On-site assessment was carried out at first. However, due to the impact of the COVID-19 epidemic, we changed to a remote form after May 2021, some laboratory measurements were canceled, and online meetings and questionnaires were used to replace the original assessments.
Results: The results indicated that: (1) Children in both groups significantly improved in social communication skills, including parent-reported social engagement, expressive language, receptive language, imitation/play skills, vocabulary production and mean length of utterances, as well as the frequency of communication and higher order joint engagement during parent-child interaction. They also significantly reduced externalizing problem behaviors but showed no significant change in the adaptive behaviors. (2) During the follow-up, children in both groups were able to maintain most of the progress of social communication skills but showed no significant change in problem behaviors and adaptive behaviors. (3) Coach-assisted group had greater gains in parent fidelity; however, children’s outcomes did not significantly differ by group. If the effect size and progress within the group were considered, there’s a trend towards greater gains for the coach-assisted group in children’s expressive language, and the frequency of verbal and non-verbal communication, non-instrumental communication and higher order joint engagement. (4) We found a significant relationship between degree of change in parental interaction skill and rate of children’s improvement on expressive language and higher order joint engagement.
Conclusions: The results preliminarily suggested a potential role for both self-directed and coach-assisted programs for improving social communication skills of children with ASD, and the progress can be maintained in a short term. We also found an association between parents’ progress and children`s progress in expressive language and social engagement. In future, a larger sample size, comparing to usual community treatment group, and adding other objective indicators are needed. Also, it’s important to further exploring the factors that may affect the progress of children and parents. The ultimate goal is to develop an effective and accessible localized telehealth-based PMI for parents in Taiwan.		en_US
dc.description.tableofcontents 謝誌 i
摘要 iii
Abstract v
目次 vii
表次 ix
圖次 x
第一章 緒論 1
第一節 研究背景及目的 1
第二節 文獻回顧 4
第三節 研究問題與假設 23
第二章 研究方法 26
第一節 研究流程及研究對象 26
第二節 線上課程及視訊會議設計 30
第三節 研究測量 34
第四節 資料分析 52
第三章 研究結果 53
第一節 基本資料概述及樣本流失分析 53
第二節 教練協助組及家長自助組之兒童療效比較 59
第三節 家長介入真確度進展與兒童介入效果關聯性分析 80
第四章 結論與討論 83
第一節 遠距家長訓練方案之兒童療效及維持效果 83
第二節 加入教練協助的額外效果 86
第三節 家長進展與兒童療效之關聯性 90
第四節 結論與建議 92
參考文獻 95
附錄一 溝通表現評分定義（Carta et al., 2010） 108		zh_TW
dc.format.extent 4188436 bytes-
dc.format.mimetype application/pdf-
dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0108752005en_US
dc.subject (關鍵詞) 自閉症類群障礙症zh_TW
dc.subject (關鍵詞) 丹佛早療模式zh_TW
dc.subject (關鍵詞) 讓家長成為孩子溝通訓練的老師zh_TW
dc.subject (關鍵詞) 遠距醫療zh_TW
dc.subject (關鍵詞) 由家長引導的介入zh_TW
dc.subject (關鍵詞) 兒童療效zh_TW
dc.subject (關鍵詞) Autism spectrum disorderen_US
dc.subject (關鍵詞) Early Start Denver Modelen_US
dc.subject (關鍵詞) Improving Parents As Communication Teachersen_US
dc.subject (關鍵詞) Telehealthen_US
dc.subject (關鍵詞) Parent-mediated interventionen_US
dc.subject (關鍵詞) Children`s outcomeen_US
dc.title (題名) 自閉症幼童的遠距家長訓練方案：兒童療效探討zh_TW
dc.title (題名) Telehealth Parent-mediated Intervention for Young Children with Autism Spectrum Disorder: Children`s Outcomeen_US
dc.type (資料類型) thesisen_US
dc.relation.reference (參考文獻) 林容蒂、吳進欽、姜忠信、周文君與侯育銘（2015）。自閉症類疾患兒童模仿表現與相關因素。中華心理學刊，57(1)，45-66。https://doi.org/10.6129/CJP.20140411a
吳進欽、朱慶琳、侯育銘、姚淑芬（2014）。克氏行為量表篩檢 4 歲以下自閉症類疾患兒童效度探究。中華心理衛生學刊，27(1)，131-161。https://doi.org/10.30074/FJMH.201403_27(1).0005
吳進欽、姜忠信、侯育銘（2005）。自閉症兒童的立即模仿與延遲模仿之研究。中華心理衛生學刊，18(2)，1-24。https://doi.org/10.30074/FJMH.200506_18(2).0001
柯慧貞、朱倍毅、陸偉明、高振傑、龔毅珊、邱郁雯、方曉喻、林木芬、胡崇元 （2008）。更新學齡前兒童行為發展量表的常模。測驗學刊，55(2)，313-340。https://doi.org/10.7108/PT.200808.0313
徐澄清、蘇喜、蕭淑貞、林家青、宋維村、張珏（1978）。學齡前兒童行爲發展量表之修訂及初步常模之建立。Acta Paediatrica Sinica，19(2)，142-157。
張正芬、陳心怡、邱春瑜（2020）。文蘭適應行為量表第3版（中文版）。中國行為科學社。
陳怡群、黃惠玲、趙家琛（2009）。阿肯巴克實證衡鑑系統。心理出版社。
陳孟筳、何淑賢、吳欣治、姜忠信（2020）。訓練家長成為自閉症兒童介入方案的執行者：從現場教學到遠距教學的回顧與前瞻。中華心理衛生學刊，33(3)，219-245。https://doi.org/10.30074/FJMH.202009_33(3).0001
劉惠美、曹峰銘（2010）。華語嬰幼兒溝通發展量表（台灣版）。心理出版社。
衛生福利部統計處（2022）。身心障礙者人數按年齡及類別分。https://dep.mohw.gov.tw/dos/cp-5224-62359-113.html
謝清芬、宋維村、徐澄清（1983）。自閉症: 克氏行為量表的效度研究。中華民國神經精神學會會刊，9(1)，17-27。
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596
Bellomo, T. R., Prasad, S., Munzer, T., & Laventhal, N. (2020). The impact of the COVID-19 pandemic on children with autism spectrum disorders. Journal of Pediatric Rehabilitation Medicine, 13(3), 349-354. https://doi.org/10.3233/PRM-200740
Bearss K., Johnson C., Smith T., Lecavalier L., Swiezy N., Aman M., McAdam D. B., Butter E., Stillitano C., Minshawi N., Sukhodolsky D. G., Mruzek D. W., Turner K., Neal T., Hallett V., Mulick J. A., Green B., Handen B., Deng Y., …, Scahill L. (2015). Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder: A randomized clinical trial. Jama, 313(15), 1524-1533. https://doi.org/10.1001/jama.2015.3150
Bottema-Beutel, K., Yoder, P. J., Hochman, J. M., & Watson, L. R. (2014). The role of supported joint engagement and parent utterances in language and social communication development in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 44, 2162-2174. https://doi.org/10.1007/s10803-014-2092-z
Breitenstein, S. M., Gross, D., & Christophersen, R. (2014). Digital delivery methods of parenting training interventions: a systematic review. Worldviews on Evidence‐Based Nursing, 11(3), 168-176. https://doi.org/10.1111/wvn.12040
Bruinsma, Y. E., Minjarez, M. B., Schreibman, L., & Stahmer, A. C. (2020). Naturalistic Developmental Behavioral Interventions for Autism Spectrum Disorder. ERIC.
Carr, E. G., & Kologinsky, E. (1983). Acquisition of sign language by autistic children II: Spontaneity and generalization effects. Journal of Applied Behavior Analysis, 16(3), 297-314. https://doi.org/10.1901/jaba.1983.16-297
Carta, J. J., Greenwood, C. R., Walker, D., & Buzhardt, J. (2010). Using IGDIs: Monitoring Progress and Improving Intervention for Infants and Young Children. Brookes Publishing Company.
Chaturvedi, S., & Shweta, R. (2015). Evaluation of inter-rater agreement and inter-rater reliability for observational data: an overview of concepts and methods. Journal of the Indian Academy of Applied Psychology, 41(3), 20-27.
Chiang, C.H., Chu, C.L., & Lee, T.C. (2016). Efficacy of caregiver-mediated joint engagement intervention for young children with autism spectrum disorders. Autism, 20(2), 172-182. https://doi.org/10.1177/1362361315575725
Chiang, C.H., Lin, T.L., Lin, H.Y., Ho, S.Y., Wong, C.C., & Wu, H.C. (2022). Short-term low-intensity Early Start Denver Model program implemented in regional hospitals in Northern Taiwan. Autism, 27(3), 778-787. https://doi.org/10.1177/13623613221117444
Clark, M. L. E., Vinen, Z., Barbaro, J., & Dissanayake, C. (2018). School age outcomes of children diagnosed early and later with autism spectrum disorder. Journal of Autism and Developmental Disorders, 48(1), 92-102. https://doi.org/10.1007/s10803-017-3279-x
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Routledge. https://doi.org/10.4324/9780203771587
Council, N. R. (2001). Educating children with autism. National Academies Press.
Crank, J. E., Sandbank, M., Dunham, K., Crowley, S., Bottema‐Beutel, K., Feldman, J., & Woynaroski, T. G. (2021). Understanding the effects of naturalistic developmental behavioral interventions: a project AIM meta‐analysis. Autism Research, 14(4), 817-834. https://doi.org/10.1002/aur.2471
Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., Donaldson, A., & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23. https://doi.org/10.1542/peds.2009-0958
de Nocker, Y. L., & Toolan, C. K. (2021). Using telehealth to provide interventions for children with ASD: A systematic review. Review Journal of Autism and Developmental Disorders, 1-31. https://doi.org/10.1007/s40489-021-00278-3
Farmer, C., Adedipe, D., Bal, V., Chlebowski, C., & Thurm, A. (2020). Concordance of the Vineland Adaptive Behavior Scales, second and third editions. Journal of Intellectual Disability Research, 64(1), 18-26. https://doi.org/10.1111/jir.12691
Fenske, E. C., Zalenski, S., Krantz, P. J., & McClannahan, L. E. (1985). Age at intervention and treatment outcome for autistic children in a comprehensive intervention program. Analysis and Intervention in Developmental Disabilities, 5(1-2), 49-58. https://doi.org/10.1016/S0270-4684(85)80005-7
Fenson, L., Dale, P., Reznick, J., Thal, D., Bates, E., Hartung, J., & Reilly, J. (1993). The MacArthur communicative development inventory: Words and sentences. San Diego, CA: Singular.
Frazier, T. W., Klingemier, E. W., Anderson, C. J., Gengoux, G. W., Youngstrom, E. A., & Hardan, A. Y. (2021). A longitudinal study of language trajectories and treatment outcomes of early intensive behavioral intervention for autism. Journal of Autism and Developmental Disorders, 51(12), 4534-4550. https://doi.org/10.1007/s10803-021-04900-5
Gengoux, G. W., Berquist, K. L., Salzman, E., Schapp, S., Phillips, J. M., Frazier, T. W., Minjarez, M. B., & Hardan, A. Y. (2015). Pivotal response treatment parent training for autism: Findings from a 3-month follow-up evaluation. Journal of Autism and Developmental Disorders, 45, 2889-2898. https://doi.org/10.1007/s10803-015-2452-3
Green, V. A., Pituch, K. A., Itchon, J., Choi, A., O’Reilly, M., & Sigafoos, J. (2006). Internet survey of treatments used by parents of children with autism. Research in Developmental Disabilities, 27(1), 70-84. https://doi.org/10.1016/j.ridd.2004.12.002
Greenspan, S., & Wieder, S. (2008). DIR®/Floortime™ Model. The International Council on Developmental and Learning Disorders.
Greenwood, C. R., Walker, D., & Buzhardt, J. (2010). The early communication indicator for infants and toddlers: Early Head Start growth norms from two states. Journal of Early Intervention, 32(5), 310-334. https://doi.org/10.1177/1053815110392335
Guthrie, W., Swineford, L. B., Nottke, C., & Wetherby, A. M. (2013). Early diagnosis of autism spectrum disorder: stability and change in clinical diagnosis and symptom presentation. Journal of Child Psychology and Psychiatry, 54(5), 582-590. https://doi.org/10.1111/jcpp.12008
Hardan, A. Y., Gengoux, G. W., Berquist, K. L., Libove, R. A., Ardel, C. M., Phillips, J., Frazier, T. W., & Minjarez, M. B. (2015). A randomized controlled trial of Pivotal Response Treatment Group for parents of children with autism. Journal of Child Psychology and Psychiatry, 56(8), 884-892.
https://doi.org/10.1111/jcpp.12354
Ingersoll, B. (2010). Brief report: Pilot randomized controlled trial of reciprocal imitation training for teaching elicited and spontaneous imitation to children with autism. Journal of Autism and Developmental Disorders, 40(9), 1154-1160. https://doi.org/10.1007/s10803-010-0966-2
Ingersoll, B., & Dvortcsak, A. (2009). Teaching social communication to children with autism: A practitioner`s guide to parent training and a manual for parents. Guilford Press.
Ingersoll, B., & Dvortcsak, A. (2010). Teaching social communication: A practitioner’s guide to parent training for children with autism. New York: Guilford Press.
Ingersoll, B., & Dvortcsak, A. (2020a)。教導自閉症幼兒社會溝通能力：家長手冊
（第二版）（姜忠信、陳孟筳、倪子洛、陳思臻、蔡曉薇譯）。洪葉文化。（原著出版於2019年）
Ingersoll, B., & Dvortcsak, A. (2020b)。教導自閉症幼兒社會溝通能力（第二
版）：教練手冊（姜忠信、陳孟筳、倪子洛、江淑蓉、陳思臻、蔡曉薇、
呂幸芳譯）。洪葉文化。（原著出版於2019年）
Ingersoll, B., & Schreibman, L. (2006). Teaching reciprocal imitation skills to young children with autism using a naturalistic behavioral approach: Effects on language, pretend play, and joint attention. Journal of Autism and Developmental Disorders, 36(4), 487. https://doi.org/10.1007/s10803-006-0089-y
Ingersoll, B., Shannon, K., Berger, N., Pickard, K., & Holtz, B. (2017). Self-directed telehealth parent-mediated intervention for children with autism spectrum disorder: Examination of the potential reach and utilization in community settings. Journal of Medical Internet Research, 19(7), e248.
Ingersoll, B., & Wainer, A. (2013). Initial efficacy of Project ImPACT: A parent-mediated social communication intervention for young children with ASD. Journal of Autism and Developmental Disorders, 43(12), 2943-2952. https://doi.org/10.1007/s10803-013-1840-9
Ingersoll, B., Wainer, A. L., Berger, N. I., Pickard, K. E., & Bonter, N. (2016). Comparison of a self-directed and therapist-assisted telehealth parent-mediated intervention for children with ASD: A pilot RCT. Journal of Autism and Developmental Disorders, 46(7), 2275-2284. https://doi.org/10.1007/s10803-016-2755-z
Kanne, S. M., Mazurek, M. O., Sikora, D., Bellando, J., Branum-Martin, L., Handen, B., Katz, T., Freedman, B., Powell, M. P., & Warren, Z. (2014). The Autism Impact Measure (AIM): initial development of a new tool for treatment outcome measurement. Journal of Autism and Developmental Disorders, 44(1), 168-179. https://doi.org/10.1007/s10803-013-1862-3
Kasari, C., Freeman, S., & Paparella, T. (2006). Joint attention and symbolic play in young children with autism: A randomized controlled intervention study. Journal of Child Psychology and Psychiatry, 47(6), 611-620. https://doi.org/10.1111/j.1469-7610.2005.01567.x
Koegel, R. L., Bimbela, A., & Schreibman, L. (1996). Collateral effects of parent training on family interactions. Journal of Autism and Developmental Disorders, 26(3), 347-359. https://doi.org/10.1007/BF02172479
Koegel, R. L., Koegel, L. K., & Carter, C. M. (1999). Pivotal teaching interactions for children with autism. School Psychology Review, 28(4), 576-594. https://doi.org/10.1080/02796015.1999.12085986
Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 159-174. https://doi.org/10.2307/2529310
Liljequist, D., Elfving, B., & Skavberg Roaldsen, K. (2019). Intraclass correlation–A discussion and demonstration of basic features. PloS one, 14(7), e0219854. https://doi.org/10.1371/journal.pone.0219854
Lin, T.-L., Chiang, C.-H., Ho, S. Y., Wu, H.-C., & Wong, C.-C. (2020). Preliminary clinical outcomes of a short-term low-intensity Early Start Denver Model implemented in the Taiwanese public health system. Autism, 24(5), 1300-1306. https://doi.org/10.1177/1362361319897179
Lindgren, S., Wacker, D., Suess, A., Schieltz, K., Pelzel, K., Kopelman, T., Lee, J., Romani, P., & Waldron, D. (2016). Telehealth and autism: Treating challenging behavior at lower cost. Pediatrics, 137(Supplement 2), S167-S175. https://doi.org/10.1542/peds.2015-2851O
Liu, Q., Hsieh, W.-Y., & Chen, G. (2020). A systematic review and meta-analysis of parent-mediated intervention for children and adolescents with autism spectrum disorder in mainland China, Hong Kong, and Taiwan. Autism, 24(8), 1960-1979. https://doi.org/10.1177/1362361320943380
Lord, C., Rutter, M., DiLavore, P., & Risi, S. (2002). Autism diagnostic observation (ADOS) manual. Los Angeles: Western Psychological Services.
Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3. https://doi.org/10.1037//0022-006x.55.1.3
Maenner, M. J., Warren, Z., Williams, A. R., Amoakohene, E., Bakian, A. V., Bilder, D. A., Durkin M. S., Fitzgerald R. T., Furnier S. M., Hughes M. M., Ladd-Acosta C. M., McArthur D., Pas E. T., Salinas A., Vehorn A., Williams S., Esler A., Grzybowski A., Hall-Lande J., ... & Shaw, K. A. (2023). Prevalence and characteristics of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2020. MMWR Surveillance Summaries, 72(2), 1. http://doi.org/10.15585/mmwr.ss7202a1
Magiati, I., Tay, X. W., & Howlin, P. (2014). Cognitive, language, social and behavioural outcomes in adults with autism spectrum disorders: A systematic review of longitudinal follow-up studies in adulthood. Clinical Psychology Review, 34(1), 73-86. https://doi.org/10.1016/j.cpr.2013.11.002
McEachin, J. J., Smith, T., & Ivar Lovaas, O. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. American Journal of Mental Retardation, 97(4), 359-359. https://www.ncbi.nlm.nih.gov/pubmed/8427693
McGarry, E., Vernon, T., & Baktha, A. (2020). Brief report: A pilot online pivotal response treatment training program for parents of toddlers with autism spectrum disorder. Journal of Autism and Developmental Disorders, 50, 3424-3431. https://doi.org/10.1007/s10803-019-04100-2
McGee, G. G., Krantz, P. J., Mason, D., & McClannahan, L. E. (1983). A modified incidental‐teaching procedure for autistic youth: Acquisition and generalization of receptive object labels. Journal of Applied Behavior Analysis, 16(3), 329-338. https://doi.org/10.1901/jaba.1983.16-329
Meadan, H., Ostrosky, M. M., Zaghlawan, H. Y., & Yu, S. (2009). Promoting the social and communicative behavior of young children with autism spectrum disorders: A review of parent-implemented intervention studies. Topics in Early Childhood Special Education, 29(2), 90-104. https://doi.org/10.1177/0271121409337950
Mercer, J. (2017). Examining DIR/Floortime™ as a treatment for children with autism spectrum disorders: A review of research and theory. Research on Social Work Practice, 27(5), 625-635. https://doi.org/10.1177/1049731515583062
Mullen, E. M. (1995). Mullen scales of early learning. AGS Circle Pines, MN.
Nevill, R. E., Lecavalier, L., & Stratis, E. A. (2018). Meta-analysis of parent-mediated interventions for young children with autism spectrum disorder. Autism, 22(2), 84-98. https://doi.org/10.1177/1362361316677838
Parsons, D., Cordier, R., Vaz, S., & Lee, H. C. (2017). Parent-mediated intervention training delivered remotely for children with autism spectrum disorder living outside of urban areas: Systematic review. Journal of Medical Internet Research, 19(8), e198. https://doi.org/10.2196/jmir.6651
Prizant, B. M., Wetherby, A. M., Rubin, E., & Laurent, A. C. (2003). The SCERTS model: A transactional, family-centered approach to enhancing communication and socioemotional abilities of children with autism spectrum disorder. Infants & Young Children, 16(4), 296-316.
Reese, R. M., Jamison, R., Wendland, M., Fleming, K., Braun, M. J., Schuttler, J. O., & Turek, J. (2013). Evaluating interactive videoconferencing for assessing symptoms of autism. Telemedicine and e-Health, 19(9), 671-677. https://doi.org/10.1089/tmj.2012.0312
Risi, S., Lord, C., Gotham, K., Corsello, C., Chrysler, C., Szatmari, P., Cook E. H., Leventhal B. L., & Pickles, A. (2006). Combining information from multiple sources in the diagnosis of autism spectrum disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 45(9), 1094-1103. https://doi.org/10.1097/01.chi.0000227880.42780.0e
Rogers, S., Dawson, G., Zierhut, C., Winter, J., McCormick, C., & Holly, E. (2013). The PATH curriculum checklist for young children with autism. unpublished document.
Rogers, S. J., & Dawson, G. (2010). Early Start Denver Model for young children with autism. New York, NY: Guilford.
Rogers, S. J., & Dawson, G. (2014) 。丹佛早療模式：促進自閉症兒童的語言、學
習及參與能力（姜忠信、劉瓊瑛及朱思穎譯）。洪葉文化。（原著出版於
2010年）
Rogers, S. J., Dawson, G., & Vismara, L. A. (2016) 。穩步‧慢行：自閉症孩子的生活、溝通、學習（張美惠、姜忠信譯）。洪葉文化。（原著出版於2012年）
Rogers, S. J., Estes, A., Lord, C., Munson, J., Rocha, M., Winter, J., Greenson, J., Colombi, C., Dawson, G., & Vismara, L. A. (2019). A multisite randomized controlled two-phase trial of the Early Start Denver Model compared to treatment as usual. Journal of the American Academy of Child & Adolescent Psychiatry, 58(9), 853-865. https://doi.org/10.1016/j.jaac.2019.01.004
Rogers, S. J., Estes, A., Lord, C., Vismara, L., Winter, J., Fitzpatrick, A., Guo, M., & Dawson, G. (2012). Effects of a brief Early Start Denver Model (ESDM)–based parent intervention on toddlers at risk for autism spectrum disorders: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 51(10), 1052-1065. https://doi.org/10.1016/j.jaac.2012.08.003
Rogers, S. J., Estes, A., Vismara, L., Munson, J., Zierhut, C., Greenson, J., Dawson, G., Rocha, M., Sugar, C., & Senturk, D. (2019). Enhancing low-intensity coaching in parent implemented Early Start Denver Model intervention for early autism: A randomized comparison treatment trial. Journal of Autism and Developmental Disorders, 49(2), 632-646. https://doi.org/10.1007/s10803-018-3740-5
Rogers, S. J., Hepburn, S. L., Stackhouse, T., & Wehner, E. (2003). Imitation performance in toddlers with autism and those with other developmental disorders. Journal of Child Psychology and Psychiatry, 44(5), 763-781. https://doi.org/10.1111/1469-7610.00162
Rogers, S. J., Herbison, J. M., Lewis, H. C., Pantone, J., & Reis, K. (1986). An approach for enhancing the symbolic, communicative, and interpersonal functioning of young children with autism or severe emotional handicaps. Journal of the Division for Early Childhood, 10(2), 135-148. https://doi.org/10.1177/105381518601000205
Rogers, S. J., & Pennington, B. F. (1991). A theoretical approach to the deficits in infantile autism. Development and Psychopathology, 3(2), 137-162. https://doi.org/10.1017/S0954579400000043
Rogers, S. J., Vismara, L. A., & Dawson, G. (2021). Coaching parents of young children with autism: Promoting connection, communication, and learning. Guilford Publications.
Rooks-Ellis, D., Howorth, S. K., Kunze, M., Boulette, S., & Sulinski, E. (2020). Effects of a parent training using telehealth: Equity and access to early intervention for rural families. Journal of Childhood, Education & Society, 1(2), 141-166. https://doi.org/10.37291/2717638X.20201242
Rutter, M., Le Couteur, A., & Lord, C. (2003). Autism diagnostic interview-revised. Los Angeles, CA: Western Psychological Services, 29(2003), 30.
Sandbank, M., Bottema-Beutel, K., Crowley, S., Cassidy, M., Dunham, K., Feldman, J. I., Crank, J., Albarran, S. A., Raj, S., & Mahbub, P. (2020). Project AIM: Autism intervention meta-analysis for studies of young children. Psychological Bulletin, 146(1), 1. https://doi.org/10.1037/bul0000215
Schopler, E., Mesibov, G. B., & Hearsey, K. (1995). Structured teaching in the TEACCH system. In Learning and cognition in autism (pp. 243-268). Springer. https://doi.org/10.1007/978-1-4899-1286-2_13
Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., Kasari, C., Ingersoll, B., Kaiser, A. P., & Bruinsma, Y. (2015). Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(8), 2411-2428. https://doi.org/10.1007/s10803-015-2407-8
Shalev, R. A., Lavine, C., & Di Martino, A. (2020). A systematic review of the role of parent characteristics in parent-mediated interventions for children with autism spectrum disorder. Journal of Developmental and Physical Disabilities, 32, 1-21. https://doi.org/10.1007/s10882-018-9641-x
Simacek, J., Elmquist, M., Dimian, A. F., & Reichle, J. (2021). Current trends in telehealth applications to deliver social communication interventions for young children with or at risk for autism spectrum disorder. Current Developmental Disorders Reports, 8, 15-23. https://doi.org/10.1007/s40474-020-00214-w
Sparrow, S. S., Balla, D. A., & Cicchetti, D. V. (2005). Vineland-II adaptive behavior scales. AGS Publishing.
Stahmer, A. C., Rieth, S. R., Dickson, K. S., Feder, J., Burgeson, M., Searcy, K., & Brookman-Frazee, L. (2020). Project ImPACT for toddlers: pilot outcomes of a community adaptation of an intervention for autism risk. Autism, 24(3), 617-632. https://doi.org/10.1177/1362361319878080
Stone, W. L., Ousley, O. Y., & Littleford, C. D. (1997). Motor imitation in young children with autism: What`s the object? Journal of Abnormal Child Psychology, 25(6), 475-485. https://doi.org/10.1023/a:1022685731726
Symon, J. B. (2005). Expanding interventions for children with autism: Parents as trainers. Journal of Positive Behavior Interventions, 7(3), 159-173. https://doi.org/10.1177/10983007050070030501
Tamm, L., Day, H. A., & Duncan, A. (2022). Comparison of adaptive functioning measures in adolescents with autism spectrum disorder without intellectual disability. Journal of Autism and Developmental Disorders, 52(3), 1247-1256. https://doi.org/10.1007/s10803-021-05013-9
Virues-Ortega, J., Julio, F. M., & Pastor-Barriuso, R. (2013). The TEACCH program for children and adults with autism: A meta-analysis of intervention studies. Clinical Psychology Review, 33(8), 940-953. https://doi.org/10.1016/j.cpr.2013.07.005
Vismara, L. A., McCormick, C., Young, G. S., Nadhan, A., & Monlux, K. (2013). Preliminary findings of a telehealth approach to parent training in autism. Journal of Autism and Developmental Disorders, 43(12), 2953-2969. https://doi.org/10.1007/s10803-013-1841-8
Vismara, L. A., McCormick, C. E., Wagner, A. L., Monlux, K., Nadhan, A., & Young, G. S. (2018). Telehealth parent training in the Early Start Denver Model: Results from a randomized controlled study. Focus on Autism and Other Developmental Disabilities, 33(2), 67-79. https://doi.org/10.1177/1088357616651064
Vygotsky, L. S. (1978). Socio-cultural theory. Mind in society, 52-58.
Wainer, A. L., Berger, N. I., & Ingersoll, B. R. (2017). Brief report: The preliminary psychometric properties of the Social Communication Checklist. Journal of Autism and Developmental Disorders, 47(4), 1231-1238. https://doi.org/10.1007/s10803-016-3026-8
Waizbard‐Bartov, E., Ferrer, E., Heath, B., Rogers, S. J., Nordahl, C. W., Solomon, M., & Amaral, D. G. (2022). Identifying autism symptom severity trajectories across childhood. Autism Research, 15(4), 687-701. https://doi.org/10.1002/aur.2674
Zhou, B., Xu, Q., Li, H., Zhang, Y., Wang, Y., Rogers, S. J., & Xu, X. (2018). Effects of parent‐implemented Early Start Denver Model intervention on Chinese Toddlers with autism spectrum disorder: A non‐randomized controlled trial. Autism Research, 11(4), 654-666. https://doi.org/10.1002/aur.1917		zh_TW