1. NCCU Academic Hub
  2. Publications
  3. College of Science
  4. Theses
  5. Item

Publications-Theses

Article View/Open

Publication Export

Google ScholarTM

NCCU Library

Citation Infomation

Related Publications in TAIR

題名 台灣自閉症類群障礙兒童丹佛早療模式之縱貫研究：學齡期兒童療效追蹤
A Follow-up Study on the Implementation of Early Start Denver Model for School-Age Children with Autism Spectrum Disorder in Taiwan: Children Outcomes
作者 湯于萱
Tang, Yu-Syuan
貢獻者 姜忠信
Chiang, Chung-Hsin
湯于萱
Tang, Yu-Syuan
關鍵詞 自閉症
丹佛早療模式
早期介入
學齡期
縱貫研究
Autism Spectrum Disorder
Early Start Denver Model
Early Intervention
School-age
Longitudinal Study
日期 2025
上傳時間 1-Jul-2025 14:12:17 (UTC+8)
摘要 研究目的：國內外的自閉症類群障礙症（Autism Spectrum Disorder, ASD）盛行率皆在上升，然而目前國內外針對早期介入（early intervention, EI）的長期追蹤研究仍不多，結果亦不一致。丹佛早療模式（Early Start Denver Model, ESDM）為一項結合行為、發展和關係基礎取向的綜合性早期介入模式， Chiang等人（2023）曾進行一項短期、低密集度的ESDM個別介入方案，本研究以同一群研究參與兒童為對象，進行四年後於各項發展領域的追蹤評估，以瞭解ESDM的長期影響。 研究方法：本研究為準實驗設計，參與者在2至4歲時曾接受ESDM個別介入（ESDM介入組）或一般早療介入（一般社區介入組），已於三個時間點進行資料收集（T1：介入前；T2：介入後；T3：介入後6個月）。本研究於介入後四年（T4）對兩組參與者進行追蹤評估，以認知能力、語言能力及適應行為作為初級療效指標，並以症狀嚴重度、挑戰行為、特殊教育服務時數及同儕關係作為次級療效指標。 研究結果：在各項初級及次級療效指標方面，ESDM介入組與一般社區介入組T3至T4的變化趨勢皆無顯著差異，兩組參與兒童在語言能力方面皆隨著時間有所進步，而症狀嚴重度則皆隨著時間顯著上升。在特殊教育服務資源的使用上，ESDM介入組於T4時所接受的特殊教育服務時數顯著高於一般社區介入組。 結論：T4時，ESDM介入組與一般社區介入組在語言和症狀嚴重度方面呈現相似的發展趨勢，且組間差異未達統計顯著。然而，ESDM介入組在T4接受的特殊教育服務時數顯著較多，顯示特定的介入經驗可能影響後續服務參與型態。
Objective: The prevalence of Autism Spectrum Disorder (ASD) has been increasing globally. However, longitudinal studies on the long-term effects of early intervention (EI) remain limited, with inconsistent findings. The Early Start Denver Model (ESDM) is a comprehensive EI approach that integrates behavioral, developmental, and relationship-based principles. Chiang et al. (2023) previously conducted a short-term, low-intensity individual ESDM intervention. This study followed the same cohort to assess their developmental outcomes four years later and examine the long-term effects of ESDM. Methods: This study employed a quasi-experimental design. Participants had received either individual ESDM intervention (ESDM group) or general early intervention (community intervention group) between the ages of 2 and 4. Data were collected at three previous time points: T1 (pre-intervention), T2 (post-intervention), and T3 (6 months post-intervention). At T4 (four years post-intervention), a follow-up assessment was conducted on both groups (n = 17 per group, mean chronological age = 99.05 and 99.30 months, respectively). Primary outcome measures included cognitive ability, language ability, and adaptive behavior, while secondary outcome measures included symptom severity, challenging behavior, and hours of special education services received. Results: Across all primary and secondary outcome indicators, no significant group-by-time interaction was observed between the ESDM intervention group and the community intervention group from T3 to T4. Both groups showed improvement in verbal abilities over time, while autism symptom severity significantly increased in both groups. Regarding the use of special education services, children in the ESDM group received significantly more hours of special education services at T4 compared to those in the community group. Conclusion: At T4, the ESDM and community intervention groups exhibited similar trends in language development and symptom severity, with no statistically significant differences between groups. However, the ESDM group received significantly more hours of special education services, suggesting that the type of early intervention may influence patterns of subsequent service utilization.
參考文獻 林姿伶、姜忠信、吳欣治（2016）。自閉症類群兒童綜合性早期療育的療效研究：文獻回顧。中華心理衛生學刊，29（1），1-46。 林清山（1981）。心理與教育統計學。臺灣東華書局股份有限公司。 姜忠信、劉瓊瑛、朱思穎（譯）（2014）。丹佛早療模式：促進自閉症幼兒的語言、學習及參與能力。台北：洪葉文化事業有限公司。(S. J. Rogers, & G. Dawson., 2010)。 張美惠（譯）（2018）。學習、互動與融入：自閉症幼兒的丹佛早療團體模式。台北：張老師文化事業股份有限公司。(G. Vivanti, Ed Duncan, G. Dawson, & S. J. Rogers, 2017)。 張美惠、姜忠信（譯）（2016）穩步‧慢行：自閉症孩子的生活、溝通、學習。台北：張老師文化事業股份有限公司。(S. J. Rogers, G. Dawson, & L. A. Vismara, 2012)。 陳心怡（2018）。魏氏兒童智力量表第五版中文版。台北：中國行為科學社。 陳心怡、陳榮華（2013）。魏氏幼兒智力量表第四版中文版。台北：中國行為科學社。 陳怡群、黃惠玲、趙家琛（譯）（2009）。阿肯巴克實證衡鑑系統。新北：心理出版社。 盧台華、陳心怡（2018）。適應行為評量系統第二版（ABAS–II）中文版－兒童版。台北：中國行為科學社。 劉昱志, 劉士愷, 商志雍, 林健禾, 杜長齡, & 高淑芬. (2006). 注意力缺陷過動症中文版 Swanson, Nolan, and Pelham, Version IV (SNAP-IV) 量表之常模及信效度. 台灣精神醫學, 20(4), 290-304. Akshoomoff, N., Stahmer, A. C., Corsello, C., & Mahrer, N. E. (2010). What happens next? Follow-up from the children’s toddler school program. Journal of Positive Behavior Interventions, 12(4), 245-253. Aman, M. G., Singh, N. N., Stewart, A. W., & Field, C. (1985). The aberrant behavior checklist: a behavior rating scale for the assessment of treatment effects. American journal of mental deficiency, 89(5), 485-491. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Ashburner, J., Ziviani, J., & Rodger, S. (2010). Surviving in the mainstream: Capacity of children with autism spectrum disorders to perform academically and regulate their emotions and behavior at school. Research in Autism Spectrum Disorders, 4(1), 18-27. Asta, L., & Persico, A. M. (2022). Differential predictors of response to early start Denver model vs. early intensive behavioral intervention in young children with autism spectrum disorder: a systematic review and meta-analysis. Brain Sciences, 12(11), 1499. Baer, D. M., & Sherman, J. A. (1964). Reinforcement control of generalized imitation in young children. Journal of Experimental Child Psychology, 1(1), 37-49. Bauminger, N., & Kasari, C. (2000). Loneliness and friendship in high‐functioning children with autism. Child development, 71(2), 447-456. Benjamin et al. (2018). “Redefine statistical significance.” Nature Human Behaviour, 2(1), 6-10. Blanca, M. J. et al. (2024). “How to proceed when both normality and sphericity are violated in repeated-measures ANOVA.” Anales de Psicología, 40(3), 466-480. Bruinsma, Y. E., Minjarez, M. B., Schreibman, L., & Stahmer, A. C. (2020). Naturalistic Developmental Behavioral Interventions for Autism Spectrum Disorder. Brookes Publishing Company. PO Box 10624, Baltimore, MD 21285. Buescher, A. V., Cidav, Z., Knapp, M., & Mandell, D. S. (2014). Costs of autism spectrum disorders in the United Kingdom and the United States. JAMA pediatrics, 168(8), 721-728. Chandler, S., Howlin, P., Simonoff, E., Kennedy, J., & Baird, G. (2016). Comparison of parental estimate of developmental age with measured IQ in children with neurodevelopmental disorders. Child: Care, Health and Development, 42(4), 486-493. Chiang, C. H., Lin, T. L., Lin, H. Y., Ho, S. Y., Wong, C. C., & Wu, H. C. (2023). Short-term low-intensity early start Denver Model program implemented in regional hospitals in Northern Taiwan. Autism, 27(3), 778-787. Cidav, Z., Munson, J., Estes, A., Dawson, G., Rogers, S., & Mandell, D. (2017). Cost offset associated with Early Start Denver Model for children with autism. Journal of the American Academy of Child & Adolescent Psychiatry, 56(9), 777-783. Cidav, Z., Mandell, D., Ingersoll, B., & Pellecchia, M. (2023). Programmatic costs of project impact for children with autism: a time-driven activity based costing study. Administration and Policy in Mental Health and Mental Health Services Research, 50(3), 402-416. 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, 92-102. Cohen, J. (1992). Statistical power analysis. Current directions in psychological science, 1(3), 98-101. Cohen, J. (2013). Statistical power analysis for the behavioral sciences. routledge. Colombi, C., Fish, A., & Ghaziuddin, M. (2020). Utility of the ADOS-2 in children with psychiatric disorders. European child & adolescent psychiatry, 29, 989-992. Colombi, C., Narzisi, A., Ruta, L., Cigala, V., Gagliano, A., Pioggia, G., Siracusano, R., Rogers, S. J., & Muratori, F. (2018). Implementation of the Early Start Denver Model in an Italian community. Autism, 22(2), 126–133. Dawson, G., & Adams, A. (1984). Imitation and social responsiveness in autistic children. Journal of abnormal child psychology, 12(2), 209-226. Dawson, G., Jones, E. J., Merkle, K., Venema, K., Lowy, R., Faja, S., ... & Webb, S. J. (2012). Early behavioral intervention is associated with normalized brain activity in young children with autism. Journal of the American Academy of Child & Adolescent Psychiatry, 51(11), 1150-1159. Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., ... & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23. Dawson, G., Webb, S. J., & McPartland, J. (2005). Understanding the nature of face processing impairment in autism: Insights from behavioral and electrophysiological studies. Developmental Neuropsychology, 27(3), 403–424. Devescovi, R., Monasta, L., Mancini, A., Bin, M., Vellante, V., Carrozzi, M., & Colombi, C. (2016). Early diagnosis and Early Start Denver Model intervention in autism spectrum disorders delivered in an Italian Public Health System service. Neuropsychiatric disease and treatment, 12, 1379. Eapen, V., Črnčec, R., & Walter, A. (2013). Clinical outcomes of an early intervention program for preschool children with autism spectrum disorder in a community group setting. BMC pediatrics, 13(1), 1-9. Estes, A., Munson, J., Rogers, S. J., Greenson, J., Winter, J., & Dawson, G. (2015). Long-term outcomes of early intervention in 6-year-old children with autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 54(7), 580-587. Farmer, C., Golden, C., & Thurm, A. (2016). Concurrent validity of the differential ability scales, with the Mullen Scales of Early Learning in young children with and without neurodevelopmental disorders. Child Neuropsychology, 22(5), 556-569. Fountain, C., Winter, A. S., & Bearman, P. S. (2012). Six developmental trajectories characterize children with autism. Pediatrics, 129(5), e1112-e1120. Fox, S.A. An Early Start Denver Model-Based Group Intervention for Parents of Very Young Children Diagnosed with or at Risk for Autism Spectrum Disorder. Ph.D. Thesis, University at Albany. Department of Psychology, Albany, NY, USA, 2017. Fuller, E. A., & Kaiser, A. P. (2020). The effects of early intervention on social communication outcomes for children with autism spectrum disorder: A meta-analysis. Journal of autism and developmental disorders, 50(5), 1683-1700. Geoffray, M. M., Denis, A., Mengarelli, F., Peter, C., Gallifet, N., Beaujeard, V., ... & Touzet, S. (2019). Using ESDM 12 hours per week in children with autism spectrum disorder: Feasibility and results of an observational study. Psychiatria Danubina, 31(3), 333-339. Georgiades, S., Tait, P. A., McNicholas, P. D., Duku, E., Zwaigenbaum, L., Smith, I. M., ... & Szatmari, P. (2022). Trajectories of symptom severity in children with autism: Variability and turning points through the transition to school. Journal of autism and developmental disorders, 1-10. Godel, M., Robain, F., Kojovic, N., Franchini, M., Wood de Wilde, H., & Schaer, M. (2022). Distinct patterns of cognitive outcome in young children with autism spectrum disorder receiving the Early Start Denver Model. Frontiers in Psychiatry, 13, 835580. Harris, S. L., & Handleman, J. S. (2000). Age and IQ at intake as predictors of placement for young children with autism: A four-to six-year follow-up. Journal of autism and developmental disorders, 30, 137-142. Hart, B. M., & Risley, T. R. (1968). Establishing use of descriptive adjectives in the spontaneous speech of disadvantaged preschool children. Journal of Applied Behavior Analysis, 1, 109–120. Hart, B., & Risley, T. R. (1975). Incidental teaching of language in the preschool 1. Journal of applied behavior analysis, 8(4), 411-420. Holzinger, D., Laister, D., Vivanti, G., Barbaresi, W. J., & Fellinger, J. (2019). Feasibility and outcomes of the Early Start Denver Model implemented with low intensity in a community setting in Austria. Journal of Developmental & Behavioral Pediatrics, 40(5), 354-363. Ingersoll, B., & Wainer, A. (2013a). Initial efficacy of Project ImPACT: A parent-mediated social communication intervention for young children with ASD. Journal of Autism and Developmental Disorders, 43, 2943–2952. Ingersoll, B., & Wainer, A. (2013b). Pilot study of a school-based parent training program for preschoolers with ASD. Autism—International Journal of Research and Practice, 17, 434–448. Itzchak, E. B., & Zachor, D. A. (2009). Change in autism classification with early intervention: Predictors and outcomes. Research in Autism Spectrum Disorders, 3(4), 967-976. Johnson, V. E. (2013). “Revised standards for statistical evidence.” PNAS, 110(48), 19313–19317. Kaale, A., Fagerland, M. W., Martinsen, E. W., & Smith, L. (2014). Preschool-based social communication treatment for children with autism: 12-month follow-up of a randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 53, 188–198. Kaale, A., Smith, L., & Sponheim, E. (2012). A randomized controlled trial of preschool based joint attention intervention for children with autism. Journal of Child Psychology and Psychiatry, 53, 97–105. Kaiser, A. P., & Hester, P. P. (1994). Generalized effects of enhanced milieu teaching. Journal of Speech, Language, and Hearing Research, 37(6), 1320-1340. Kanner, L. (1943). Autistic disturbances of affective contact. Nervous child, 2(3), 217-250. Kasari, C., Gulsrud, A., Freeman, S., Paparella, T., & Hellemann, G. (2012). Longitudinal follow-up of children with autism receiving targeted interventions on joint attention and play. Journal of the American Academy of Child & Adolescent Psychiatry, 51(5), 487-495. Kasari, C., Gulsrud, A., Wong, C., Kwon, S., & Locke, J. (2010). Randomized controlled caregiver mediated joint engagement intervention for toddlers with autism. Journal of Autism and Developmental Disorders, 40, 1045–1056. Kasari, C., Kaiser, A., Goods, K., Nietfeld, J., Mathy, P., Landa, R., . . . Almirall, D. (2014). Communication interventions for minimally verbal children with autism: A sequential multiple assignment randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 53, 635–646. Kasari, C., Lawton, K., Shih, W., Landa, R., Lord, C., Orlich, F., . . . Senturk, D. (2014). Caregiver-mediated intervention for low-resourced preschoolers with autism: An RCT. Pediatrics, 134, e72–e79. Kasari, C., Locke, J., Gulsrud, A., & Rotheram-Fuller, E. (2011). Social networks and friendships at school: Comparing children with and without ASD. Journal of autism and developmental disorders, 41, 533-544. Kasari, C., Paparella, T., Freeman, S. N., & Jahromi, L. (2008). Language outcome in autism: Randomized comparison of joint attention and play interventions. Journal of Consulting and Clinical Psychology, 76, 125–137. Koegel, R. L., & Koegel, L. K. (1988). Generalized responsivity and pivotal behaviors. In R. H. Horner, G. Dunlap, & R. L. Koegel (Eds.), Generalization and maintenance: Life-style changes in applied settings (pp. 41–66). Paul H. Brookes Publishing. Koegel, R. L., & Koegel, L. K. (2006). Pivotal response treatments for autism: Communication, social, & academic development. Paul H Brookes Publishing. Koegel, R. L., Schreibman, L., Good, A. B., Cerniglia, L., Murphy, C., & Koegel, L. K. (1989). How to teach pivotal behaviors to autistic children. Santa Barbara: University of California. Liu, W. X., Shan, L., Li, C. L., Liu, Y. M., Xue, Y., OuYang, Y. L., & Jia, F. Y. (2025). Effects of the Early Start Denver Model on emotional dysregulation and behavior problems in children with Autism spectrum disorder: Effects of the early start Denver model on emotional dysregulation and behavior problems in Chinese children with Autism spectrum disorder. BMC pediatrics, 25(1), 19. Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., ... & Rutter, M. (2000). The Autism Diagnostic Observation Schedule—Generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of autism and developmental disorders, 30, 205-223. Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview-Revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of autism and developmental disorders, 24(5), 659-685. Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., & Pickles, A. (2006). Autism from 2 to 9 years of age. Archives of general psychiatry, 63(6), 694-701. 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. Lovaas, O. I., Berberich, J. P., Perloff, B. F., & Schaeffer, B. (1966). Acquisition of imitative speech by schizophrenic children. Science, 151(3711), 705-707. Lovaas, O. I., Freitag, G., Gold, V. J., & Kassorla, I. C. (1965). Experimental studies in childhood schizophrenia: Analysis of self-destructive behavior. Journal of Experimental Child Psychology, 2(1), 67-84. Magiati, I., Moss, J., Charman, T., & Howlin, P. (2011). Patterns of change in children with autism spectrum disorders who received community based comprehensive interventions in their pre-school years: A seven year follow-up study. Research in Autism Spectrum Disorders, 5(3), 1016-1027. McEachin, J. J., Smith, T., & Lovaas, O. I. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. american Journal on mental retardation. McGee, G. G., Morrier, M. J., & Daly, T. (1999). An incidental teaching approach to early intervention for toddlers with autism. Journal of the association for persons with severe handicaps, 24(3), 133-146. Mok, P. L., Pickles, A., Durkin, K., & Conti‐Ramsden, G. (2014). Longitudinal trajectories of peer relations in children with specific language impairment. Journal of Child Psychology and Psychiatry, 55(5), 516-527. Moss, J., Howlin, P., Savage, S., Bolton, P., & Rutter, M. (2008). Recognition of autism spectrum disorder in children with Down syndrome. Journal of Autism and Developmental Disorders, 38(4), 685–693. Mullen EM. Mullen Scales of Early Learning: AGS edition. Circle Pines, MN: American Guidance Service Publishing; 1995. O’Connor, A. B., & Healy, O. (2010). Long-term post-intensive behavioral intervention outcomes for five children with autism spectrum disorder. Research in Autism Spectrum Disorders, 4(4), 594-604. Orsmond, G. I., Krauss, M. W., & Seltzer, M. M. (2004). Peer relationships and social and recreational activities among adolescents and adults with autism. Journal of autism and developmental disorders, 34(3), 245-256. Peköz, H. & Acikel, C. (2021). “Permutation tests are robust and powerful at 0.5% and 5% significance levels.” Behavior Research Methods, 53, 2481–2501. 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. 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. Rogers, S. J., & Dawson, G. (2010). Early Start Denver Model for young children with autism: Promoting language, learning, and engagement. New York, NY: Guilford Press. Rogers, S. J., & DiLalla, D. L. (1991). A comparative study of the effects of a developmentally based instructional model on young children with autism and young children with other disorders of behavior and development. Topics in Early Childhood Special Education, 11(2), 29-47. Rogers, S. J., & Pennington, B. F. (1991). A theoretical approach to the deficits in infantile autism. Development and psychopathology, 3(2), 137-162. Rogers, S. J., Estes, A., Lord, C., Munson, J., Rocha, M., Winter, J., ... & Talbott, M. (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. Rogers, S. J., Estes, A., Lord, C., Vismara, L., Winter, J., Fitzpatrick, A., ... & 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. Rogers, S. J., Herbison, J., Lewis, H., Pantone, J., & Reis, K. (1986). An approach for enhancing the symbolic, communicative and interpersonal functioning of young children with autism and severe emotional handicaps. Journal of the Division of Early Childhood, 10, 135–148. Ryberg, K. H. (2015). Evidence for the implementation of the Early Start Denver Model for young children with autism spectrum disorder. Journal of the American Psychiatric Nurses Association, 21(5), 327-337. Sallows, G. O., & Graupner, T. D. (2005). Intensive behavioral treatment for children with autism: Four-year outcome and predictors. American journal on mental retardation, 110(6), 417-438. Sandbank, M., Pustejovsky, J. E., Bottema-Beutel, K., Caldwell, N., Feldman, J. I., LaPoint, S. C., & Woynaroski, T. (2024). Determining associations between intervention amount and outcomes for young autistic children: a meta-analysis. JAMA pediatrics, 178(8), 763-773. Sattler, J. M., & Atkinson, L. (1993). Item equivalence across scales: The WPPSI—R and WISC-III. Psychological assessment, 5(2), 203. Schreibman, L. (2005). The science and fiction of autism. Harvard University Press. Schreibman, L., & Pierce, K. (1993). Achieving greater generalization of treatment effects in children with autism: Pivotal response training and self management. The Clinical Psychologist, 46, 184-191. Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., ... & Halladay, A. (2015). Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder. Journal of autism and developmental disorders, 45(8), 2411-2428. Sinai-Gavrilov, Y., Gev, T., Mor-Snir, I., Vivanti, G., & Golan, O. (2020). Integrating the Early Start Denver Model into Israeli community autism spectrum disorder preschools: Effectiveness and treatment response predictors. Autism, 24(8), 2081-2093. Smith, E. A. (2017). Evolutionary ecology and human behavior. Routledge. Spelke, E., Bernier, E. P., & Skerry, A. E. (2013). Core social cognition. In Navigating the social world. What infants, children, and other species can teach us (pp. 11–16). Oxford: Oxford University Press. Starr, E. M., Popovic, S., & McCall, B. P. (2016). Supporting children with autism spectrum disorder at primary school: Are the promises of early intervention maintained?. Current Developmental Disorders Reports, 3, 46-56. Ungar, W. J., Tsiplova, K., Millar, N., & Smith, I. M. (2018). Development of the Resource Use Questionnaire (RUQ–P) for families with preschool children with neurodevelopmental disorders: Validation in children with autism spectrum disorder. Clinical Practice in Pediatric Psychology, 6(2), 164. Vinen, Z., Clark, M., & Dissanayake, C. (2022). Social and Behavioural Outcomes of School Aged Autistic Children Who Received Community-Based Early Interventions. Journal of Autism and Developmental Disorders, 1-12. Vinen, Z., Clark, M., Paynter, J., & Dissanayake, C. (2018). School age outcomes of children with autism spectrum disorder who received community-based early interventions. Journal of autism and developmental disorders, 48(5), 1673-1683. 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. Vivanti, G., & Rogers, S. J. (2014). Autism and the mirror neuron system: insights from learning and teaching. Philosophical Transactions of the Royal Society B: Biological Sciences, 369(1644), 20130184. Vivanti, G., Bottema-Beutel, K., & Turner-Brown, L. (Eds.). (2020). Clinical guide to early interventions for children with autism. Berlin/Heidelberg, Germany: Springer. Vivanti, G., Dissanayake, C., & Victorian ASELCC Team. (2016). Outcome for children receiving the Early Start Denver Model before and after 48 months. Journal of autism and developmental disorders, 46, 2441-2449. Vivanti, G., Dissanayake, C., Zierhut, C., Rogers, S. J., & Victorian ASELCC Team. (2013). Brief report: Predictors of outcomes in the Early Start Denver Model delivered in a group setting. Journal of autism and developmental disorders, 43, 1717-1724. Vivanti, G., Paynter, J., Duncan, E., Fothergill, H., Dissanayake, C., Rogers, S. J., & Victorian ASELCC Team. (2014). Effectiveness and feasibility of the Early Start Denver Model implemented in a group-based community childcare setting. Journal of autism and developmental disorders, 44, 3140-3153. 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. Wang, Z., Loh, S. C., Tian, J., & Chen, Q. J. (2022). A meta-analysis of the effect of the Early Start Denver Model in children with autism spectrum disorder. International Journal of Developmental Disabilities, 68(5), 587-597. Wing, L. (1988). The continuum of autistic characteristics (pp. 91-110). Springer US. Xu, Y., Yang, J., Yao, J., Chen, J., Zhuang, X., Wang, W., ... & Lee, G. T. (2018). A pilot study of a culturally adapted early intervention for young children with autism spectrum disorders in China. Journal of Early Intervention, 40(1), 52-68. Yang, Y., Wang, H., Xu, H., Yao, M., & Yu, D. (2023). Randomized, controlled trial of a mixed early start Denver model for toddlers and preschoolers with autism. Autism Research, 16(8), 1640-1649. 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.
描述 碩士
國立政治大學
心理學系
110752022
資料來源 http://thesis.lib.nccu.edu.tw/record/#G0110752022
資料類型 thesis
dc.contributor.advisor 姜忠信zh_TW
dc.contributor.advisor Chiang, Chung-Hsinen_US
dc.contributor.author (Authors) 湯于萱zh_TW
dc.contributor.author (Authors) Tang, Yu-Syuanen_US
dc.creator (作者) 湯于萱zh_TW
dc.creator (作者) Tang, Yu-Syuanen_US
dc.date (日期) 2025en_US
dc.date.accessioned 1-Jul-2025 14:12:17 (UTC+8)-
dc.date.available 1-Jul-2025 14:12:17 (UTC+8)-
dc.date.issued (上傳時間) 1-Jul-2025 14:12:17 (UTC+8)-
dc.identifier (Other Identifiers) G0110752022en_US
dc.identifier.uri (URI) https://nccur.lib.nccu.edu.tw/handle/140.119/157658-
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) 110752022zh_TW
dc.description.abstract (摘要) 研究目的：國內外的自閉症類群障礙症（Autism Spectrum Disorder, ASD）盛行率皆在上升，然而目前國內外針對早期介入（early intervention, EI）的長期追蹤研究仍不多，結果亦不一致。丹佛早療模式（Early Start Denver Model, ESDM）為一項結合行為、發展和關係基礎取向的綜合性早期介入模式， Chiang等人（2023）曾進行一項短期、低密集度的ESDM個別介入方案，本研究以同一群研究參與兒童為對象，進行四年後於各項發展領域的追蹤評估，以瞭解ESDM的長期影響。 研究方法：本研究為準實驗設計，參與者在2至4歲時曾接受ESDM個別介入（ESDM介入組）或一般早療介入（一般社區介入組），已於三個時間點進行資料收集（T1：介入前；T2：介入後；T3：介入後6個月）。本研究於介入後四年（T4）對兩組參與者進行追蹤評估，以認知能力、語言能力及適應行為作為初級療效指標，並以症狀嚴重度、挑戰行為、特殊教育服務時數及同儕關係作為次級療效指標。 研究結果：在各項初級及次級療效指標方面，ESDM介入組與一般社區介入組T3至T4的變化趨勢皆無顯著差異，兩組參與兒童在語言能力方面皆隨著時間有所進步，而症狀嚴重度則皆隨著時間顯著上升。在特殊教育服務資源的使用上，ESDM介入組於T4時所接受的特殊教育服務時數顯著高於一般社區介入組。 結論：T4時，ESDM介入組與一般社區介入組在語言和症狀嚴重度方面呈現相似的發展趨勢，且組間差異未達統計顯著。然而，ESDM介入組在T4接受的特殊教育服務時數顯著較多，顯示特定的介入經驗可能影響後續服務參與型態。zh_TW
dc.description.abstract (摘要) Objective: The prevalence of Autism Spectrum Disorder (ASD) has been increasing globally. However, longitudinal studies on the long-term effects of early intervention (EI) remain limited, with inconsistent findings. The Early Start Denver Model (ESDM) is a comprehensive EI approach that integrates behavioral, developmental, and relationship-based principles. Chiang et al. (2023) previously conducted a short-term, low-intensity individual ESDM intervention. This study followed the same cohort to assess their developmental outcomes four years later and examine the long-term effects of ESDM. Methods: This study employed a quasi-experimental design. Participants had received either individual ESDM intervention (ESDM group) or general early intervention (community intervention group) between the ages of 2 and 4. Data were collected at three previous time points: T1 (pre-intervention), T2 (post-intervention), and T3 (6 months post-intervention). At T4 (four years post-intervention), a follow-up assessment was conducted on both groups (n = 17 per group, mean chronological age = 99.05 and 99.30 months, respectively). Primary outcome measures included cognitive ability, language ability, and adaptive behavior, while secondary outcome measures included symptom severity, challenging behavior, and hours of special education services received. Results: Across all primary and secondary outcome indicators, no significant group-by-time interaction was observed between the ESDM intervention group and the community intervention group from T3 to T4. Both groups showed improvement in verbal abilities over time, while autism symptom severity significantly increased in both groups. Regarding the use of special education services, children in the ESDM group received significantly more hours of special education services at T4 compared to those in the community group. Conclusion: At T4, the ESDM and community intervention groups exhibited similar trends in language development and symptom severity, with no statistically significant differences between groups. However, the ESDM group received significantly more hours of special education services, suggesting that the type of early intervention may influence patterns of subsequent service utilization.en_US
dc.description.tableofcontents 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 壹、自然且具發展原則的行為療育法（Naturalistic developmental behavioral interventions, NDBIs）4 貳、丹佛早療模式（ESDM）7 參、ASD早期介入之縱貫研究 18 第三節 研究問題與假設 27 第二章 研究方法 29 第一節 研究對象 29 第二節 研究測量 38 壹、認知與語言能力 38 貳、適應行為 40 參、症狀嚴重度 41 肆、挑戰行為 42 伍、特殊教育服務時數 43 陸、同儕關係 44 第三節 ESDM個別介入方案與一般社區介入 45 第四節 資料分析 46 第三章 研究結果 47 第一節 初級療效指標分析 47 壹、認知能力 47 貳、語言能力 48 參、適應行為 48 第二節 次級療效指標分析 51 壹、症狀嚴重度 51 貳、挑戰行為 51 參、特殊教育服務時數 53 肆、同儕關係 53 第四章 討論 57 第一節 療效指標結果解釋 57 壹、初級療效指標與研究假設一 57 貳、次級療效指標與研究假設二 57 參、T4新增指標與研究假設三 60 肆、與其他文獻比較 61 第二節 研究貢獻與限制 64 參考文獻 66 附錄一 自閉症資源使用問卷－學齡版（Resource Use Questionnaire for Family of School-aged children, RUQ-S）80zh_TW
dc.format.extent 1651968 bytes-
dc.format.mimetype application/pdf-
dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0110752022en_US
dc.subject (關鍵詞) 自閉症zh_TW
dc.subject (關鍵詞) 丹佛早療模式zh_TW
dc.subject (關鍵詞) 早期介入zh_TW
dc.subject (關鍵詞) 學齡期zh_TW
dc.subject (關鍵詞) 縱貫研究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) Early Interventionen_US
dc.subject (關鍵詞) School-ageen_US
dc.subject (關鍵詞) Longitudinal Studyen_US
dc.title (題名) 台灣自閉症類群障礙兒童丹佛早療模式之縱貫研究：學齡期兒童療效追蹤zh_TW
dc.title (題名) A Follow-up Study on the Implementation of Early Start Denver Model for School-Age Children with Autism Spectrum Disorder in Taiwan: Children Outcomesen_US
dc.type (資料類型) thesisen_US
dc.relation.reference (參考文獻) 林姿伶、姜忠信、吳欣治（2016）。自閉症類群兒童綜合性早期療育的療效研究：文獻回顧。中華心理衛生學刊，29（1），1-46。 林清山（1981）。心理與教育統計學。臺灣東華書局股份有限公司。 姜忠信、劉瓊瑛、朱思穎（譯）（2014）。丹佛早療模式：促進自閉症幼兒的語言、學習及參與能力。台北：洪葉文化事業有限公司。(S. J. Rogers, & G. Dawson., 2010)。 張美惠（譯）（2018）。學習、互動與融入：自閉症幼兒的丹佛早療團體模式。台北：張老師文化事業股份有限公司。(G. Vivanti, Ed Duncan, G. Dawson, & S. J. Rogers, 2017)。 張美惠、姜忠信（譯）（2016）穩步‧慢行：自閉症孩子的生活、溝通、學習。台北：張老師文化事業股份有限公司。(S. J. Rogers, G. Dawson, & L. A. Vismara, 2012)。 陳心怡（2018）。魏氏兒童智力量表第五版中文版。台北：中國行為科學社。 陳心怡、陳榮華（2013）。魏氏幼兒智力量表第四版中文版。台北：中國行為科學社。 陳怡群、黃惠玲、趙家琛（譯）（2009）。阿肯巴克實證衡鑑系統。新北：心理出版社。 盧台華、陳心怡（2018）。適應行為評量系統第二版（ABAS–II）中文版－兒童版。台北：中國行為科學社。 劉昱志, 劉士愷, 商志雍, 林健禾, 杜長齡, & 高淑芬. (2006). 注意力缺陷過動症中文版 Swanson, Nolan, and Pelham, Version IV (SNAP-IV) 量表之常模及信效度. 台灣精神醫學, 20(4), 290-304. Akshoomoff, N., Stahmer, A. C., Corsello, C., & Mahrer, N. E. (2010). What happens next? Follow-up from the children’s toddler school program. Journal of Positive Behavior Interventions, 12(4), 245-253. Aman, M. G., Singh, N. N., Stewart, A. W., & Field, C. (1985). The aberrant behavior checklist: a behavior rating scale for the assessment of treatment effects. American journal of mental deficiency, 89(5), 485-491. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Ashburner, J., Ziviani, J., & Rodger, S. (2010). Surviving in the mainstream: Capacity of children with autism spectrum disorders to perform academically and regulate their emotions and behavior at school. Research in Autism Spectrum Disorders, 4(1), 18-27. Asta, L., & Persico, A. M. (2022). Differential predictors of response to early start Denver model vs. early intensive behavioral intervention in young children with autism spectrum disorder: a systematic review and meta-analysis. Brain Sciences, 12(11), 1499. Baer, D. M., & Sherman, J. A. (1964). Reinforcement control of generalized imitation in young children. Journal of Experimental Child Psychology, 1(1), 37-49. Bauminger, N., & Kasari, C. (2000). Loneliness and friendship in high‐functioning children with autism. Child development, 71(2), 447-456. Benjamin et al. (2018). “Redefine statistical significance.” Nature Human Behaviour, 2(1), 6-10. Blanca, M. J. et al. (2024). “How to proceed when both normality and sphericity are violated in repeated-measures ANOVA.” Anales de Psicología, 40(3), 466-480. Bruinsma, Y. E., Minjarez, M. B., Schreibman, L., & Stahmer, A. C. (2020). Naturalistic Developmental Behavioral Interventions for Autism Spectrum Disorder. Brookes Publishing Company. PO Box 10624, Baltimore, MD 21285. Buescher, A. V., Cidav, Z., Knapp, M., & Mandell, D. S. (2014). Costs of autism spectrum disorders in the United Kingdom and the United States. JAMA pediatrics, 168(8), 721-728. Chandler, S., Howlin, P., Simonoff, E., Kennedy, J., & Baird, G. (2016). Comparison of parental estimate of developmental age with measured IQ in children with neurodevelopmental disorders. Child: Care, Health and Development, 42(4), 486-493. Chiang, C. H., Lin, T. L., Lin, H. Y., Ho, S. Y., Wong, C. C., & Wu, H. C. (2023). Short-term low-intensity early start Denver Model program implemented in regional hospitals in Northern Taiwan. Autism, 27(3), 778-787. Cidav, Z., Munson, J., Estes, A., Dawson, G., Rogers, S., & Mandell, D. (2017). Cost offset associated with Early Start Denver Model for children with autism. Journal of the American Academy of Child & Adolescent Psychiatry, 56(9), 777-783. Cidav, Z., Mandell, D., Ingersoll, B., & Pellecchia, M. (2023). Programmatic costs of project impact for children with autism: a time-driven activity based costing study. Administration and Policy in Mental Health and Mental Health Services Research, 50(3), 402-416. 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, 92-102. Cohen, J. (1992). Statistical power analysis. Current directions in psychological science, 1(3), 98-101. Cohen, J. (2013). Statistical power analysis for the behavioral sciences. routledge. Colombi, C., Fish, A., & Ghaziuddin, M. (2020). Utility of the ADOS-2 in children with psychiatric disorders. European child & adolescent psychiatry, 29, 989-992. Colombi, C., Narzisi, A., Ruta, L., Cigala, V., Gagliano, A., Pioggia, G., Siracusano, R., Rogers, S. J., & Muratori, F. (2018). Implementation of the Early Start Denver Model in an Italian community. Autism, 22(2), 126–133. Dawson, G., & Adams, A. (1984). Imitation and social responsiveness in autistic children. Journal of abnormal child psychology, 12(2), 209-226. Dawson, G., Jones, E. J., Merkle, K., Venema, K., Lowy, R., Faja, S., ... & Webb, S. J. (2012). Early behavioral intervention is associated with normalized brain activity in young children with autism. Journal of the American Academy of Child & Adolescent Psychiatry, 51(11), 1150-1159. Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., ... & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23. Dawson, G., Webb, S. J., & McPartland, J. (2005). Understanding the nature of face processing impairment in autism: Insights from behavioral and electrophysiological studies. Developmental Neuropsychology, 27(3), 403–424. Devescovi, R., Monasta, L., Mancini, A., Bin, M., Vellante, V., Carrozzi, M., & Colombi, C. (2016). Early diagnosis and Early Start Denver Model intervention in autism spectrum disorders delivered in an Italian Public Health System service. Neuropsychiatric disease and treatment, 12, 1379. Eapen, V., Črnčec, R., & Walter, A. (2013). Clinical outcomes of an early intervention program for preschool children with autism spectrum disorder in a community group setting. BMC pediatrics, 13(1), 1-9. Estes, A., Munson, J., Rogers, S. J., Greenson, J., Winter, J., & Dawson, G. (2015). Long-term outcomes of early intervention in 6-year-old children with autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 54(7), 580-587. Farmer, C., Golden, C., & Thurm, A. (2016). Concurrent validity of the differential ability scales, with the Mullen Scales of Early Learning in young children with and without neurodevelopmental disorders. Child Neuropsychology, 22(5), 556-569. Fountain, C., Winter, A. S., & Bearman, P. S. (2012). Six developmental trajectories characterize children with autism. Pediatrics, 129(5), e1112-e1120. Fox, S.A. An Early Start Denver Model-Based Group Intervention for Parents of Very Young Children Diagnosed with or at Risk for Autism Spectrum Disorder. Ph.D. Thesis, University at Albany. Department of Psychology, Albany, NY, USA, 2017. Fuller, E. A., & Kaiser, A. P. (2020). The effects of early intervention on social communication outcomes for children with autism spectrum disorder: A meta-analysis. Journal of autism and developmental disorders, 50(5), 1683-1700. Geoffray, M. M., Denis, A., Mengarelli, F., Peter, C., Gallifet, N., Beaujeard, V., ... & Touzet, S. (2019). Using ESDM 12 hours per week in children with autism spectrum disorder: Feasibility and results of an observational study. Psychiatria Danubina, 31(3), 333-339. Georgiades, S., Tait, P. A., McNicholas, P. D., Duku, E., Zwaigenbaum, L., Smith, I. M., ... & Szatmari, P. (2022). Trajectories of symptom severity in children with autism: Variability and turning points through the transition to school. Journal of autism and developmental disorders, 1-10. Godel, M., Robain, F., Kojovic, N., Franchini, M., Wood de Wilde, H., & Schaer, M. (2022). Distinct patterns of cognitive outcome in young children with autism spectrum disorder receiving the Early Start Denver Model. Frontiers in Psychiatry, 13, 835580. Harris, S. L., & Handleman, J. S. (2000). Age and IQ at intake as predictors of placement for young children with autism: A four-to six-year follow-up. Journal of autism and developmental disorders, 30, 137-142. Hart, B. M., & Risley, T. R. (1968). Establishing use of descriptive adjectives in the spontaneous speech of disadvantaged preschool children. Journal of Applied Behavior Analysis, 1, 109–120. Hart, B., & Risley, T. R. (1975). Incidental teaching of language in the preschool 1. Journal of applied behavior analysis, 8(4), 411-420. Holzinger, D., Laister, D., Vivanti, G., Barbaresi, W. J., & Fellinger, J. (2019). Feasibility and outcomes of the Early Start Denver Model implemented with low intensity in a community setting in Austria. Journal of Developmental & Behavioral Pediatrics, 40(5), 354-363. Ingersoll, B., & Wainer, A. (2013a). Initial efficacy of Project ImPACT: A parent-mediated social communication intervention for young children with ASD. Journal of Autism and Developmental Disorders, 43, 2943–2952. Ingersoll, B., & Wainer, A. (2013b). Pilot study of a school-based parent training program for preschoolers with ASD. Autism—International Journal of Research and Practice, 17, 434–448. Itzchak, E. B., & Zachor, D. A. (2009). Change in autism classification with early intervention: Predictors and outcomes. Research in Autism Spectrum Disorders, 3(4), 967-976. Johnson, V. E. (2013). “Revised standards for statistical evidence.” PNAS, 110(48), 19313–19317. Kaale, A., Fagerland, M. W., Martinsen, E. W., & Smith, L. (2014). Preschool-based social communication treatment for children with autism: 12-month follow-up of a randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 53, 188–198. Kaale, A., Smith, L., & Sponheim, E. (2012). A randomized controlled trial of preschool based joint attention intervention for children with autism. Journal of Child Psychology and Psychiatry, 53, 97–105. Kaiser, A. P., & Hester, P. P. (1994). Generalized effects of enhanced milieu teaching. Journal of Speech, Language, and Hearing Research, 37(6), 1320-1340. Kanner, L. (1943). Autistic disturbances of affective contact. Nervous child, 2(3), 217-250. Kasari, C., Gulsrud, A., Freeman, S., Paparella, T., & Hellemann, G. (2012). Longitudinal follow-up of children with autism receiving targeted interventions on joint attention and play. Journal of the American Academy of Child & Adolescent Psychiatry, 51(5), 487-495. Kasari, C., Gulsrud, A., Wong, C., Kwon, S., & Locke, J. (2010). Randomized controlled caregiver mediated joint engagement intervention for toddlers with autism. Journal of Autism and Developmental Disorders, 40, 1045–1056. Kasari, C., Kaiser, A., Goods, K., Nietfeld, J., Mathy, P., Landa, R., . . . Almirall, D. (2014). Communication interventions for minimally verbal children with autism: A sequential multiple assignment randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 53, 635–646. Kasari, C., Lawton, K., Shih, W., Landa, R., Lord, C., Orlich, F., . . . Senturk, D. (2014). Caregiver-mediated intervention for low-resourced preschoolers with autism: An RCT. Pediatrics, 134, e72–e79. Kasari, C., Locke, J., Gulsrud, A., & Rotheram-Fuller, E. (2011). Social networks and friendships at school: Comparing children with and without ASD. Journal of autism and developmental disorders, 41, 533-544. Kasari, C., Paparella, T., Freeman, S. N., & Jahromi, L. (2008). Language outcome in autism: Randomized comparison of joint attention and play interventions. Journal of Consulting and Clinical Psychology, 76, 125–137. Koegel, R. L., & Koegel, L. K. (1988). Generalized responsivity and pivotal behaviors. In R. H. Horner, G. Dunlap, & R. L. Koegel (Eds.), Generalization and maintenance: Life-style changes in applied settings (pp. 41–66). Paul H. Brookes Publishing. Koegel, R. L., & Koegel, L. K. (2006). Pivotal response treatments for autism: Communication, social, & academic development. Paul H Brookes Publishing. Koegel, R. L., Schreibman, L., Good, A. B., Cerniglia, L., Murphy, C., & Koegel, L. K. (1989). How to teach pivotal behaviors to autistic children. Santa Barbara: University of California. Liu, W. X., Shan, L., Li, C. L., Liu, Y. M., Xue, Y., OuYang, Y. L., & Jia, F. Y. (2025). Effects of the Early Start Denver Model on emotional dysregulation and behavior problems in children with Autism spectrum disorder: Effects of the early start Denver model on emotional dysregulation and behavior problems in Chinese children with Autism spectrum disorder. BMC pediatrics, 25(1), 19. Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., ... & Rutter, M. (2000). The Autism Diagnostic Observation Schedule—Generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of autism and developmental disorders, 30, 205-223. Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview-Revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of autism and developmental disorders, 24(5), 659-685. Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., & Pickles, A. (2006). Autism from 2 to 9 years of age. Archives of general psychiatry, 63(6), 694-701. 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. Lovaas, O. I., Berberich, J. P., Perloff, B. F., & Schaeffer, B. (1966). Acquisition of imitative speech by schizophrenic children. Science, 151(3711), 705-707. Lovaas, O. I., Freitag, G., Gold, V. J., & Kassorla, I. C. (1965). Experimental studies in childhood schizophrenia: Analysis of self-destructive behavior. Journal of Experimental Child Psychology, 2(1), 67-84. Magiati, I., Moss, J., Charman, T., & Howlin, P. (2011). Patterns of change in children with autism spectrum disorders who received community based comprehensive interventions in their pre-school years: A seven year follow-up study. Research in Autism Spectrum Disorders, 5(3), 1016-1027. McEachin, J. J., Smith, T., & Lovaas, O. I. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. american Journal on mental retardation. McGee, G. G., Morrier, M. J., & Daly, T. (1999). An incidental teaching approach to early intervention for toddlers with autism. Journal of the association for persons with severe handicaps, 24(3), 133-146. Mok, P. L., Pickles, A., Durkin, K., & Conti‐Ramsden, G. (2014). Longitudinal trajectories of peer relations in children with specific language impairment. Journal of Child Psychology and Psychiatry, 55(5), 516-527. Moss, J., Howlin, P., Savage, S., Bolton, P., & Rutter, M. (2008). Recognition of autism spectrum disorder in children with Down syndrome. Journal of Autism and Developmental Disorders, 38(4), 685–693. Mullen EM. Mullen Scales of Early Learning: AGS edition. Circle Pines, MN: American Guidance Service Publishing; 1995. O’Connor, A. B., & Healy, O. (2010). Long-term post-intensive behavioral intervention outcomes for five children with autism spectrum disorder. Research in Autism Spectrum Disorders, 4(4), 594-604. Orsmond, G. I., Krauss, M. W., & Seltzer, M. M. (2004). Peer relationships and social and recreational activities among adolescents and adults with autism. Journal of autism and developmental disorders, 34(3), 245-256. Peköz, H. & Acikel, C. (2021). “Permutation tests are robust and powerful at 0.5% and 5% significance levels.” Behavior Research Methods, 53, 2481–2501. 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. 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. Rogers, S. J., & Dawson, G. (2010). Early Start Denver Model for young children with autism: Promoting language, learning, and engagement. New York, NY: Guilford Press. Rogers, S. J., & DiLalla, D. L. (1991). A comparative study of the effects of a developmentally based instructional model on young children with autism and young children with other disorders of behavior and development. Topics in Early Childhood Special Education, 11(2), 29-47. Rogers, S. J., & Pennington, B. F. (1991). A theoretical approach to the deficits in infantile autism. Development and psychopathology, 3(2), 137-162. Rogers, S. J., Estes, A., Lord, C., Munson, J., Rocha, M., Winter, J., ... & Talbott, M. (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. Rogers, S. J., Estes, A., Lord, C., Vismara, L., Winter, J., Fitzpatrick, A., ... & 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. Rogers, S. J., Herbison, J., Lewis, H., Pantone, J., & Reis, K. (1986). An approach for enhancing the symbolic, communicative and interpersonal functioning of young children with autism and severe emotional handicaps. Journal of the Division of Early Childhood, 10, 135–148. Ryberg, K. H. (2015). Evidence for the implementation of the Early Start Denver Model for young children with autism spectrum disorder. Journal of the American Psychiatric Nurses Association, 21(5), 327-337. Sallows, G. O., & Graupner, T. D. (2005). Intensive behavioral treatment for children with autism: Four-year outcome and predictors. American journal on mental retardation, 110(6), 417-438. Sandbank, M., Pustejovsky, J. E., Bottema-Beutel, K., Caldwell, N., Feldman, J. I., LaPoint, S. C., & Woynaroski, T. (2024). Determining associations between intervention amount and outcomes for young autistic children: a meta-analysis. JAMA pediatrics, 178(8), 763-773. Sattler, J. M., & Atkinson, L. (1993). Item equivalence across scales: The WPPSI—R and WISC-III. Psychological assessment, 5(2), 203. Schreibman, L. (2005). The science and fiction of autism. Harvard University Press. Schreibman, L., & Pierce, K. (1993). Achieving greater generalization of treatment effects in children with autism: Pivotal response training and self management. The Clinical Psychologist, 46, 184-191. Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., ... & Halladay, A. (2015). Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder. Journal of autism and developmental disorders, 45(8), 2411-2428. Sinai-Gavrilov, Y., Gev, T., Mor-Snir, I., Vivanti, G., & Golan, O. (2020). Integrating the Early Start Denver Model into Israeli community autism spectrum disorder preschools: Effectiveness and treatment response predictors. Autism, 24(8), 2081-2093. Smith, E. A. (2017). Evolutionary ecology and human behavior. Routledge. Spelke, E., Bernier, E. P., & Skerry, A. E. (2013). Core social cognition. In Navigating the social world. What infants, children, and other species can teach us (pp. 11–16). Oxford: Oxford University Press. Starr, E. M., Popovic, S., & McCall, B. P. (2016). Supporting children with autism spectrum disorder at primary school: Are the promises of early intervention maintained?. Current Developmental Disorders Reports, 3, 46-56. Ungar, W. J., Tsiplova, K., Millar, N., & Smith, I. M. (2018). Development of the Resource Use Questionnaire (RUQ–P) for families with preschool children with neurodevelopmental disorders: Validation in children with autism spectrum disorder. Clinical Practice in Pediatric Psychology, 6(2), 164. Vinen, Z., Clark, M., & Dissanayake, C. (2022). Social and Behavioural Outcomes of School Aged Autistic Children Who Received Community-Based Early Interventions. Journal of Autism and Developmental Disorders, 1-12. Vinen, Z., Clark, M., Paynter, J., & Dissanayake, C. (2018). School age outcomes of children with autism spectrum disorder who received community-based early interventions. Journal of autism and developmental disorders, 48(5), 1673-1683. 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. Vivanti, G., & Rogers, S. J. (2014). Autism and the mirror neuron system: insights from learning and teaching. Philosophical Transactions of the Royal Society B: Biological Sciences, 369(1644), 20130184. Vivanti, G., Bottema-Beutel, K., & Turner-Brown, L. (Eds.). (2020). Clinical guide to early interventions for children with autism. Berlin/Heidelberg, Germany: Springer. Vivanti, G., Dissanayake, C., & Victorian ASELCC Team. (2016). Outcome for children receiving the Early Start Denver Model before and after 48 months. Journal of autism and developmental disorders, 46, 2441-2449. Vivanti, G., Dissanayake, C., Zierhut, C., Rogers, S. J., & Victorian ASELCC Team. (2013). Brief report: Predictors of outcomes in the Early Start Denver Model delivered in a group setting. Journal of autism and developmental disorders, 43, 1717-1724. Vivanti, G., Paynter, J., Duncan, E., Fothergill, H., Dissanayake, C., Rogers, S. J., & Victorian ASELCC Team. (2014). Effectiveness and feasibility of the Early Start Denver Model implemented in a group-based community childcare setting. Journal of autism and developmental disorders, 44, 3140-3153. 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. Wang, Z., Loh, S. C., Tian, J., & Chen, Q. J. (2022). A meta-analysis of the effect of the Early Start Denver Model in children with autism spectrum disorder. International Journal of Developmental Disabilities, 68(5), 587-597. Wing, L. (1988). The continuum of autistic characteristics (pp. 91-110). Springer US. Xu, Y., Yang, J., Yao, J., Chen, J., Zhuang, X., Wang, W., ... & Lee, G. T. (2018). A pilot study of a culturally adapted early intervention for young children with autism spectrum disorders in China. Journal of Early Intervention, 40(1), 52-68. Yang, Y., Wang, H., Xu, H., Yao, M., & Yu, D. (2023). Randomized, controlled trial of a mixed early start Denver model for toddlers and preschoolers with autism. Autism Research, 16(8), 1640-1649. 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.zh_TW