自閉症類群障礙兒童家長之自學網路療育課程：隨機控制研究的初步發現

Development of a Self-Directed Internet Program for Parents with Young Children with Autism Spectrum Disorder

研究目的：本研究設計自閉症類群障礙（Autism Spectrum Disorder, ASD）兒童之家長的網路自學課程，並探討此課程之成效。研究方法：44名（18至54個月）ASD兒童之家長，以隨機控制試驗設計，分為家長自學組和對照組。測量指標共三項：（1）家長對療育知識的理解度；（2）家長執行療育技巧的品質；（3）兒童的社交溝通能力表現。研究結果：家長自學組與對照組在課程前，三項指標的表現未有顯著差異；十三週後，相較於對照組，家長自學組家長在療育知識及療育真確度具顯著進展，然兩組兒童的社交溝通能力未有顯著組間差異。研究結論：網站自學課程不僅可增進家長對療育知識的概念，亦能提升親子互動的介入品質，但短期內尚未能有效增進兒童的社交溝通能力表現。未來應納入更大量的樣本，並以標準化工具評估兒童表現，來探究其療效。

Purpose: We developed a self-directed internet program for parents who have children with autism spectrum disorder (ASD) designed to increase their intervention knowledge and strategies for improving their children’s communication skills. We examined the program’s learning outcomes in terms of intervention knowledge, parental intervention quality, and change in child social communication skills. Methods: A total of 44 parents who have children with ASD (aged between 18-54 months) completed the program and all measures. Families were randomly assigned to a self-directed or control group. All parents received
their regular community intervention. Parents in the self-directed group additionally received access to the 13 weekly online lessons designed for this study. All participants completed 3 measures at the beginning and end of the 13 weeks: (1) a questionnaire we developed to reflect parental intervention knowledge, (2) the fidelity rating system of the Early Start Denver Model to evaluate parental intervention quality, (3) and a parentreport social communication checklist to assess child social communication skills. Results: Analysis of the initial baseline measurement indicated no significant difference in scores on any of the measures between the self-directed and control groups. After 13 weeks, only the self-directed group demonstrated significant improvement in intervention knowledge and implementation fidelity. Parents of both groups reported significant gains in child social communication skills. Conclusions: The preliminary findings suggest that a self-directed internet program can improve parental intervention knowledge and quality. However, it may not be effective for improving children’s social communication skills in the short term. Future studies are needed to investigate additional objective outcome indicators for the children’s performance. Recruiting a larger group of families may also allow for additional insights into the effectiveness of web-based self-directed programs supporting parents who have children with ASD.