Factors influencing the rehabilitation effect of children with autism spectrum disorder receiving program for the education &amp; enrichment of relational skills training and construction of a Nomogram prediction model

DONG Haipeng; YANG Siyuan; LI Weidong; YU Jing

doi:10.11852/zgetbjzz2022-0821

PDF(1197 KB)

Chinese Journal of Child Health Care ›› 2023, Vol. 31 ›› Issue (3) : 252-258. DOI: 10.11852/zgetbjzz2022-0821

Factors influencing the rehabilitation effect of children with autism spectrum disorder receiving program for the education & enrichment of relational skills training and construction of a Nomogram prediction model

DONG Haipeng, YANG Siyuan, LI Weidong, YU Jing

Author information +

History +

Abstract

Objective To explore the influencing factors of program for the education & enrichment of relational skills(PEERS) training on the rehabilitation effect of children with autism spectrum disorder (ASD), to construct a Nomogram for predicting rehabilitation effect, and to test the predictive efficiency of the model. Method A total of 146 ASD children who received PEERS training in Guangzhou Women and Children Medical Center from February 2019 to September 2021 were included in the study. The participants were divided randomly into training set (102 cases) and validation set (44 cases) in a ratio of 7∶3, by using the R software. All children were evaluated by the Autism Treatment Evaluation Checklist(ATEC) before and after training, and were divided into good rehabilitation group (ATEC score decline rate ≥30%) and poor rehabilitation group (ATEC score decline rate < 30%) according to the rehabilitation effect. The t-test and χ²test were used to compare the baseline characteristics of the training set and validation set. Univariate Logistic analysis and multivariate Logistic analysis were used to determine the factors influencing the rehabilitation effect of children with ASD in training set. Nomogram was constructed by the RMS packages in R software based on the multivariate Logistic model, and the differentiation and prediction efficiency was evaluated. Results Among 102 ASD children receiving PEERS training, of whom 75 cases (73.53%) recovered well and 27 cases (26.47%) recovered poorly. Multivariate Logistic regression analysis of the training set showed that the initial age of training (OR=1.708, P=0.013), severity of disease (OR=3.040, P=0.034), and no confidence in healing of caregivers (OR=4.265, P=0.013) were risk factors for the rehabilitation effect of ASD children after PEERS training. The receiver operating characteristic (ROC) curve showed that the Nomogram model has good discrimination (AUC=0.791, 95%CI:0.685 - 0.896), and the calibration curve showed that the model has good prediction efficiency. Conclusion The Nomogram prediction model, based on four factors:the severity of the child's condition, the child's age at training onset, the caregiver's education and the caregiver's confidence in healing, has good discriminatory and predictive power for the rehabilitation outcomes of ASD children after group social training.

Key words

group social training / program for the education &enrichment of relational skills / autism spectrum disorder / rehabilitation effect / Nomogram prediction model

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

DONG Haipeng, YANG Siyuan, LI Weidong, YU Jing. Factors influencing the rehabilitation effect of children with autism spectrum disorder receiving program for the education & enrichment of relational skills training and construction of a Nomogram prediction model[J]. Chinese Journal of Child Health Care. 2023, 31(3): 252-258 https://doi.org/10.11852/zgetbjzz2022-0821

References

[1] 付林燕, 柯晓燕. 孤独症谱系障碍同胞前瞻性队列行为学及脑影像学研究进展[J]. 中华实用儿科临床杂志, 2021, 36(23):1834-1837.
Fu LY, Ke XY. Research progress of behaviors and brain imaging in siblings with autism spectrum disorders of prospective cohorts[J]. Chin J Appl Clin Pediatr, 2021, 36(23):1834-1837.
[2] Tret G. Imitation recognition by minimally verbal young children:A comparison between down syndrome and autism spectrum disorder[J]. Focus Autism Other Dev Disabl, 2022, 37(1):34-45.
[3] 祖燕飞,杜亚松,姚德胜,等.上海孤独谱系障碍患儿、母亲社交PEERS团体训练效果的研究[J].中国儿童保健杂志,2020,28(5):502-505.
Zu YF, Du YS, Yao DS, et al. Research on effect of social PEERS training for mother and children with autism spectrum disorder in Shanghai[J]. Chin J Child Health Care,2020,28(5):502-505.
[4] 宋蕊, 杜亚松. PEERS对注意缺陷多动障碍青少年社交技能改善的研究进展[J].中国儿童保健杂志, 2018, 26(10):1092-1095.
Song R, Du YS. Research progress on the effect of program for the education & enrichment of relational skills on social skill improvement among adolescents with attention deficit hyperactivity disorder[J]. Chin J Child Health Care, 2018, 26(10):1092-1095.
[5] Veytsman E, Baker E, Martin AM, et al. Perceived and observed treatment gains following PEERS:A preliminary study with Latinx adolescents with ASD[J]. J Autism Dev Disord, 2022:1-14.
[6] Zheng S, Kim H, Salzman E, et al. Improving social knowledge and skills among adolescents with autism:Systematic review and Meta-analysis of UCLA PEERS^® for adolescents[J]. J Autism Dev Disord, 2021,51(12):4488-4503.
[7] Tang M, Wang H, Cao Y, et al. Nomogram for predicting occurrence and prognosis of liver metastasis in colorectal cancer:A population-based study[J].Int J Colorectal Dis,2021, 36(2):271-282.
[8] 美国精神医学学会.精神障碍诊断与统计手册[M].张道龙,译.北京:北京大学出版社,2016:20-50.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders[M]. Zhang DL. Beijing:Peking University Press, 2016:20-50.
[9] Mahapatra S, Vyshedsky D, Martinez S, et al. Autism Treatment Evaluation Checklist (ATEC)norms:A "growth chart" for ATEC score changes as a function of age[J]. Children, 2018,5(2):25-36.
[10] 方慧,任艳玲,李春燕,等. 孤独症治疗评定量表中文版的信度和效度检验[J].四川精神卫生, 2019, 32(6):518-522.
Fang H, Ren YL, Li CY,et al. Reliability and validity of the Chinese version of Autism Treatment Evaluation Checklist [J]. Sichuan Mental Health, 2019, 32(6):518-522.
[11] 周浩,张利利,严卫丽,等.中文修订版孤独症谱系评定量表结构效度分析[J].中国当代儿科杂志,2015,17(12):1282-1285.
Zhou H, Zhang LL, Yan WL, et al. Construct validity of the Autism Spectrum Rating Scale of the Revised Chinese Version[J]. Chin J Contemp Pediatr, 2015,17(12):1282-1285.
[12] 耿丽,李兴华,安辉,等.个体化预测哮喘控制不佳的列线图模型的建立[J].实用心脑肺血管病杂志,2018,26(7):55-59.
Geng L, Li XH, An H, et al. Establishment of a Individualized Predictive Nomogram Model for poor asthma control effect[J]. Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, 2018,26(7):55-59.
[13] Manoli DS, State MW. Autism spectrum disorder genetics and the search for pathological mechanisms [J]. Am J Psychiatry, 2021,178(1):30-38.
[14] 李改智,杜亚松. 社交技能教育和促进项目对孤独谱系障碍青少年社交技能的提升作用研究进展[J].中国儿童保健杂志,2017,25(9):917-920.
Li GZ, Du YS. Research progress on program for the education & enrichment of relational skills to the improvement of social skills in teens with autism spectrum disorder[J]. Chin J Child Health Care, 2017,25(9):917-920.
[15] Green RM, Travers AM, Howe Y, et al. Women and autism spectrum disorder:Diagnosis and implications for treatment of adolescents and adults[J]. Curr Psychiatry Rep, 2019,21(4):22.
[16] 单亚, 朱敏. 特殊教育结合感觉统合训练治疗孤独症谱系障碍患儿疗效观察[J]. 康复学报, 2019, 29(6):55-58.
Shan Y, Zhu M. Special education combined with sensory integration training for children with autism spectrum disorder[J]. Rehabilitation Medicine, 2019, 29(6):55-58,69.
[17] 才娜, 陈晨, 郑雨潇,等. 儿童自闭症综合干预效果及影响因素分析[J]. 现代预防医学, 2018, 45(8):1405-1408.
Cai N, Chen C, Zheng YX, et al. Research on the comprehensive intervention and influencing factors of children with autism[J]. Modern Preventive Medicine, 2018, 45(8):1405-1408.
[18] 汪斯斯, 闫燕, 赵勇帅. 自闭症谱系障碍群体社交技能的干预:效果及其影响因素的元分析[J]. 中国特殊教育, 2019,26(10):43-51,69.
Wang SS, Yan Y, Zhao YS. Interventions for social skills in autism spectrum disorders:A Meta-analysis of effect and influencing factors [J]. Chinese Journal of Special Education, 2019, 26(10):43-51,69.
[19] 傅毅,周爱琴, 戴琼,等.孤独症谱系障碍儿童综合干预年龄及持续时间对治疗效果影响的探讨[J].中国儿童保健杂志, 2016, 24(12):1312-1315.
Fu Y, Zhou AQ, Dai Q, et al. Discussion on the effect of began age and duration of comprehensive intervention on children with autism spectrum disorders[J]. Chin J Child Health Care, 2016, 24(12):1312-1315.
[20] 李洪华, 温和花, 杨丽娟, 等. 不同性别和年龄孤独症谱系障碍儿童症状严重程度及发育水平的差异分析[J].中华行为医学与脑科学杂志,2021,30(1):27-32.
Li HH, Wen HH, Yang LJ, et al. Differences in the autistic severity and developmental level of children with autism spectrum disorder of different gender and age[J]. Chin J Behav Med Brain Sci, 2021,30(1):27-32.
[21] 高迪,于婷,李春丽,等.早期介入丹佛模式的密集训练结合家长培训对孤独症谱系障碍儿童疗效及其对父母育儿压力的影响[J]. 中国当代儿科杂志, 2020, 22(2):158-163.
Gao D, Yu T, Li CL, et al. Effect of parental training based on Early Start Denver Model combined with intensive training on children with autism spectrum disorder and its impact on parenting stress[J]. Chin J Contemp Pediatr, 2020, 22(2):158-163.
[22] 陈玲,陈敏榕,季婧敏.父母团体认知行为干预对孤独症谱系障碍儿童及家庭治疗效果的影响[J].中国儿童保健杂志,2019,27(1):84-87.
Chen L, Chen MR, Ji JM. Treatment effect of parents' cognitive-behavioral group psychotherapy on children with autism spectrum disorder and their families[J].Chin J Child Health Care, 2019,27(1):84-87.