Objective To identify background factors influencing outcomes of rehabilitation interventions in children with autism spectrum disorder (ASD), so as to provide evidence for the optimization of individualized rehabilitation strategies. Methods A retrospective cohort study was conducted on 75 children diagnosed with ASD who received evidence-based and diversified interventions at the Department of Rehabilitation, Children's Hospital, Zhejiang University School of Medicine between December 2020 and March 2025. The follow-up duration was 0.76 (0.39, 1.19) years. Clinical and demographic data, as well as follow-up data from the Griffiths Developmental Scales were collected. Generalized estimating equations (GEE) were used to assess the effects of intervention duration and background factors on changes in developmental quotients (DQs) across Griffiths subscales. Results After intervention, significant improvements were observed in the DQs for language (Z=4.04), personal-social (t=3.43), hand-eye coordination (t=2.07), performance (t=2.68), logical reasoning (t=5.23), and general developmental quotient (t＝3.93) (P<0.05). Notably, DQs in domains of personal-social (β=8.55), language (β=11.01), hand-eye coordination (β=5.55), performance (β=8.02), and logical reasoning (β=10.63) significantly improved for children who received intervention for more than one year (P<0.05). Multiple background factors showed significant main effects on intervention efficacy. Among them, prematurity, Mandarin-speaking environment, father's high educational level, and parents of appropriate age were associated with higher DQ improvements (P<0.05). Significant interaction effects were found between intervention duration and factors such as the child's gender and caregiver structure (P<0.05). For male children, the benefits in personal-social increased significantly with intervention duration (χ2=12.993, P=0.005). In terms of caregiving structure, children initially cared for exclusively by parents or grandparents showed faster improvement, whereas the co-parenting by two generations model proved to be optimal in the long term(P<0.01). Conclusions Rehabilitation outcomes in children with ASD are shaped by multiple individual and family background factors. Longer intervention duration is associated with higher DQs. Tailored and sustained intervention strategies should be developed based on a comprehensive consideration of individual characteristics and family factors.
Key words
autism spectrum disorder /
rehabilitation intervention /
Griffiths Developmental Scales
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