Дополнительные и альтернативные вмешательства при расстройствах аутистического спектра: обзор для родителей и клиницистов

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Аннотация

Методы дополнительных и альтернативных вмешательств (Complementary and Alternative Therapy, CAT), применяемые в работе с детьми с расстройствами аутистического спектра (РАС), распространены в европейских странах и в Российской Федерации, однако их эффективность и безопасность обычно не рассматриваются клиницистами и родителями составлении рекомендаций и использовании. Данный аналитический обзор посвящен наиболее распространенным дополнительным и альтернативным вмешательствам, применяемым в работе с детьми с РАС. На основе анализа информации, представленной в мета-анализах, систематических обзорах и рандомизированных контролируемых исследованиях в базе данных PubMed, рассматриваются безопасность и эффективность каждого вида вмешательств. Обнаружено, что из всех рассмотренных методов только вмешательства с применением мелатонина можно считать безопасными и эффективными для детей с РАС с сопутствующими нарушениями сна. Методы, которые были классифицированы как безопасные, но не доказавшие свою эффективность, рекомендуется применять только в том случае, если они не противоречат терапии РАС «первой линии» – применению прикладного анализа поведения (Applied Behavioral Analysis, ABA). Методы, доказательств эффективности которых обнаружено не было, такие как терапия слуховой интеграции, биоакустическая коррекция, терапия сенсорной интеграции, микрополяризация, пет-терапия и диета, не должны рекомендоваться в качестве альтернативных методов терапии и могут использоваться только в дополнение к методам лечения на основе ABA-вмешательства. Не рекомендуется использовать хелатирование, гипербарическую кислородную терапию и холдинг- терапию по причине их установленного вредоносного психологического и физического воздействия. При выборе методов дополнительных и альтернативных вмешательств при РАС мы рекомендуем родителям и клиницистам использовать критерии, предложенные Н. Лофтхаусом и коллегами (2012): могут быть рекомендованы только безопасные, простые, экономные и разумные методы вмешательств, тогда как методы лечения, которые являются рискованными, трудно реализуемыми или дорогими, использовать не следует.

Общая информация

Ключевые слова: дополнительные вмешательства, альтернативные вмешательства, CAT, модель безопасность-эффективность, расстройства аутистического спектра

Рубрика издания: Методы и методики

Тип материала: научная статья

DOI: https://doi.org/10.17759/cpse.2020090310

Финансирование. Подготовка данной статьи была профинансирована Российским Фондом Фундаментальных Исследований (№17-29-02384, руководитель – Е.Л. Григоренко).

Тематический сетевой сборник: Клинико-психологические аспекты развития и обучения детей с ограниченными возможностями здоровья

Для цитаты: Жукова М.А., Таланцева О.И., Логвиненко Т.И., Титова О.С., Григоренко Е.Л. Дополнительные и альтернативные вмешательства при расстройствах аутистического спектра: обзор для родителей и клиницистов [Электронный ресурс] // Клиническая и специальная психология. 2020. Том 9. № 3. С. 142–173. DOI: 10.17759/cpse.2020090310

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Информация об авторах

Жукова Марина Андреевна, кандидат психологических наук, постдокторант, Бостонская детская больница, Гарвардская медицинская школа, Бостон, США, ORCID: https://orcid.org/0000-0002-3069-570X, e-mail: marina.zhukova@childrens.harvard.edu

Таланцева Оксана Игоревна, старший специалист Научного центра когнитивных исследований, Научно-технологический университет «Сириус» (АНО ВО «Университет “Сириус”»), пгт. Сириус, Россия, ORCID: https://orcid.org/0000-0002-7555-1216, e-mail: talantseva.oi@talantiuspeh.ru

Логвиненко Татьяна Игоревна, клинический психолог, научный сотрудник, Университетская клиника, Мюнхенский университет имени Людвига-Максимилиана, приглашенный исследователь, Институт образования, Национальный исследовательский университет «Высшая школа экономики» (ФГАОУ ВО «НИУ ВШЭ»), Мюнхен, Германия, ORCID: https://orcid.org/0000-0001-7430-1963, e-mail: logvinenkota.spb@gmail.com

Титова Ольга С., инженер-исследователь, лаборатория междисциплинарных исследований развития человека, Санкт-Петербургский государственный университет, Санкт-Петербург, Россия, ORCID: https://orcid.org/0000-0002-3839-7555, e-mail: olga.tiitova@gmail.com

Григоренко Елена Леонидовна, PhD, профессор, заслуженный профессор психологии Хью Рой и Лилли Кранц Каллен, Хьюстонский университет, Хьюстон, Техас, США; ведущий научный сотрудник, Московский государственный психолого-педагогический университет (МГППУ), Москва, Россия; профессор и и.о. директора Научного центра когнитивных исследований, Научно-технологический университет «Сириус», ФТ «Сириус», Россия; адъюнкт-профессор, Центр исследований детства и Лаборатории Хаскинса, Йельский университет, Нью-Хейвен, Коннектикут, США; профессор, Медицинский колледж Бейлора, Член редакционных советов журналов «Клиническая и специальная психология», «Экспериментальная психология» и «Психологическая наука и образование», Хьюстон, США, ORCID: https://orcid.org/0000-0001-9646-4181, e-mail: elena.grigorenko@times.uh.edu

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