Characteristics of friendship interventions.

Rationale Children with neurodevelopmental disorders such as attention-deficit hyperactivity disorder (ADHD), autism, developmental language disorder (DLD), intellectual disability (ID), and social (pragmatic) communication disorder (SPCD) experience difficulties with social functioning due to differences in their social, emotional and cognitive skills. Previous systematic reviews have focussed on specific aspects of social functioning rather than broader peer functioning and friendships. Objective To systematically review and methodologically appraise the quality and effectiveness of existing intervention studies that measured friendship outcomes for children with ADHD, autism, DLD, ID, and SPCD. Method Following PRISMA guidelines, we searched five electronic databases: CINAHL, Embase, Eric, PsycINFO, and PubMed. Two independent researchers screened all abstracts and disagreements were discussed with a third researcher to reach consensus. The methodological quality of studies was assessed using the Cochrane Risk of Bias Tool for Randomised Trials. Results Twelve studies involving 15 interventions were included. Studies included 683 children with a neurodevelopmental disorder and 190 typically-developing children and diagnosed with either autism or ADHD. Within-group meta-analysis showed that the pooled intervention effects for friendship across all interventions were small to moderate (z = 2.761, p = 0.006, g = 0.485). The pooled intervention effect between intervention and comparison groups was not significant (z = 1.206, p = 0.400, g = 0.215). Conclusion Findings provide evidence that some individual interventions are effective in improving social functioning and fostering more meaningful friendships between children with neurodevelopmental disorders and their peers. Effective interventions involved educators, targeted child characteristics known to moderate peer functioning, actively involved peers, and incorporated techniques to facilitate positive peer perceptions and strategies to support peers. Future research should evaluate the effectiveness of friendship interventions for children with DLD, ID and SPCD, more comprehensively assess peer functioning, include child self-report measures of friendship, and longitudinally evaluate downstream effects on friendship.研究背景：患有注意缺陷与多动障碍（attention-deficit hyperactivity disorder, ADHD）、孤独症（autism）、发育性语言障碍（developmental language disorder, DLD）、智力障碍（intellectual disability, ID）及社交（语用）沟通障碍（social (pragmatic) communication disorder, SPCD）等神经发育障碍（neurodevelopmental disorders）的儿童，由于其社交、情绪与认知技能存在差异，往往存在社交功能受损的问题。既往系统综述多聚焦于社交功能的特定维度，而非更宽泛的同伴交往与友谊领域。 研究目的：本研究旨在对现有针对ADHD、孤独症、DLD、ID及SPCD儿童、且以友谊为结局指标的干预研究开展系统综述，并从方法学层面评估其研究质量与干预效果。 研究方法：本研究遵循系统综述与荟萃分析报告规范（PRISMA），检索了CINAHL、Embase、ERIC、PsycINFO及PubMed共5个电子数据库。由2名独立研究者对所有摘要进行筛查，若出现意见分歧，则与第三名研究者共同讨论以达成共识。研究的方法学质量采用Cochrane随机试验偏倚风险评估工具进行评定。 研究结果：本研究共纳入12项涉及15项干预措施的研究，受试对象包括683名神经发育障碍儿童与190名典型发育儿童，其中神经发育障碍儿童均被诊断为孤独症或ADHD。组内荟萃分析结果显示，所有干预措施针对友谊的合并效应量为小至中等水平（z=2.761，p=0.006，g=0.485）。干预组与对照组的合并干预效应未达到统计学显著性（z=1.206，p=0.400，g=0.215）。 研究结论：本研究结果证实，部分个体化干预措施可有效改善神经发育障碍儿童的社交功能，并助力其与同伴建立更具意义的友谊关系。有效的干预措施通常包含教育者参与、针对已知可调节同伴交往能力的儿童特征进行干预、主动纳入同伴参与，以及采用可促进同伴积极认知的技术与支持同伴的策略。未来研究应针对DLD、ID及SPCD儿童开展友谊干预效果评估，更全面地测评同伴交往功能，纳入儿童自我报告的友谊评估工具，并纵向追踪友谊相关的下游效应。