Charting the trajectory of executive control in autism in order to optimize delivery of intervention

在了解早期症状的过程和发展方面取得了显著的进展。 自闭症谱系障碍(ASD)儿童的早期干预。尽管如此，治疗反应仍然很高。 变化无常，难以预测。为了了解患有自闭症儿童的个体轨迹(IACC， 2013)，必须更好地了解相关减损的过程。Brains R01项目的目标是 将启动一项跨学科的纵向研究计划，旨在提供详细的 认知控制和工作记忆的NIMH RDoC域的特征，因为它们为早期 ASD的病程。这种方法为绘制ASD的早期轨迹提供了一个创新的视角 决定何时、何地和如何进行干预的命令(NIMH战略目标2)。执行控制是 自闭症患者普遍受损，包括认知控制和工作记忆的各个方面 (Guerts等人，2014年；Kenworth等人，2008年)。使用加速纵向设计来遵循行为 以及120名2岁和120名4岁儿童(患有自闭症和年龄-以及智商匹配)的神经轨迹 对比儿童)三年来，该项目将解决三个关键目标：(1)准确确定 首先出现独特和稳定的执行障碍轮廓的时间点；(2)映射神经和 通过检查不同但相互关联的 执行控制的子域，以便更好地了解个体随时间的差异；以及，(3) 在自闭症的早期检查执行控制和社会功能之间的关系，以确定 执行控制是否对优化社会结果至关重要。这一信息可能会对 通过提供基本信息，改变对患有自闭症儿童的早期干预的方式 关于幼儿和儿童的潜在生物和行为治疗目标和干预结果 患有自闭症的学龄前儿童。它还使用脑电生理学提供了一个开创性的一瞥 ASD儿童在确诊后的第一年内的早期纵向脑发育。我们的 认知神经科学实验室对幼儿的跨学科专业知识独一无二 通过在PI目前由K99/R00资助的研究基础上进行研究，使我们能够实现这些目标 有针对性的执行控制训练的执行控制和治疗反应的个体差异 自闭症学龄儿童。此外，该Brains项目还将聘请一个外部顾问委员会 具有在典型发展和早期执行功能出现的测量方面的专业知识- 为患有自闭症的儿童制定有针对性的治疗，以便(1)优化创新的测量方法 用电池表征执行控制--从ASD的诊断到开学，以及(2)准备 用于后续的干预研究。

Striking advances have been made in understanding the early course of symptoms and the development of early intervention for children with autism spectrum disorder (ASD). Nonetheless, treatment response is highly variable and difficult to predict. In order to understand the individual trajectories of children with ASD (IACC, 2013), the course of associated impairments must be better understood. The goal of this BRAINS R01 project will be to launch an interdisciplinary longitudinal research program aimed at providing a detailed characterization of the NIMH RDoC domains of cognitive control and working memory as they inform the early the course of ASD. This approach provides an innovative perspective to charting the early trajectory of ASD in order to determine when, where, and how to intervene (NIMH Strategic Objective 2). Executive control is generally impaired in individuals with ASD and encompasses aspects of cognitive control and working memory (Guerts et al., 2014; Kenworthy et al., 2008). Using an accelerated longitudinal design to follow the behavioral and neural trajectories of 120 2-year-olds and 120 4-year-olds (with ASD and age- as well as IQ-matched comparison children) for three years, this project will address three critical goals: (1) to precisely determine the point at which a unique and stable profile of executive impairments first emerges; (2) to map the neural and neuropsychological profile of executive control development by examining distinct, but interrelated, subdomains of executive control in order to better understand individual differences over time; and, (3) to examine the relation between executive control and social function early in the course of ASD to determine whether executive control is critical to optimizing social outcomes. This information potentially stands to change the way early intervention is delivered for young children with ASD by providing essential information about potential biological and behavioral treatment targets and intervention outcomes for toddlers and preschoolers with ASD. It also uses electroencephaolography to provide a groundbreaking glimpse into the early, longitudinal brain development of children with ASD in the first years following diagnosis. Our interdisciplinary expertise with very young children at the Laboratories of Cognitive Neuroscience uniquely positions us to achieve these goals by building on the PI's current K99/R00 funded study that examines individual differences in executive control and treatment response to targeted executive control training among school aged children with ASD. In addition, this BRAINS project will employ an external advisory committee with expertise in the measurement of the emergence of executive function in typical development and early- targeted treatment development for children with ASD in order to (1) optimize an innovative measurement battery to characterize executive control–from diagnosis of ASD to the beginning of school, and (2) to prepare for a subsequent intervention study.