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

绘制自闭症执行控制轨迹以优化干预措施

• 批准号: 10172979
• 负责人: Susan Faja
• 金额: $ 51.24万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10172979
• 关键词: 2 year old; 4 year old; Address; Advisory Committees; Affect; Age; Behavior Therapy; Behavioral; Biological Markers; Biological Response Modifier Therapy; Brain; Child; Child Development; Child Rearing; Chronology; Cognition; Cognitive; Complex; Conflict (Psychology); Development; Developmental Delay Disorders; Diagnosis; Early Intervention; Electroencephalography; Enrollment; Executive Dysfunction; Exhibits; Funding; Goals; Impairment; Individual; Individual Differences; Intellectual functioning disability; Intervention; Intervention Studies; Investigation; Laboratories; Life; Link; Maintenance; Maps; Matched Group; Measurement; National Institute of Mental Health; Neuropsychology; Nursery Schools; Onset of illness; Outcome; Pattern; Positioning Attribute; Psyche structure; Research; Research Domain Criteria; Sampling; School-Age Population; Schools; Secondary to; Services; Severities; Short-Term Memory; Social Development; Social Functioning; Social outcome; Social skills development; Structure; Symptoms; System; Testing; Time; Toddler; Training; Update; Work; autism spectrum disorder; autistic children; cognitive ability; cognitive control; cognitive development; cognitive neuroscience; cognitive system; cohort; effective therapy; executive function; individuals with autism spectrum disorder; innovation; longitudinal design; mental age; neural correlate; novel; programs; relating to nervous system; response; service intervention; social; social deficits; social skills; success; targeted treatment; treatment response

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.

在了解症状的早期过程和疾病的发展方面已经取得了惊人的进展。 自闭症谱系障碍儿童的早期干预。尽管如此，治疗反应是高度 多变且难以预测。为了了解ASD儿童（IACC， 2013），必须更好地理解相关损害的过程。BRAINS R 01项目的目标是 将启动一个跨学科的纵向研究计划，旨在提供一个详细的 表征认知控制和工作记忆的NIMH RDoC域，因为它们告知了早期 ASD的病程。这种方法提供了一个创新的视角来绘制ASD的早期轨迹， 以确定何时、何地以及如何进行干预（NIMH战略目标2）。执行控制是 通常在ASD患者中受损，包括认知控制和工作记忆方面 （Guidel等人，2014; Kenworthy等人，2008年）。使用加速纵向设计来遵循行为 120名2岁儿童和120名4岁儿童的神经轨迹（ASD和年龄以及智商匹配） 三年来，该项目将致力于三个关键目标：（1）准确确定 点，在这一点上，一个独特的和稳定的档案执行障碍首次出现;（2）映射的神经和 执行控制发展的神经心理学概况，通过检查不同的，但相互关联的， 执行控制的子领域，以便更好地了解随着时间的推移的个体差异;（3） 在ASD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。这一信息可能意味着 通过提供必要的信息，改变为ASD幼儿提供早期干预的方式 关于潜在的生物和行为治疗目标和幼儿干预结果， 患有自闭症的学龄前儿童它还使用脑电图来提供一个开创性的一瞥， ASD儿童在诊断后的第一年内的早期纵向大脑发育。我们 在认知神经科学实验室， 使我们能够在PI目前K99/R 00资助的研究的基础上实现这些目标， 执行控制和治疗反应的个体差异有针对性的执行控制训练， ASD学龄儿童此外，BRAINS项目还将聘请外部咨询委员会 具有测量典型发育和早期执行功能出现的专业知识， 针对ASD儿童的靶向治疗开发，以便（1）优化创新测量 电池表征执行控制-从ASD的诊断开始上学，（2）准备 进行后续干预研究。