Exploring predictors of response to a peer-mediated communication intervention for minimally verbal preschoolers with ASD

项目摘要 这项R21提案将探索和检查个别儿童的社会变量，这些变量预测了患有自闭症谱系障碍（ASD）的学龄前儿童对同伴介导干预的反应，并仅限于不说话。 通信这个自闭症儿童亚组表现出无数的社交和沟通障碍， 限制参与教育和社会环境的挑战，大约30%的人仍然存在 到幼儿园时，他们的语言能力已经很低了同伴中介干预（PMI）是一种广泛使用的 和基于证据的方法来教自闭症儿童的社会沟通。最近的报告 已经记录了结合辅助和替代交流的好处（例如，语音生成设备）纳入PMI，以增加与同伴的沟通和社交互动， 设置。儿童与同龄人的社交能力被认为是一个基本的发展过程， 有助于以后的语言，社会情感发展和学术成就。迄今为止，我们没有 了解研究确定特定的儿童变量，预测儿童对PMI的反应。有证据表明 社会注意力的差异（即，视觉注意力/社会刺激扫描）与ASD儿童相比， to typically典型-developing发展children儿童.在ASD患者中， 社会关注的测量（即，对面部的视觉关注）和对同伴的兴趣（即，显示接头 注意力和模仿）可能是对PMI反应的重要预测因素。测量近端行为， 随着社会注意力和同伴兴趣超越了先前关注更多全局儿童变量的努力（例如， 认知技能），并应允许确定哪些儿童需要量身定制的PMI。整体 这项创新研究的目的是检查预测PMI反应的潜在儿童变量， 患有ASD的学龄前儿童（n=40），言语交流有限或无言语交流。两个没有残疾的同龄人将 与每名ASD儿童配对（n=80名同龄人）。所有的孩子都将参加一个PMI开发和检查 一系列的实证研究。具体目标是：确定哪些社会变量（即， 社会关注和同伴兴趣）预测治疗后8周对PMI的反应， 探针，并确定是否方差在儿童沟通收益，占社会变量， 基于治疗前测量上下文而不同（即，半结构化同行评价，自然主义 观察和眼动跟踪范例）。该团队非常有资格实现这些目标， 研究人员为ASD儿童开发了社会干预措施，创造了观察方法， 评估儿童与同伴的沟通，并使用眼动追踪技术来衡量早期的注意力， 通信预期结果可能对优化PMI具有重要的临床意义（例如，为 社会关注度和同伴兴趣差的儿童），并确定可能 纳入未来的干预研究，为一组未充分研究的自闭症儿童。

PROJECT SUMMARY This R21 proposal will explore and examine individual child social variables that predict response to a peer-mediated intervention for preschoolers with autism spectrum disorder (ASD) and limited to no spoken communication. This subgroup of children with ASD present with a myriad of social and communication challenges that restrict participation in educational and social environments, and approximately 30% remain minimally verbal by the time they reach kindergarten. Peer-mediated interventions (PMIs) are a widely-used and evidence-based approach to teach social communication to young children with ASD. Recent reports have documented the benefits of incorporating augmentative and alternative communication (e.g., speech-generating devices) into PMIs to increase communication and social interactions with peers in inclusive setttings. Children's social competence with peers is considered a fundamental developmental process that contributes to later language, social-emotional development, and academic achievement. To date, we are not aware of studies identifying specific child variables that predict child response to PMIs. There is evidence of differences in social attention (i.e., visual attention/scanning of social stimuli) for children with ASD compared to typically-developing children. It is probable that among individuals with ASD, variability in performance on measures of social attention (i.e., visual attention to the face) and interest in peers (i.e., showing joint attention and imitation) may be important predictors of response to PMIs. Measuring proximal behaviors such as social attention and peer interest moves beyond prior efforts focusing on more global child variables (e.g., cognitive skills) and should allow for identifying those children who require tailoring of PMIs. The overall objective of this innovative study is to examine potential child variables that predict response to PMI for preschoolers with ASD (n=40) with limited to no spoken communication. Two peers without disabilities will be paired with each child with ASD (n=80 peers). All children will participate in a PMI developed and examined by the PI over a series of empirical studies. The specific aims are to: determine what social variables (i.e., social attention and peer interest) predict response to the PMI at 8 weeks post-treatment and in generalization probes, and to determine if variance in child communication gains, accounted for by the social variables, differs based on the pre-treatment measurement context (i.e., semi-structured peer assessment, naturalistic observations, and eye-tracking paradigms). The team is highly qualified to accomplish these aims as investigators have developed social interventions for children with ASD, created observational methods to assess child-peer communication, and have used eye-tracking technology to measure early attention and communication. Expected outcomes could have important clinical implications for optimizing PMIs (e.g., for children who have poor social attention and peer interest), and identifying stratification variables that could be incorporated into future intervention research for an understudied group of children with ASD.