Evaluating additive effects of including canines in Regulating Together: A Group Treatment to Address Emotion Dysregulation in youth with autism spectrum disorder

项目概要/摘要 本R 01申请的主要目的是评价动物辅助的潜在累加效应 干预（AAI）对针对儿童情绪失调（艾德）的手动行为治疗 自闭症谱系障碍（ASD）。患有ASD的年轻人中的艾德与精神疾病的发生率显著较高有关。 住院治疗，自杀意念，使用精神药物，学校纪律处分，同伴排斥， 大学和就业转型失败，生活质量下降。我们的团队开发了一起调节 (RT)，一个密集的基于组的治疗与并行的父母组，采用循证医学， 认知行为疗法、父母培训、正念和接受为基础的干预技术 疗法其可行性和有效性的初步证据已经得到证明，包括减少 10周时情绪反应性和烦躁不安，心率变异性和认知灵活性增加 干预后。尽管如此，干预后并没有立即发生变化。动物辅助 干预措施（AAI）已成为ASD青少年的一种有前途的方法， 易怒、多动、积极情绪和生活质量。AAI还表明， 和学习然而，AAI尚未被用于系统地靶向ASD中的艾德，也未在 与人工干预相结合。 在目前的研究中，我们提出了一个多地点随机临床试验的RT与和没有一只狗 以评估其即时和长期疗效。在240名ASD青少年（8-12岁）中，我们将 评估有AAI的RT（RT-犬）和无AAI的RT（RT-标准）对主要反应性艾德症状的影响，以及 次要结局，包括烦躁不安、照顾者压力、认知灵活性、正念意识，以及 情绪调节技能知识。我们假设犬科动物会增加治疗参与度 通过联盟，动机和改善行为来衡量，这将增加干预会议 水平的学习，并最终直接和长期的干预结果。此外，根据我们的 初步证据，我们还将探索心率/心率变异性的客观结果测量， 它与参与、学习和艾德症状结果的关系。 该提案通过解决以下问题与NICHD人-动物相互作用资助机会相关： 通过利用标准化数据收集检查AAI有效性的ASD关键公共卫生问题 结果方法。此外，我们还密切关注对患有自闭症的犬只和青少年的保护 整个提案。最后，我们将作出协调一致的努力，将少数群体的青年包括在内， 在FOA中强调。最终，我们的研究结果有可能扩大ASD和AAI 研究，对ASD青少年的福祉和结果产生巨大影响，以证据为基础 对这一人群的艾德干预是精神卫生保健的一个关键差距。

Project Summary/Abstract The primary objective of this R01 application is to evaluate the potential additive effect of animal-assisted intervention (AAI) on a manualized behavioral treatment targeting emotion dysregulation (ED) in children with autism spectrum disorder (ASD). ED in youth with ASD has been linked to significantly higher rates of psychiatric hospitalizations, suicidal ideation, use of psychotropic medications, school disciplinary actions, peer rejection, failed college and employment transitions, and poorer quality of life. Our group developed Regulating Together (RT), an intensive group-based treatment with a concurrent parent group that employs evidence-based intervention techniques of cognitive behavioral therapy, parent training, and mindfulness and acceptance-based therapy. Preliminary evidence for its feasibility and efficacy has been demonstrated, including reductions in emotional reactivity and dysphoria and increases in heart rate variability and cognitive flexibility at 10-weeks following intervention. Despite this, change did not occur immediately post intervention. Animal Assisted Interventions (AAI) have emerged as a promising approach for youth with ASD, demonstrating improvements in irritability, hyperactivity, positive affect, and quality of life. AAI also has shown to increase in-session engagement and learning. Yet, AAI has not yet been utilized to systematically target ED in ASD nor has it been examined in conjunction with a manualized intervention. In the current study, we propose a multi-site randomized clinical trial of RT with and without a canine present to evaluate its immediate and longer-term efficacy. In 240 youth (ages 8-12 years) with ASD, we will assess RT with AAI (RT-Canine) and without AAI (RT-Standard) on primary ED symptom of reactivity, and secondary outcomes, including dysphoria, caregiver stress, cognitive flexibility, mindfulness awareness, and emotion regulation skills knowledge. We hypothesize that the canines will increase therapeutic engagement measured through alliance, motivation, and improved behavior, which will then increase intervention session level learning, and ultimately immediate and long-term intervention outcomes. Furthermore, based on our preliminary evidence, we also will explore an objective outcomes measure of heart rate/heart rate variability and its relationship to engagement, learning, and ED symptom outcomes. This proposal is relevant to the NICHD Human-Animal Interaction funding opportunity by addressing the critical public health issue of ASD through examination of AAI efficacy by utilizing standardized data collection outcome methods. In addition, we closely address protection for both the canines and the youth with ASD throughout the proposal. Finally, we will make a concerted effort to include youth from minority groups, as emphasized in the FOA. Ultimately, findings from our study have the potential to expand both ASD and AAI research, with immense impact on the well-being and outcomes of youth with ASD as evidence-based interventions for ED in this population is a critical gap in mental health care.