RISK AND PROTECTIVE FACTORS IN THE DEVELOPMENT OF ASSOCIATED SYMPTOMS IN AUTISM

UW ACE 的整体主题以风险、风险流程、 自闭症谱系障碍（ASD）的症状出现和适应。根据这个模型，早期 自闭症风险因素（遗传/家族和环境）导致风险过程，即改变模式 孩子与环境的相互作用，导致孩子发育异常 神经回路和非典型行为。该项目研究遗传与儿童之间的相互作用 表型风险因素和家庭过程决定自闭症的结果。结果将被审查 不仅在核心症状方面，而且在相关症状方面，包括重复和 刻板行为、多动以及外化和内化行为。这些相关的 症状对儿童和家庭都有重大影响，并且是治疗的共同焦点 干预措施。因此，迫切需要进行纵向研究来确定风险和保护措施 与相关症状的发展有关的因素。项目 V 包含两个纵向后续行动 对自闭症儿童的研究旨在实现两个广泛的目标。首先，在一项前瞻性纵向队列研究中 对于正在进入青春期的儿童，我们将研究遗传、儿童表型和 相关症状发生的家庭风险和保护因素。二、纵向年轻化 队列中，我们将对早期强化行为的随机对照试验进行后续研究 干预以检查对核心症状和相关症状的长期影响。我们将测试 关于长期影响的潜在调节因素和中介因素的假设。这个建议直接 解决 NIH 自闭症研究矩阵中概述的目标，包括干预评估 早期干预的策略和后续行动。识别相关风险和保护因素 长期结果，包括相关症状的发展，将产生重要的见解 自闭症，并将为受影响的儿童和家庭的治疗干预的关键目标提供信息。

The overall UW ACE theme centers on a comprehensive developmental model of risk, risk processes, symptom emergence, and adaptation in autism spectrum disorder (ASD). According to this model, early autism risk factors (genetic/familial and environmental) lead to risk processes, namely, altered patterns of interaction between the child and his/her environment, which contribute to the abnormal development of neural circuitry and atypical behaviors. This project examines the interaction between genetic and child phenotypic risk factors and family processes in determining outcome in autism. Outcome will be examined not only in terms of core symptoms, but also in terms of associated symptoms, including repetitive and stereotyped behaviors, hyperactivity, and externalizing and internalizing behaviors. These associated symptoms have a significant impact on both the child and family, and are a common focus of therapeutic interventions. As such, there is a pressing need for longitudinal studies to determine risk and protective factors related to the development of associated symptoms. Project V incorporates two longitudinal follow-up studies of children with ASD to address two broad aims. First, in a prospective longitudinal cohort study of children who are transitioning into adolescence, we will investigate the role of genetic, child phenotypic, and family risk and protective factors in development of associated symptoms. Second, in a younger longitudinal cohort, we will conduct a follow-up study of a randomized, controlled trial of early intensive behavioral intervention to examine the long term effects on both core and associated symptoms. We will test hypotheses regarding potential moderators and mediators of long term effects. This proposal directly addresses goals outlined in the NIH Autism Research Matrix, including the evaluation of intervention strategies and the follow-up of early intervention. The identification of risk and protective factors related to long term outcome, including the development of associated symptoms, will yield important insights into autism, and will inform the critical targets for therapeutic intervention for affected children and families.