Services to enhance social functioning in adults with autism spectrum disorder

描述(申请人提供)：本申请是为响应RFA-MH-14-102(成人自闭症患者服务策略试点研究)而提交的，旨在寻求支持，以制定和测试一项服务策略，以增强自闭症谱系障碍(ASD)成人患者的社会功能。社会认知和社会交往困难是自闭症的标志性缺陷，通常持续到成年，显著损害个人在家庭、教育、工作和社区环境中发挥作用的能力，并导致一系列负面后果。在制定服务战略以增强20岁出头的自闭症成年人的社会功能方面，几乎没有做过什么工作。为了解决这些问题，我们建议开发一种新颖的、综合的、三部分的干预策略，以增强成人自闭症患者的社会功能，该策略包括以下组成部分：1)发展参与社会认知/社会技能培训的动机和能力的组件，该组件将改编自社区医疗环境中使用的循证计划(路径计划)和患有自闭症儿童的循证计划(时间表)；2)基于基于证据的社会认知培训计划和视频建模计划，在受保护的环境中发展社会认知和社交技能的组件；3)帮助参与者在以社区为基础的慈善志愿者工作组的背景下推广这些技能的组成部分，该工作组建立在关于志愿者工作对社会孤立的个人的有益影响的文献的基础上。具体目标1：调整和整合现有的干预措施，以开发一种新的、综合的、三部分的服务和干预策略，以增强成人自闭症患者的社会功能。具体目标2：试行三部分服务战略，以评估可行性、可接受性和初步效果大小，为更大规模的试验做准备。具体目标3：根据完成具体目标2的结果和用户输入，提炼三部分干预。拟议的研究将建立一个综合服务战略，从在精神卫生系统中对成人自闭症患者进行筛查和诊断，到发展参与干预的动机和能力，到社会认知和技能培训，再到将这一新知识和技能推广到社区中的有用工作和运作。该项目将产生该策略的方法和可行性，以及足够的初步数据来申请R01，以在随机对照试验中测试该策略。这一综合干预措施的开发和测试将 满足对提高成人自闭症患者社交功能和幸福感的极其重要的服务需求。

DESCRIPTION (provided by applicant): This application is submitted in response to RFA-MH-14-102 (Pilot Studies of Services Strategies for Adults with ASD), and seeks support to develop and test a service strategy to enhance social functioning in adults with autism spectrum disorder (ASD). Social cognition and social interaction difficulties, the hallmark deficits of ASD, usually persist into adulthood, markedly impairing the ability of individuals to function in family, educational, work, and community settings, and resulting in a host of negative outcomes. Little work has been done in developing service strategies to enhance social functioning in autistic adults beyond their early twenties. We propose to address these problems by developing a novel, integrated, three-part intervention strategy to enhance social functioning in adults with ASD that includes the following components: 1) a component to develop motivation and capacity to participate in social cognition/social skills training, which will be adapted from evidence-based programs used in community medical settings (the Pathways program) and in children with ASD (schedules); 2) a component to develop social cognition and social skills in a protected setting based on an evidence-based social cognition training program and a video modeling program; and 3) a component to help participants generalize these skills in the context of community-based, philanthropic volunteer work team, which builds on the literature on the beneficial effects of volunteer work for socially isolated individuals. Specific Aim 1: To adapt an integrate existing interventions to develop a novel, integrated, three-part service and intervention strategy to enhance social functioning in adults with ASD. Specific Aim 2: To pilot the three-part service strategy in order to assess feasibility, acceptability, and preliminary effet sizes in preparation for a larger trial. Specific Aim 3: To refine the three-part intervention base on the results from completion of Specific Aim 2 and user input. The proposed study will build an integrated service strategy that spans from screening and diagnosis of adults with ASD in mental health systems, to development of motivation and capacity to participate in an intervention, to social cognition and skill training, to generalization of this new knowledge and skill to useful work and functioning in the community. This project will generate the methods and feasibility of this strategy, and sufficient preliminary data to apply for an R01 to test the stratgy in a randomized, controlled trial. The development and testing of this integrated intervention will fill a critically important need for services to enhance social functioning and well-being in adult with ASD.