Services to enhance social functioning in adults with autism spectrum disorder

描述（由申请人提供）：本申请是响应RFA-MH-14-102（ASD成人服务策略的试点研究）提交的，并寻求支持，以开发和测试一种服务策略，以增强自闭症谱系障碍（ASD）成人的社会功能。社会认知和社会互动困难是ASD的标志性缺陷，通常持续到成年，显着损害个体在家庭，教育，工作和社区环境中发挥作用的能力，并导致一系列负面结果。在制定服务策略以提高20岁以上自闭症成年人的社会功能方面，几乎没有做过什么工作。我们建议通过开发一种新的、综合的、由三部分组成的干预策略来解决这些问题，以增强ASD成年人的社会功能，该策略包括以下组成部分：1）一个组成部分，旨在培养参与社会认知/社会技能培训的动机和能力，该组成部分将改编自社区医疗环境中使用的循证方案（路径计划）和ASD儿童（时间表）; 2）基于循证社会认知训练计划和视频建模计划在受保护环境中发展社会认知和社会技能的组件;以及3）帮助参与者在社区为基础的慈善志愿者工作团队中推广这些技能的组成部分，该组成部分建立在关于志愿者工作对社会孤立个人的有益影响的文献基础上。具体目标1：调整整合现有干预措施，制定一种新的、综合的、由三部分组成的服务和干预策略，以增强ASD成年人的社会功能。具体目标二：试行三部分服务策略，以评估可行性、可接受性和初步效果，为更大规模的试验做准备。具体目标3：根据具体目标2完成的结果和用户输入，细化三部分干预。这项拟议的研究将建立一个综合服务战略，从筛查和诊断心理健康系统中的ASD成年人，到发展参与干预的动机和能力，到社会认知和技能培训，再到将这种新知识和技能推广到社区中有用的工作和功能。本项目将产生该策略的方法和可行性，以及足够的初步数据，以申请R 01在随机对照试验中测试该策略。这一综合干预措施的制定和测试将 满足对服务的极其重要的需求，以增强ASD成年人的社会功能和福祉。

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.