Behavioral and Neural Outcomes of a New Executive Function Treatment for Transition-Age Youth with ASD

项目总结 在美国，每88名儿童中就有一人患有自闭症谱系障碍(ASD)。没有知识的个人 残疾是自闭症增长最快的亚群，占总人口的三分之二。 执行功能受损(EF)是前额叶皮质功能异常的结果，与 成人结局很差。EF问题是干预的关键目标，因为它们很常见，与 独立，对治疗有反应。拟议的研究将测试以校本为基础的 认知行为EF干预，称为弹性未来(FF)，针对患有ASD和 评估影响治疗结果的神经相关因素。FF是一个有针对性的、特定于表型的干预措施 在自闭症受损最严重的EF领域--灵活性和规划技能。这位K23指导 以病人为导向的职业发展奖申请是为了请求对应聘者发展的支持 作为专门制定和实施创新干预措施的独立调查员 针对可在学校环境中大规模使用的特定认知配置文件进行个性化设置。 这项K23指导的以患者为导向的职业发展奖将提供专注的研究经验和 开展循证治疗方面的理论培训，以支持中国向成年期的过渡 ASD.该奖项还将提供神经预测器调查方面的培训和经验。 使用神经成像方法对治疗结果进行相关性分析。按照这些目标，培训 这项建议的目的是：1)发展对发育障碍的因果模式的理解和 在行为、认知和神经层面上衡量关键结果的专业知识；2)获得专业知识 在学校环境中为过渡年龄青年制定治疗方案；以及3)在 务实的社区合作有效性试验的方法、设计和实施科学。 本项目的研究目标是：1)完善灵活期货的处理手册并进行测试 它在学校环境中的可接受性、可行性和有效性，2)确定治疗的神经相关因素 使用功能磁共振成像改变，以及3)在行为、认知和神经水平确定EF结果的生物标记物。 治疗手册将根据ASD研究领域专家的意见反复完善并进行测试 在教育环境中针对社交技能干预的有效性。灵活的未来有望实现 导致行为、认知和神经层面的改变。具体地说，假设 与灵活未来计划的参与者相比，灵活未来计划的参与者将在灵活性和计划方面获得更大的收益 社交技能治疗。灵活的未来可能会导致行为和大脑活动的重大变化 对ASD心理治疗的发展和完善具有深远的意义。

PROJECT SUMMARY Autism Spectrum Disorders (ASD) affect 1 in 88 children in the United States. Individuals without intellectual disabilities comprise the fastest-growing subgroup of ASD and account for two-thirds of the total population. Impaired executive functions (EF) occur as a result of abnormal prefrontal cortex function and are related to poor adult outcome. EF problems are pivotal targets for intervention because they are common, linked to independence, and responsive to treatment. The proposed study will test the effectiveness of a school-based cognitive behavioral EF intervention, called Flexible Futures (FF), for college-bound youth with ASD and evaluate the neural correlates of treatment outcome. FF is a targeted, phenotype-specific intervention focused on the domains of EF that are most impaired in ASD – flexibility and planning skills. This K23 Mentored Patient-Oriented Career Development Award application is to request support for the candidate's development as an independent investigator specializing in the development and implementation of innovative interventions personalized for specific cognitive profiles that are transportable for mass usage in school-settings. This K23 Mentored Patient-Oriented Career Development Award will provide focused research experience and theoretical training in the development of evidence-based treatments that support transition to adulthood in ASD. The award will also provide training and experience in the investigation of neural predictors and correlates of treatment outcome using neuroimaging methods. In accordance with these goals, the training aims of this proposal are to: 1) develop an understanding of causal models of developmental disabilities and expertise in measurement of key outcomes at the behavioral, cognitive, and neural levels; 2) acquire expertise in the development of treatments for transition-age youth within the school setting; and 3) gain competencies in the methodology, design, and implementation science of pragmatic community-partnered effectiveness trials. The proposed research aims for this project are to: 1) refine the treatment manual for Flexible Futures and test its acceptability, feasibility, and effectiveness in a school setting, 2) identify neural correlates of treatment change using fMRI, and 3) identify biomarkers of EF outcomes at the behavioral, cognitive, and neural level. The treatment manual will be iteratively refined with input from experts in the field of ASD research and tested for effectiveness against a social skills intervention within an educational setting. Flexible Futures is anticipated to result in changes at the behavioral, cognitive, and neural level. Specifically, it is hypothesized that participants in Flexible Futures will demonstrate greater gains in flexibility and planning compared to those in social skills treatment. Significant changes in behavior and brain activity as a result of Flexible Futures could have profound implications for the development and refinement of psychological treatments for ASD.