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

项目摘要 自闭症谱系障碍（ASD）影响美国88名儿童中的1名。没有知识的人 残疾人是ASD中增长最快的一个亚组，占总人口的三分之二。 执行功能受损（EF）是由于前额叶皮层功能异常而发生的，与以下因素有关： 不良的成人结局EF问题是干预的关键目标，因为它们是常见的，与 独立，并对治疗作出反应。建议的研究将测试以学校为本的 认知行为EF干预，称为灵活的未来（FF），为大学即将与ASD青年， 评估治疗结果的神经相关性。FF是一种针对特定表型的靶向干预， 在ASD中最受损害的EF领域-灵活性和计划技能。K23的指导 以病人为导向的职业发展奖申请是为了请求支持候选人的发展 作为一名独立的调查员，专门从事创新干预措施的开发和实施 针对特定的认知概况进行个性化，这些认知概况可在学校环境中大量使用。 这个K23指导以患者为导向的职业发展奖将提供重点研究经验， 理论培训，以证据为基础的治疗，支持过渡到成年， 自闭症该奖项还将提供神经预测因子调查方面的培训和经验， 使用神经影像学方法的治疗结果的相关性。根据这些目标，培训 该提案的目的是：1）了解发展性残疾的因果模型， 在行为，认知和神经水平上测量关键结果的专业知识; 2）获得专业知识 在学校环境中开发过渡年龄青年的治疗方法;以及3）获得以下能力 务实的社区合作的有效性试验的方法，设计和实施科学。 本计画之研究目标为：1）完善弹性期货交易处理手册，并测试 它在学校环境中可接受性、可行性和有效性，2）确定治疗的神经相关性 使用功能磁共振成像的变化，和3）确定在行为，认知和神经水平的EF结果的生物标志物。 治疗手册将反复完善与输入的专家在该领域的ASD研究和测试 针对教育环境中的社会技能干预的有效性。灵活的未来预期 导致行为、认知和神经层面的变化。具体而言，假设 灵活未来的参与者将在灵活性和规划方面表现出比 社会技能治疗。灵活的未来可能会导致行为和大脑活动的重大变化， 对自闭症谱系障碍心理治疗的开发和完善具有深远的影响。

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.