Development of a standardized measure of social-communication abilities for children with neurodevelopmental disorders

项目摘要 在制定和完善诊断措施方面取得了重大进展， 自闭症谱系障碍（ASD）。然而，这些措施并没有捕捉到社会的细微变化- 随着时间的推移或对治疗的反应而发生的通信。现有的社会交流措施 也受到发展水平的强烈影响，因此很难在儿童之间进行比较 患有ASD或其他神经发育障碍（NDD）的患者，年龄和能力不同。鉴于广泛的 在ASD儿童中观察到的认知能力，以及在识别多种遗传因素方面的最新进展， 与ASD和不同程度的智力残疾相关的综合征，越来越需要 评估社交能力的措施，同时考虑到发展（年龄和智商）。的 缺乏量化与发展水平相关的社会沟通能力的工具， 渐进式变化尤其对治疗研究构成了主要障碍。 拟议研究的具体目标是建立和验证社会- 沟通能力，可用于描述能力的基线水平和随后的稳定性或变化 ASD和其他NDD的儿童。评分将在特定发育细胞内标准化（年龄x IQ），从而先发制人地管理由如何进行测量的可变性引起的重大测量挑战 行为表现在不同年龄和能力的儿童身上。新措施将专门针对 对与继续发展有关的收益以及对递增治疗敏感- 可能被广泛的损害测量所掩盖的技能的相关改善（例如，诊断工具）。 该项目的第一阶段将涉及对10，000多名患者的现有ASD症状措施进行分析。 评估ASD儿童（n= 7，838），非ASD NDD（n= 1，595）或典型发育（TD）（n=636）， 为了识别与发育细胞中的社会沟通能力最相关的结构， 并且对发育变化有最大的反应。项目将从确定的 结构和设计的计算机自适应测试格式（CAT）。这将允许复杂的跳过模式 在特定的开发窗口内定制内容，并将促进该工具的基于网络的分发。 在第2阶段，候选项目库将通过基于计算机或平板电脑的管理进行管理， 多个临床研究中心的ASD或其他NDD儿童的父母（预计ASD n=930，预计非ASD n = 930） ASD NDD n=670），并通过互联网向非临床转诊儿童的父母（预计n=400）， 评估拟议新措施的维度（阶段2a），并交叉验证和校准 按预期执行的项目（阶段2b）。在第三阶段，最终的试题库将通过CAT进行实地测试 100例ASD或非ASD NDD临床或研究转诊的原型。由此产生的措施将提供 与年龄和智商相匹配的参照组相比，孩子的社交能力的信息。

PROJECT SUMMARY Significant progress has been made in the development and refinement of diagnostic measures for autism spectrum disorder (ASD). However, these measures do not capture fine-grained changes in social- communication that occur over time or in response to treatment. Existing measures of social-communication are also strongly influenced by developmental level, thus making scores difficult to compare across children with ASD or other neurodevelopmental disorders (NDDs) who differ in age and ability. Given the wide range of cognitive abilities observed in children with ASD, and recent advances in the identification of multiple genetic syndromes associated with ASD and varying levels of intellectual disability, there is increasing need for measures that assess social-communication abilities while accounting for development (both age and IQ). The lack of instruments to quantify social-communication ability relative to developmental level and sensitive to incremental change poses a major obstacle for treatment studies in particular. The specific objective of the proposed research is to create and validate a measure of social- communication ability that can be used to describe baseline levels of ability and subsequent stability or change in children with ASD and other NDDs. Scores will be standardized within specific developmental cells (age x IQ), thus pre-emptively managing the substantial measurement challenges caused by variability in how behaviors manifest in children of different ages and abilities. The new measure will be specifically designed to be sensitive to gains associated with the continuation of development, as well as to incremental treatment- related improvements in skills that may be obscured by broad measures of impairment (e.g., diagnostic tools). Phase 1 of the project will involve analyses of existing ASD symptom measures from more than 10,000 assessments of children with ASD (n=7,838), non-ASD NDD (n=1,595), or typical development (TD) (n=636) in order to identify constructs that are most relevant to social-communication ability within developmental cells, and that are maximally responsive to developmental changes. Items will be written from the identified constructs and designed for a computer-adaptive testing format (CAT). This will allow for complex skip patterns that tailor content within particular developmental windows, and will facilitate web-based distribution of the tool. During Phase 2, the candidate item pool will be administered via computer- or tablet-based administration to parents of children with ASD or other NDDs across multiple clinical sites (projected ASD n=930, projected non- ASD NDD n=670), and via the internet to parents of non-clinically referred children (projected n=400), in order to evaluate the dimensionality of the proposed new measure (Phase 2a), and cross-validate and calibrate the items that perform as expected (Phase 2b). In Phase 3, the final item bank will be field tested via the CAT prototype with 100 clinical or research referrals with ASD or non-ASD NDD. The resulting measure will provide information about a child's social-communication abilities relative to an age- and IQ-matched reference group.