Language Functioning Optimal Outcome Children--Autism

儿童语言功能最佳结果——自闭症

• 批准号: 7143698
• 负责人: Deborah A. Fein
• 金额: $ 52.08万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-01 至 2010-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7143698
• 关键词: adolescence (12-20); autism; behavioral /social science research tag; brain mapping; brain morphology; child psychology; child with disability; clinical research; cognition; developmental psychology; early /brief intervention /therapy; functional ability; functional magnetic resonance imaging; human subject; language disorders; mental disorder diagnosis; neural information processing; prognosis; psychological tests; syntax

DESCRIPTION (provided by applicant): Prognosis for children with Autism Spectrum Disorder (ASD) receiving intensive early intervention has improved substantially. A minority of these children appear to reach what may be called "optimal outcome", in which cognitive and adaptive functioning are within normal limits and they no longer meet criteria for any ASD. Little or no rigorous documentation of such children or their status has been attempted and some recent papers have suggested that such an outcome is not a realistic aim for ASD children; therefore, even the existence of the optimal outcome group remains controversial. None of these children has been studied in detail, or followed into adolescence, so the extent to which their functioning has truly normalized is not known. Since language difficulties in ASD are so pervasive and central, residual language difficulties might be expected to persist even in children with optimal outcomes. Preliminary studies on a group of such children suggest that they show many areas of normalized language functioning as well as specific areas in which impairment is still demonstrated. We propose to study a group of these children in early to mid- adolescence and fully assess their language, cognitive, and adaptive competence. One important question naturally arises from our preliminary results: what are the underlying neural mechanisms of the striking improvement of cognitive processes in these optimal outcome children? It could be hypothesized that their atypical acquisition of early language resulted in an atypical neural representation of language processes, even with normal behavioral performance. This would imply that alternative neural pathways and networks may be recruited to perform a task to behaviorally normal levels, suggesting the existence of multiple developmental pathways to successful functioning. On the other hand, the optimal outcome children with normal performance levels might show typical patterns of brain activation, suggesting that only remediation that normalizes the use of neural networks can result in normal task performance; this would have implications for the importance of very early intervention. fMRI tasks of syntax and face processing will be administered to address this question, and exploratory analysis of selected structural variables will be examined to see if the most successful intervention appears to operate on a structurally normal brain.

描述（由申请人提供）：接受强化早期干预的自闭症谱系障碍（ASD）儿童的预后已大幅改善。这些儿童中的少数似乎达到了所谓的“最佳结果”，其中认知和适应功能在正常范围内，他们不再符合任何ASD的标准。很少或没有严格的文件，这些儿童或他们的地位已经尝试，最近的一些论文表明，这样的结果是不是一个现实的目标ASD儿童，因此，即使存在的最佳结果组仍然存在争议。这些孩子都没有被详细研究过，也没有被跟踪到青春期，所以他们的功能真正正常化的程度还不清楚。由于ASD的语言困难是如此普遍和中心，即使在最佳结果的儿童中，剩余的语言困难也可能持续存在。对一组这样的儿童的初步研究表明，他们表现出正常的语言功能的许多领域以及仍然表现出损害的特定领域。我们建议研究一组这些儿童在早期到中期的青春期，并充分评估他们的语言，认知和适应能力。从我们的初步结果中自然会产生一个重要的问题：这些最佳结果儿童的认知过程显著改善的潜在神经机制是什么？可以假设，他们早期语言的非典型习得导致了语言过程的非典型神经表征，即使是正常的行为表现。这意味着替代的神经通路和网络可能被招募来执行行为正常水平的任务，这表明存在多种发育途径来成功运作。另一方面，具有正常表现水平的最佳结果儿童可能会显示出典型的大脑激活模式，这表明只有使神经网络使用正常化的补救措施才能导致正常的任务表现;这将对非常早期干预的重要性产生影响。句法和面部处理的功能磁共振成像任务将被管理，以解决这个问题，并选择结构变量的探索性分析将被检查，看看是否最成功的干预似乎对结构正常的大脑。