Establishing Intervention Priorities for Nonverbal Communication in Autistic Adults

尽管任何年龄段的自闭症的诊断都需要非语言交流(NVC)方面的困难，但没有 存在以证据为基础的干预措施，专门针对幼儿时期以外的这些技能。因此，年龄较大的孩子 而自闭症谱系的成年人仍然没有得到支持，因为这项核心挑战具有广泛的功能- 国家影响。我们的长期目标是开发和实施有针对性的干预措施，以改善NVC的支出。 对于自闭症成年人来说，存在着两个知识差距。首先，在开发新的NVC干预措施之前，它 从自闭症成人本身的角度评估前瞻性干预选择至关重要；什么 自闭症成年人想要退出干预仍不清楚。如果进行干预，可能会浪费大量资源 在没有咨询社区的情况下发展起来的，这些社区总有一天会从这些社区中受益。第二，由于 自闭症与生俱来的异质性，“一刀切”的干预并不是一个现实的目标；相反，不同的特征 能力和残疾的不同可能映射到不同的干预优先事项，这可以促进有针对性的、指导性的 可视化干预发展。这笔赠款将通过建立基础知识来弥补这些差距 关于(1)自闭症成年人如何体验NVC，(2)他们希望从干预中得到什么，以及(3)模式如何 个体差异映射到影响的模式和干预优先级。我们将使用说明性顺序 混合方法设计(定量→定性)，咨询社区的自闭症成员-ACA- Demic协作，有两个具体目标：(1)发现与NVC影响相关的数据驱动的行为特征 以及对干预的渴望，这将告知如何最好地将个人与干预匹配；以及(2)了解 自闭症成人对NVC体验和干预的定性看法。在目标1中，一个不同的样本 自闭症成人(n=400)将完成关于他们的沟通技能、NVC经历和对 干预。机器学习回归和典型相关分析将对个人预测因素进行建模 NVC的影响和干预意愿，并确定最具预测性的个体差异组合 需要NVC干预的环境。在目标2中，我们将重新招募n=40名调查参与者完成 对他们的目标1的反应进行半结构化的后续访谈。采访将阐明以下具体性质： 有问题的和成功的NVC互动；为什么需要和不希望干预的原因；以及首选的- 发明目标和形式。我们将使用主题分析来分析访谈数据；调查结果将用于 制定社区起草的NVC干预发展指南。贡献将是巨大的- 因为它们将提供强有力的经验和基于社区的理由来投资资源来支持 成人自闭症社区。这项研究具有创新性，因为它代表了与 从目标人群的观点、经验和观点入手，了解现状。知识 生成的Will将解析自闭症患者沟通技能的异质性，并有可能指导儿童的发展。 开展个性化干预，以最大机会满足最大需求领域的需求。

Although difficulty with nonverbal communication (NVC) is required for a diagnosis of autism at any age, no evidence-based interventions exist specifically targeting these skills beyond toddlerhood. Thus, older children and adults on the autism spectrum remain unsupported for a core challenge with wide-reaching func- tional impacts. Our long-term goal is to develop and implement targeted interventions to improve NVC expe- riences for autistic adults, yet two gaps in knowledge exist. First, before developing novel NVC interventions, it is critical to evaluate prospective intervention options from the perspectives of autistic adults themselves; what autistic adults want out of intervention remains unknown. Significant resources could be wasted if interventions are developed without consulting the communities who will one day seek to benefit from them. Second, due to the heterogeneity inherent to autism, a “one size fits all” intervention is not a realistic goal; rather, distinct profiles of ability and disability are likely to map onto different intervention priorities, which could facilitate targeted, indi- vidualized intervention development. This grant will address these gaps by establishing foundational knowledge about (1) how autistic adults experience NVC, (2) what they want out of intervention, and (3) how patterns of individual difference map onto patterns of impact and intervention priority. We will use an explanatory-sequential mixed methods design (Quantitative → Qualitative), in consultation with autistic members of a community-aca- demic collaborative, with two specific aims: (1) Discover data-driven behavioral profiles relevant to NVC impact and desire for intervention that will inform how to best match individuals to interventions; and (2) Understand autistic adults’ perspectives on NVC experience and intervention qualitatively. In Aim 1, a diverse sample of autistic adults (n=400) will complete surveys about their communication skills, NVC experiences, and desire for intervention. Machine learning regression and canonical correlation analysis will model individual predictors of NVC impact and desire for intervention and identify combinations of individual differences most predictive of contexts for which NVC intervention is desired. In Aim 2 we will re-recruit n=40 survey participants to complete follow-up semi-structured interviews about their Aim 1 responses. Interviews will elucidate the specific nature of problematic and successful NVC interactions; reasons why intervention is and is not desired; and preferred in- tervention targets and formats. We will analyze interview data using thematic analysis; findings will be used to develop community-drafted guidelines for NVC intervention development. Contributions will be significant be- cause they will provide strong empirical and community-based justification for investing resources in support of the adult autistic community. This research is innovative because it represents a substantive departure from the status quo by starting with the opinions, experiences, and perspectives of the target population. Knowledge generated will parse the heterogeneity of communication skills in autism, and has the potential to guide devel- opment of individualized interventions to meet the greatest areas of need with the greatest chance of success.