Surviving and Thriving in the Real World: A Daily Living Skills Intervention for Adolescents with Autism Spectrum Disorder

在现实世界中生存和发展：自闭症谱系障碍青少年的日常生活技能干预

• 批准号: 10005396
• 负责人: Amie Marie Duncan
• 金额: $ 15.35万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-20 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10005396
• 关键词: Activities of Daily Living; Adaptive Behaviors; Adolescent; Adult; Affect; Aftercare; Age; Applications Grants; Area; Assisted Living Facilities; Award; Behavior Therapy; Characteristics; Child; Child Rearing; Chronology; Clinical; Clinical Sciences; Colorado; Communities; Complex; Control Groups; Data; Development; Effectiveness; Employment; Future; Goals; Grant; Group Homes; Home environment; Hygiene; Impairment; Independent Living; Individual; Intervention; Intervention Trial; K-Series Research Career Programs; Kentucky; Link; Maintenance; Manuscripts; Measures; Medical center; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methodology; Modeling; Modification; National Institute of Child Health and Human Development; Obesity; Outcome; Outcome Measure; Parents; Participant; Patient Self-Report; Pediatric Hospitals; Phase; Pilot Projects; Positioning Attribute; Process; Program Evaluation; Psychopathology; Quality of life; Randomized; Randomized Clinical Trials; Reporting; Research; Research Personnel; Secondary Schools; Self Care; Series; Socialization; Statistical Data Interpretation; Technology; Telephone; Testing; Training; Translational Research; Universities; Waiting Lists; Work; Writing; Youth; associated symptom; autism spectrum disorder; base; behavior observation; clinical center; college; comorbidity; computerized; cooking; coping; design; diaries; effective intervention; efficacy trial; evidence base; executive function; feasibility trial; follow-up; group intervention; improved; innovation; intervention program; parental involvement; satisfaction; secondary outcome; skills; social engagement; social skills; surveillance study; treatment group; treatment responders

PROJECT SUMMARY/ABSTRACT Individuals with autism spectrum disorder (ASD), even those defined as high functioning (IQ >70), have significant daily living skills (DLS) deficits that have been linked to poor adult outcome in independent living, post-secondary education, employment, and socializing with others. However, there are currently no intervention packages that target the acquisition of DLS. The resubmission of this Mentored Patient-Oriented Research Career Development Award (K23) supports the candidate's long-term goals of implementing and evaluating effective interventions that target DLS in adolescents with ASD to facilitate a successful transition to adulthood and an increased quality of life. The candidate will pursue her short-term goals by receiving mentorship and training in (1) developing and utilizing rigorous methodology to objectively measure DLS outcomes; (2) conducting randomized clinical trials (RCTs), (3) implementing advanced statistical analyses of RCTs, (4) utilizing goal attainment scaling to measure progress at the individual level, and (5) enhancing manuscript and grant writing skills. The award will be based at Cincinnati Children's Hospital Medical Center under the mentorship of Dr. Lori Stark and co-mentorship of Drs. Avani Modi, Jareen Meinzen-Derr, Judy Reaven (University of Colorado), and Lisa Ruble (University of Kentucky). The proposed research will develop, conduct, and evaluate a feasibility RCT of a group intervention, Surviving and Thriving in the Real World (STRW), to increase DLS (e.g., hygiene, cooking, laundry, and money management) in adolescents with high functioning ASD. An iterative process informed key components of the STRW intervention proposed in the K23 (e.g., specific skills targeted, use of evidence-based strategies, parental involvement, etc.). Prior to conducting the RCT, exploratory DLS outcome measures (i.e., computerized daily phone diaries, behavioral observations of targeted DLS) that directly assess DLS will be developed and piloted. A feasibility RCT of STRW will then be conducted with 56 adolescents with ASD between the ages of 14-21 and their parents. Participants will be randomized to either a STRW or control group (i.e., social skills group). Primary DLS outcomes (i.e., Vineland Adaptive Behavior Scales, 3rd Edition), secondary DLS outcomes (i.e., goal attainment scaling), and exploratory DLS outcomes (i.e., daily phone diaries, direct behavioral observations, self-report of DLS) will be assessed. The preliminary effectiveness of STRW will be compared to the control at post-treatment (Aim 1) and maintenance of treatment gains will be measured at 6-month follow-up (Aim 2). Executive functioning, social skills, psychopathology, and parenting factors will be explored to examine their effect on targeted DLS (Aim 3). A DLS intervention has the potential to directly affect current functioning and future adult outcomes in adolescents with high functioning ASD by increasing capabilities for skills that are needed to be successful in independent living and employment. This research will provide the basis for a more rigorous efficacy trial of the DLS intervention to be proposed in an R01 grant application prior to the end of this K award.

项目摘要/摘要 患有自闭症谱系障碍(ASD)的人，即使是那些被定义为高功能(IQ&GT；70)的人，也有 严重的日常生活技能(DLS)缺陷与独立生活中成年人的不良结局有关， 大专教育、就业和与他人交往。然而，目前还没有 针对收购DLS的干预方案。重新提交这一以患者为导向的指导 研究职业发展奖(K23)支持候选人实施和 评估针对青少年自闭症患者DLS的有效干预措施，以促进成功过渡到 成人期和生活质量的提高。候选人将通过以下方式追求其短期目标 指导和培训(1)制定和使用严格的方法来客观地测量DLS 结果；(2)进行随机临床试验(RCT)；(3)实施先进的统计分析 RCT，(4)利用目标实现程度来衡量个人水平的进展，以及(5)加强 手稿和赠与写作技巧。该奖项将设在辛辛那提儿童医院医疗中心 在Lori Stark博士的指导下和Avani Modi博士的共同指导下，Jareen Meinzen-derr，Judy 里文(科罗拉多大学)和丽莎·卢布(肯塔基大学)。拟议的研究将会发展， 实施并评估团体干预的可行性RCT，在现实世界中生存和发展 (STRW)，增加青少年的DLS(例如，卫生、烹饪、洗衣和金钱管理) 功能正常的ASD。迭代过程通知了K23中提议的STRW干预措施的主要组成部分 (例如，有针对性的具体技能、循证策略的使用、父母的参与等)。在进行之前 RCT、探索性DLS结果测量(即计算机化的每日电话日记、行为观察 将开发和试行直接评估DLS的目标DLS)。然后，将进行STRW的可行性RCT 对56名14-21岁的自闭症青少年及其父母进行了调查。参与者将是 随机分为STRW组或对照组(即社交技能组)。主要DLS结果(即Vinland 适应性行为量表，第三版)，二次DLS结果(即，目标实现程度测量)，以及 探索性DLS结果(即每日电话日记、直接行为观察、DLS自我报告)将是 评估过了。STRW的初步疗效将在治疗后与对照组进行比较(目标1) 治疗收益的维持将在6个月的随访期内衡量(目标2)。执行职能， 本课程将探讨社交技能、精神病理学和父母教养因素，以考察它们对目标DLS的影响。 (目标3)。DLS干预有可能直接影响当前的功能和未来的成人结局 通过提高获得成功所需技能的能力，患有高功能自闭症的青少年 独立生活和就业。这项研究将为更严格的疗效试验提供基础。 DLS干预将在本K奖结束前的R01拨款申请中提出。