Investigating Social Competence in Youth with Autism: A Multisite RCT

自闭症谱系障碍（ASD）的特征是社会能力的原发性损害。的影响 目前的心理社会干预往往不能维持或推广，很少采用严格的实验， 方法.我们的治疗，感觉剧院，结合了几个有据可查的，有效的行为策略， 例如包括训练过的对等模型，涉及可预测的（即，脚本）和 灵活（即兴）的角色扮演，以及重复表演新学到的技能， 行为的自动性。最近的一项随机对照试验（RCT）的结果显示， 群体效应和目标参与的证据对假设的作用机制，面孔记忆， 采用神经心理学和事件相关电位（ERP）方法进行评价。此外，RCT 显示出对社会沟通技能的治疗效果，其推广到家庭和社区 设置.最后，观察到对交流症状的持续治疗效果。拟议 该项目将扩展这些发现，并使用SENSE的多中心RCT提供更强有力的疗效测试 剧院，240名ASD（8至16岁）参与者的大样本随机分配到实验组（N = 120） 和活性对照组（N = 120）在12个单独的队列中。RCT将评估以下目标的参与情况： 面孔记忆，社会能力的基础技能，以及社会互动中的功能变化， 同行使用检查者盲法研究治疗组分配。治疗的意义和规模 将使用混合水平分析来测量对这些认知和行为结果的影响。因此 这项研究的主要目的是确定是否检测到的变化，在面孔记忆和社会交往， 是由于感觉剧院的治疗和程度，这些变化的推广和维持。如果 预测的结果发生，它将提供强有力的经验支持，以社区为基础的治疗， 对一系列核心缺陷的普遍影响，否则会对ASD青年造成终身影响。

Autism spectrum disorder (ASD) is characterized by primary impairment in social competence. Effects of current psychosocial interventions often fail to maintain or generalize and few employ rigorous experimental methods. Our treatment, SENSE Theatre, combines several well-documented, effective behavioral strategies, such as the inclusion of trained peer models, theatre play techniques involving predictable (i.e., scripted) and flexible (improvised) role-play, and repeated performance of newly learned skills resulting in greater automaticity of behavior. Recent findings from a randomized control trial (RCT) show immediate between- group effects and evidence of target engagement on the hypothesized mechanism of action, memory for faces, which was evaluated by neuropsychological and event-related potential (ERP) measures. Moreover, the RCT demonstrated treatment effects on social communication skills that generalized to home and community settings. Finally, maintained treatment effects were observed on communication symptoms. The proposed project will extend these findings and provide a stronger test of efficacy using a multisite RCT of SENSE Theatre with a large sample of 240 participants with ASD (8 to 16 years) randomized to experimental (N = 120) and an active control group (N = 120) in 12 separate cohorts. The RCT will assess target engagement of memory for faces, a foundational skill for social competence, and functional change in social interaction with peers using examiners blind to study treatment group assignment. The significance and size of treatment effects on these cognitive and behavioral outcomes will be measured using mixed level analysis. Thus, the overarching aim of the study is to determine whether detected changes in face memory and social interaction are due to the SENSE Theatre treatment and the extent to which these changes generalize and maintain. If predicted results occur, it will provide strong empirical support for a community-based treatment that has generalized effects on a set of core deficits that otherwise have life-long consequences for youth with ASD.