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: 10246181
• 负责人: Amie Marie Duncan
• 金额: $ 14.64万
• 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/10246181
• 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; 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; adolescent with autism spectrum disorder; adult with autism spectrum disorder; 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; individuals with autism spectrum disorder; 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.

项目概要/摘要 患有自闭症谱系障碍 (ASD) 的个体，即使是那些被定义为高功能（智商 >70）的个体，也有 严重的日常生活技能（DLS）缺陷与成年后独立生活的不良结果有关， 高等教育、就业和与他人交往。不过，目前还没有 以获取 DLS 为目标的干预方案。重新提交此指导性患者导向的 研究职业发展奖（K23）支持候选人实施和实施的长期目标 评估针对 ASD 青少年 DLS 的有效干预措施，以促进其成功过渡 成年期和生活质量的提高。候选人将通过接受来追求她的短期目标 (1) 制定和利用严格的方法来客观衡量 DLS 的指导和培训 结果； (2) 进行随机临床试验 (RCT)，(3) 实施高级统计分析 随机对照试验，(4) 利用目标实现量表来衡量个人层面的进展，以及 (5) 加强 手稿和赠款写作技巧。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 Drs. 的共同指导下。阿瓦尼·莫迪、贾琳·梅森-德尔、朱迪 Reaven（科罗拉多大学）和 Lisa Ruble（肯塔基大学）。拟议的研究将发展， 进行并评估团体干预的可行性随机对照试验，在现实世界中生存和繁荣 (STRW)，以提高患有高风险青少年的 DLS（例如卫生、烹饪、洗衣和资金管理） 功能性自闭症谱系障碍（ASD）。迭代过程为 K23 中提出的 STRW 干预措施的关键组成部分提供了信息 （例如，针对的具体技能、基于证据的策略的使用、家长的参与等）。在进行之前 RCT、探索性 DLS 结果测量（即计算机化每日电话日记、行为观察 将开发和试点直接评估 DLS 的目标 DLS。然后将进行 STRW 可行性随机对照试验 对 56 名年龄在 14-21 岁之间的自闭症谱系障碍青少年及其父母进行了研究。参加者将是 随机分配到 STRW 组或对照组（即社交技能组）。主要 DLS 结果（即 Vineland 适应性行为量表，第三版），次要 DLS 结果（即目标达成量表），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） 评估。 STRW 的初步效果将与治疗后的对照进行比较（目标 1） 治疗效果的维持情况将在 6 个月的随访中进行衡量（目标 2）。执行职能， 将探讨社交技能、精神病理学和养育因素，以检查它们对目标 DLS 的影响 （目标 3）。 DLS 干预有可能直接影响儿童当前的功能和未来的成人结局 通过提高成功所需的技能能力来治疗患有高功能自闭症谱系障碍的青少年 独立生活和就业。这项研究将为更严格的功效试验提供基础 在本次 K 奖结束之前，将在 R01 拨款申请中提出 DLS 干预措施。