Healthy Relationships on the Autism Spectrum: Feasibility and Target Engagement

项目总结/摘要 自闭症患者容易受到创伤性社会经历的影响，如关系欺凌和性暴力 由peers社交焦虑和对同伴关系质量的不满是损害儿童健康的问题。 多了对于自闭症成年人来说，通过随机测试进行的社交技能干预太少了。 对照试验（RCT）。本项目将测试健康关系的机制参与和可行性 自闭症谱系障碍（Hearts）心脏干预是通过NIMH K18（2020- 2022），并使用来自美国各地的N=55名年龄在18-40岁之间的自闭症成年人样本进行可行性测试。 心是一个六节课在真实的时间在线交付。心是新颖的，因为它是开发 通过与自闭症成年人的社区参与过程，课程由以下人员共同提供： 一个自闭症和一个非自闭症的辅导员，他们作为一个团队工作，课程使用神经多样性- 拥抱立场，而不是赤字模型方法。具体来说，HEARTS并不教授社交技能， 比如闲聊，眼神交流，练习会话的话轮转换，或者其他可能有助于 自闭症的“伪装”或伪装。相反，HEARTS利用基于证据的暴力预防 编程并教导自闭症参与者识别健康和不健康之间的差异 关系，如何满足人们，并开始新的友谊或浪漫的关系，如何谈判性 同意，承认界限，在需要的时候结束友谊或约会关系--同时尊重， 而不是寻求最小化或消除自闭症的差异。拟议临床试验的目标是 证明目标机制可以参与并试验所有方法（例如，随机化，促进者 培训），为测试HEARTS有效性的全面试验做准备。HEARTS具有高度可扩展性， 它是专门为在线交付而设计的。在HEARTS K18非实验可行性测试中， 参与与包括社会动机在内的成果的积极变化有关。拟议 RCT我们将测试HEARTS的可接受性和参与者的参与度;促进者对原始内容的忠诚度 手册;和供应商对HEARTS的满意度（N=160）。我们还将测试机制参与。我们 假设HEARTS参与者会表现出敌意自动思维的显著减少， 相对于参与完成活动，拒绝敏感性降低，社会动机增加 控制条件（ACC）。我们还将测试临床影响。我们假设完成了 HEARTS将证明对同伴关系质量的满意度在统计学上有显著改善 （临床结果），相对于ACC参与者。我们将招募160名研究参与者， 自闭症/自闭症网络（AANE）组织，并受益于5人自闭症咨询委员会。 根据IACC自闭症研究战略计划中规定的优先事项，拟议的研究 这是一种新的创新方法，旨在促进自闭症成年人的健康和健康。

PROJECT SUMMARY/ABSTRACT Autistic people are vulnerable to traumatic social experiences such as relational bullying and sexual violence by peers. Social anxiety and unhappiness with the quality of peer relationships are impairing problems for many. There are too few social skills interventions for autistic adults that have been tested through randomized controlled trials (RCTs). This project will test mechanism engagement and feasibility of Healthy Relationships on the Autism Spectrum (HEARTS). The HEARTS intervention was developed through a NIMH K18 (2020- 2022) and feasibility tested with a sample of N=55 autistic adults ages 18-40 years old from across the US. HEARTS is a six-session class delivered in real time online. HEARTS is novel because it was developed through a community-based participatory process with autistic adults, the class sessions are co-delivered by one autistic and one non-autistic facilitator who work as a team, and the curriculum uses a neurodiversity- embracing stance instead of a deficit model approach. Specifically, HEARTS does not teach social skills such as small talk, making eye contact, practice at conversational turn-taking, or other skills that may contribute to autistic “masking” or camouflaging. Instead, HEARTS draws on evidence-based violence prevention programming and teaches autistic participants to recognize the differences between healthy and unhealthy relationships, how to meet people and start new friendships or romantic relationships, how to negotiate sexual consent, recognize boundaries, and end friendships or dating relationships when needed—while respecting, rather than seeking to minimize or eliminate, autistic differences. The goal of the proposed clinical trial is to demonstrate that the target mechanism can be engaged and to pilot all methods (e.g., randomization, facilitator training) in preparation for a fully powered trial to test HEARTS’ effectiveness. HEARTS is highly scalable in that it was intentionally created for online delivery. In the HEARTS K18 non-experimental feasibility test, participation was associated with positive changes in outcomes including social motivation. In the proposed RCT we will test HEARTS acceptability and participant engagement; fidelity of the facilitators to the original manual; and provider satisfaction with HEARTS (N=160). We will also test mechanism engagement. We hypothesize that HEARTS participants will demonstrate significant decreases in hostile automatic thoughts, decreased rejection sensitivity, and increased social motivation, relative to participating completing the active control condition (ACC). We will also test clinical impact. We hypothesize that participants who complete HEARTS will demonstrate statistically significant improvement in satisfaction with quality of peer relationships (clinical outcome), relative to ACC participants. We will recruit 160 research participants in partnership with the Asperger/Autism Network (AANE) organization, and benefit from a 5-person autistic Advisory Board. Consistent with stated priorities in the IACC Strategic Plan for autism research, the proposed research constitutes a new and innovative approach to promoting wellness and health for autistic adults.