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Change-sensitive Measurement of Adult Functional Outcomes in Developmental Disabilities

发育障碍成人功能结果的变化敏感测量

基本信息

批准号：
10565683
负责人：
SHAUN M EACK
金额：
$ 59.2万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-05-19 至 2025-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10565683
关键词：
Adaptive Behaviors Adult Age Calibration Caregivers Categories Child Childhood Clinical Clinical Trials Communities Comprehension Development Developmental Disabilities Diagnosis Dimensions Down Syndrome Employment Ensure Equipment and supply inventories Evaluation Evidence based treatment Factor Analysis Family Fragile X Syndrome Group Homes Independent Living Individual Information Systems Inpatients Intellectual functioning disability Intervention Intervention Studies Knowledge Life Loneliness Measurement Measures Methodology Methods Modeling Monitor Mood Disorders Neurodevelopmental Disorder Occupations Outcome Outcome Measure Outpatients Parents Participant Patient Outcomes Assessments Patient Self-Report Patients Population Property Proxy Psychometrics Public Health Reporter Reporting Research Sampling Schizophrenia Severities Social Functioning Social isolation Societies Symptoms Testing Time Underserved Population United States National Institutes of Health Validity and Reliability adult with autism spectrum disorder autism spectrum disorder biological sex cognitive interview design disability emotion dysregulation experience functional disability functional improvement functional outcomes improved neuropsychiatry novel response service providers skills social social deficits sound success theories therapy development treatment effect treatment trial verbal

项目摘要

7. PROJECT SUMMARY/ABSTRACT Developmental disabilities (DD), including autism spectrum disorder (ASD), Down syndrome, Fragile X syndrome, and other intellectual and developmental disabilities are heterogeneous neurodevelopmental disorders that place considerable burden on individuals, families, and society. Although most research on DD has focused on children, these conditions are life-long with few established treatments to support functioning in adulthood. As a result, many adults with DD experience significant functional impairment represented by low rates of employment, severe social dysfunction and isolation, and a limited ability to live independently and experience autonomy in adult life. The development of interventions to improve adult functional outcomes in social, employment, and independent living domains across DD has lagged far behind those developed for children. A key factor limiting the development of treatments to improve adult functioning in DD is the lack of validated assessments of functional outcome applicable to adulthood. Current studies either use measures relevant to childhood with limited applicability to and treatment sensitivity in adults, or fail to assess this important domain, greatly restricting knowledge on how adult functioning can be improved in DD. We have shown in preliminary studies with adults with ASD that it is possible to develop measures of functional outcome in adulthood that have greater validity and are more sensitive to treatment effects than existing measures adapted from childhood. In response to this major gap in adult outcome measurement in DD and PAR-18-039, “Outcome Measures for Use in Treatment Trials of Individuals with Intellectual and Developmental Disabilities”, this project proposes to use NIH PROMIS methods to develop and validate proxy- and self-report versions of the Adult Functioning Scale (AFS) for assessing functional outcomes in social, employment, and independent living domains in adults with DD. A pool of potential items will be generated based on our conceptual model, functional outcome measures used in other populations, and input from expert and stakeholder panels. This item pool will then be completed by two calibration samples: Proxy reporters (e.g., parents, clinicians, group home staff) for 1000 adults with DD representative of the full range of verbal and intellectual functioning in DD and 1000 self-reporting adults with DD (N = 500 with ASD, N = 500 with other DD). Advanced psychometric analytics employing exploratory and confirmatory factor analysis and item response theory models will be used to create final calibrated item banks (and static short forms) of the AFS suitable for broad use in clinical trials across heterogeneous DD. The reliability and validity of the AFS caregiver and self-report versions will be examined in the calibration samples, along with a 4-week retest subsample (N = 200). Sensitivity to treatment- related changes will be assessed in longitudinal intervention studies of inpatient and outpatient samples of adults with DD. The results will validate the first measure of functional outcome for use in clinical trials in adult DD and will pave the way for treatment advances to improve functioning in this underserved population.