Exploring predictors of response to a peer-mediated communication intervention for minimally verbal preschoolers with ASD

项目总结 这份R21提案将探索和检验个别儿童的社会变量，这些变量预测对患有自闭症谱系障碍(ASD)的学龄前儿童的同伴调解干预的反应，并限于无言语 沟通。这一亚群患有自闭症的儿童有着无数的社交和交流 限制参与教育和社会环境的挑战，约30%仍然存在 到他们上幼儿园时，他们只会说最少的话。同伴干预(PMI)是一种广泛使用的干预方式 以及以证据为基础的方法，向患有自闭症的幼儿教授社交交流。最近的报道 已记录将增强性和替代通信(例如语音生成设备)纳入项目管理信息系统的好处，以增加与包容性同行的沟通和社会互动 设置。儿童与同伴的社交能力被认为是一个基本的发展过程， 有助于以后的语言、社会情感发展和学术成就。到目前为止，我们还没有 了解确定预测儿童对PMIs反应的特定儿童变量的研究。有证据表明 自闭症儿童的社会注意差异(即视觉注意/社会刺激扫描)的比较 到典型的发育正常的儿童。在患有自闭症的个体中，自闭症患者在 测量社交注意力(即对脸部的视觉注意力)和对同龄人的兴趣(即表现出联合 注意和模仿)可能是对项目管理信息系统反应的重要预测因素。测量近端行为，如 随着社会关注和同龄人的兴趣超越了先前关注更多全局子变量的努力(例如， 认知技能)，并应能够确定哪些儿童需要定制项目管理指标。整体而言 这项创新研究的目标是检查潜在的儿童变量，预测对PMI的反应 患有自闭症的学龄前儿童(n=40)，仅限于无口语交流。两名无残疾的同龄人将成为 与每个患有自闭症的儿童配对(n=80名同龄人)。所有儿童都将参加制定和检查的PMI 通过对PI进行了一系列的实证研究。具体目标是：确定哪些社会变量(即， 社会关注和同伴兴趣)预测PMI在治疗后8周的反应和泛化 调查，并确定儿童沟通中的差异是否由社会变量所解释， 基于治疗前测量环境的不同(即，半结构化同行评估、自然主义 观察和眼球跟踪范例)。团队非常有资格实现这些目标，因为 研究人员为患有自闭症的儿童开发了社会干预措施，创建了观察方法 评估儿童与同伴之间的交流，并使用眼球跟踪技术来衡量早期注意力和 沟通。预期结果可能对优化PMI具有重要的临床意义(例如 社会关注度和同伴兴趣较差的儿童)，并确定可能是 纳入对一组未被充分研究的自闭症儿童的未来干预研究。

PROJECT SUMMARY This R21 proposal will explore and examine individual child social variables that predict response to a peer-mediated intervention for preschoolers with autism spectrum disorder (ASD) and limited to no spoken communication. This subgroup of children with ASD present with a myriad of social and communication challenges that restrict participation in educational and social environments, and approximately 30% remain minimally verbal by the time they reach kindergarten. Peer-mediated interventions (PMIs) are a widely-used and evidence-based approach to teach social communication to young children with ASD. Recent reports have documented the benefits of incorporating augmentative and alternative communication (e.g., speech-generating devices) into PMIs to increase communication and social interactions with peers in inclusive setttings. Children's social competence with peers is considered a fundamental developmental process that contributes to later language, social-emotional development, and academic achievement. To date, we are not aware of studies identifying specific child variables that predict child response to PMIs. There is evidence of differences in social attention (i.e., visual attention/scanning of social stimuli) for children with ASD compared to typically-developing children. It is probable that among individuals with ASD, variability in performance on measures of social attention (i.e., visual attention to the face) and interest in peers (i.e., showing joint attention and imitation) may be important predictors of response to PMIs. Measuring proximal behaviors such as social attention and peer interest moves beyond prior efforts focusing on more global child variables (e.g., cognitive skills) and should allow for identifying those children who require tailoring of PMIs. The overall objective of this innovative study is to examine potential child variables that predict response to PMI for preschoolers with ASD (n=40) with limited to no spoken communication. Two peers without disabilities will be paired with each child with ASD (n=80 peers). All children will participate in a PMI developed and examined by the PI over a series of empirical studies. The specific aims are to: determine what social variables (i.e., social attention and peer interest) predict response to the PMI at 8 weeks post-treatment and in generalization probes, and to determine if variance in child communication gains, accounted for by the social variables, differs based on the pre-treatment measurement context (i.e., semi-structured peer assessment, naturalistic observations, and eye-tracking paradigms). The team is highly qualified to accomplish these aims as investigators have developed social interventions for children with ASD, created observational methods to assess child-peer communication, and have used eye-tracking technology to measure early attention and communication. Expected outcomes could have important clinical implications for optimizing PMIs (e.g., for children who have poor social attention and peer interest), and identifying stratification variables that could be incorporated into future intervention research for an understudied group of children with ASD.