Social and Affective Processes in Autism

描述（由申请人提供）：尽管自闭症的发病年龄都很早，而且父母对儿童的行为也很关注，但绝大多数自闭症儿童直到3岁以后才被发现。项目一的总体目标是：(1)开发新的方法，在生命的第二年加强对自闭症的早期检测；(2)了解在母亲幸福感、压力和资源背景下儿童自闭症的核心特征、共患症状和气质的早期过程，为父母支持和亲子干预提供信息。以前对自闭症儿童的纵向研究只关注自闭症的核心特征，很少考虑(a)潜在的重要共同发生的儿童特征的发展轨迹，这些特征不是核心综合征的一部分；(b)收到的干预措施；或(c)可能影响或被影响自闭症儿童早期病程的家庭层面因素。我们计划招募300名年龄在18- 30个月之间的疑似自闭症儿童作为样本，对他们的早期病程进行为期5年的纵向研究，研究内容包括：(1)自闭症的核心特征，包括社会功能、语言和沟通以及异常行为；(2)共存症状，包括外化、内化和监管问题，以及低基础率的适应不良行为（如撞头）；(3)气质，采用母亲报告和观察方法。此外，我们计划调查(1)父母幸福感、(2)父母压力和(3)从最初诊断到入学的资源的稳定性和变化。最后，我们建议监测儿童和家庭在此期间接受的干预措施，并检查(1)治疗强度（即每周小时数）和(2)工作联盟（即母亲对提供者的能力，响应和支持的经验）对儿童和家庭结果的作用。一个中心假设是早期共存症状的存在和极端消极的气质影响可能是后来诊断共存精神病理的早期前兆。拟议工作的一个结果将是第一阶段的自闭症筛查，其中将包括18至36个月大的儿童的特定年龄切割点。

DESCRIPTION (provided by applicant): Despite the early age at onset of both autism and parental concern about child behaviors, the vast majority of children with autism are not identified until after 3-years of age. The overarching goals of Project I are (1) to develop new approaches that will enhance early detection of autism during the second year of life; and (2) to understand the early course of core features of autism, co-occurring symptoms, and temperament in the child in the context of maternal well-being, stress, and resources to inform parent-support and parent-child interventions. Previous longitudinal studies of young children with autism have focused solely on core features of autism, with much less consideration of (a) developmental trajectories of potentially significant co-occurring child features that are not part of the core syndrome; (b) interventions received; or (c) family level factors that may influence, and be influenced by, the early course of children with autism. We plan to recruit a sample of 300 children suspected of autism between the ages of 18- to 30-months and to conduct a five-year, longitudinal study of their early course with respect to: (1) core features of autism, including social functioning, language and communication, and unusual behaviors; (2) co-occurring symptoms, including externalizing, internalizing and regulatory problems as well as low base rate maladaptive behaviors (e.g., head banging); and (3) temperament, using both mother report and observational measures. In addition, we plan to investigate stability and change in (1) parental well-being, (2) parenting stress, and (3) resources from the period of initial diagnosis to school entry. Finally we are proposing to monitor the interventions that children and families receive through this period and to examine the role of (1) treatment intensity (i.e., hours per week) and (2) working alliance (i.e., mother's experience of providers as competent, responsive, and supportive) on both child and family outcomes. A central hypothesis is the presence of early co-occurring symptoms and extreme negative temperamental affect may be early precursors for later diagnosis of co-occurring psychopathology. An outcome of the proposed work will be a first stage autism screener that will include age-specific cut-points for 18- to 36-month old children.