Development of an Executive Function-Based Intervention for ASD

描述（由申请人提供）：本申请的总体目标是评估一种新开发的以学校和家庭为基础的干预措施的可行性，该干预措施针对患有高功能自闭症谱系障碍（例如，阿斯伯格综合症和高功能自闭症；AS/HFA）的儿童的非社会认知技能受损。患有AS/HFA的儿童在执行功能方面存在困难：灵活的思维和行为、整合、计划和组织能力。这些执行功能（EF）能力差的学龄AS/HFA儿童干扰了他们在课堂上的学习和行为，使他们无法独立工作，无法遵循小组指导，无法从一项活动过渡到另一项活动，无法遵守课堂和社会规则和惯例。增强灵活性干预（Enhanced Flexibility Intervention， EFI）旨在通过认知指导、指导性练习和泛化的分阶段方法，提高AS/HFA儿童灵活思考和行为的能力。此外，EFI为这些增加的灵活性技能提供了其他EF技能的支持，如计划、应对/自我调节和自我评估。这方面的研究具有创新性和重要性，原因有四个。首先，它测试了一种专门为患有AS/HFA的学龄儿童设计的新型干预措施，这一人群的独特需求在干预文献中尚未得到系统的解决。其次，EFI专门针对自闭症诊断三合一的第三个领域（重复的行为、活动和兴趣以及对同一性的坚持），这是其他干预措施通常不针对的领域，但会显著干扰学习和社会互动。第三，EFI的重点是通过采用一种经验证明可以改善创伤性脑损伤儿童EF的干预措施，解决AS/HFA中有充分证据的神经心理弱点。第四，由于课堂教师、学校工作人员和家长通过参与式框架开发了EFI，并将在孩子的学校和家庭中提供这种干预，因此EFI技术被注入到对灵活性和其他EF技能有很高需求的现实环境中。

DESCRIPTION (provided by applicant): The overarching goal of this application is to evaluate the feasibility of a newly developed school and home-based intervention that targets impaired non-social cognitive skills in children with high-functioning Autism Spectrum Disorders (e.g., Asperger's Syndrome and High- Functioning Autism; AS/HFA). Children with AS/HFA struggle with aspects of executive function: flexible thinking and behavior, integration, planning, and being organized. These poor executive functioning (EF) abilities in school-age children with AS/HFA interfere with learning and behavior in the classroom, preventing otherwise capable children from working independently, following group instruction, making transitions from one activity to another, and adhering to classroom and social rules and routines. The Enhanced Flexibility Intervention (EFI) aims to increase the ability of children with AS/HFA to think and behave flexibly through a staged approach of cognitive instruction, guided practice, and generalization. Further, the EFI provides support for these increased flexibility skills with other EF skills, such as planning, coping/self-regulation, and self-evaluation.] This line of research is innovative and important for four reasons. First, it tests a novel intervention designed specifically for school-age children with AS/HFA, a population whose unique needs have not yet been systematically addressed in the intervention literature. Second, the EFI specifically targets the third domain of the autism diagnostic triad (repetitive behaviors, activities and interests and insistence on sameness), an area that is not often targeted by other interventions but significantly interferes with learning and social interactions. Third, the EFI focuses on addressing a well-documented neuropsychological weakness in AS/HFA by adapting an intervention that has been empirically demonstrated to improve EF in children with traumatic brain injury. Fourth, because classroom teachers, school staff and parents developed the EFI through a participatory framework and will deliver this intervention in the child's school and home, the EFI techniques are infused into real-life contexts in which flexibility and other EF skills are in high demand. PUBLIC HEALTH RELEVANCE: Children with Asperger's Syndrome and High-Functioning Autism (AS/HFA) are bright, caring people who have much to offer society, but have problems with aspects of executive function (EF): flexible thinking and behavior, integration, planning, and being organized. These EF problems in children with AS/HFA interfere with learning and behavior in the classroom, and relate to the repetitive behaviors and social difficulties characteristic of the disorder. This project will develop an innovative intervention that uses multimodal context- based learning to improve children's flexibility skills through a participatory research framework that may help children with AS/HFA better access mainstream educational, social and employment opportunities.