Validation of an outcome measure of early social-communication for young children with ASD

摘要 大多数针对自闭症谱系障碍(ASD)儿童的有效社交沟通措施 被设计为行为表型或诊断此核心症状领域，而不是检测变化 随着时间的推移。缺乏有效的结果衡量标准也在某种程度上扼杀了干预研究的努力 早期干预者监测其项目对儿童社交能力影响的能力 结果。很难分清不显著的治疗效果是否是真正 无效的干预措施，或者更确切地说，针对这一人群的有效措施。我们知道，在早期， ASD儿童的基本社交和语言技能可以预测他们的功能 青春期，甚至成年期，5岁之前的语言功能使用是最好的预测因素之一 远期预后。因此，临床医生已经开始将他们的努力集中在改善儿童的社会- 使用发展和行为干预的沟通和语言技能 药物治疗。回顾这些治疗试验，很明显存在一系列干预措施。 成功，更清楚的是，我们缺乏一套一致的社交沟通结果衡量标准 症状域。我们的团队一直在努力验证关键社交沟通和 语言技能，并能够从丰富的先前心理测量数据中调整和验证简短的 可在临床试验以及常规护理和实践中轻松使用的观察性测量。 我们建议调整并通过心理测量学来验证社交和语言技能的测量 12-60个月的幼儿，初步或正式诊断为自闭症。具体地说，我们计划 验证自闭症谱系障碍(ECI-ASD)的早期沟通指标 典型的多点样本，特征良好的自闭症儿童(n=400)。当前版本的 ECI是规范引用的，并允许监视进度，这意味着该度量可以用于 形成性、数据驱动的方式来监控儿童的干预进展，并在儿童没有改变的情况下做出改变 改进，但它也可以提供总结性结果数据。此外，目前的措施可以现场评分 使用移动应用程序。目前，目前还没有其他社交沟通措施专门为 患有自闭症的儿童可以轻松地进行持续的干预进度监控、数据可视化和实时 评分，这将使适应的ECI-ASD成为一种独特的结果衡量工具。此外，ECI-ASD将 提供将数据输入在线平台的能力，以比较患有自闭症儿童的进展情况 标准数据，这代表了当前衡量标准之上迫切需要和明确的创新 接近了。预期交付成果是衡量关键社会沟通和语言的一种新成果 心理健康的技能，管理和评分的负担最小，并且对 对于患有自闭症的幼儿来说，预计会出现增量变化。

Abstract The majority of validated social-communication measures for children with autism spectrum disorder (ASD) were designed to behaviorally phenotype or diagnose this core symptom domain and not to detect change over time. The lack of validated outcome measures has somewhat stifled intervention research efforts as well as early interventionists’ ability to monitor the effects of their programs on children’s social-communicative outcomes. It has become difficult to sort out whether non-significant treatment effects are a result of truly ineffective interventions, or rather poorly validated measures for this population. We know that the early, foundational social-communication and language skills of children with ASD predict their functioning into adolescence and even adulthood, with functional use of language by age 5 being one of the best predictors of long-term prognosis. As such, clinicians have begun to focus their efforts on improving children’s social- communication and language skills using both developmental and behavioral interventions as well as pharmaceutical treatments. In reviewing these treatment trials, it is clear there is a range of intervention success and even more clear that we lack a consistent set of outcome measures for the social-communication symptom domain. Our group has been working to validate measures of key social-communication and language skills and are able to draw from a wealth of prior psychometric data to adapt and validate a brief observational measure that can be easily used within clinical trials as well as within routine care and practice. We propose to adapt and psychometrically validate a measure of social-communication and language skills for young children, ages 12 – 60 months, preliminarily or formally diagnosed with ASD. Specifically, we plan to validate the Early Communication Indicator for Autism Spectrum Disorder (ECI-ASD) using a robust and representative multisite sample of well-characterized children with ASD (n = 400). The current version of the ECI is norm-referenced and allows for progress monitoring, which means the measure can be used in a formative, data-driven fashion to monitor children’s intervention progress and make changes if children are not improving, but it also can provide summative outcome data. In addition, the current measure can be scored live using a mobile app. Currently, no other current social-communication measure specifically designed for children with ASD easily allows for ongoing intervention progress monitoring, data visualization, and live scoring, which will make the adapted ECI-ASD a unique outcome measurement tool. Further, the ECI-ASD will provide the ability to enter data into an online platform to compare the progress of children with ASD to normative data and this represents a sorely needed and clear innovation above current measurement approaches. The expected deliverable is a novel outcome measure of key social-communication and language skills that is psychometrically sound, minimally burdensome to administer and score, and sensitive to the incremental change expected for young children with ASD.