Evaluating additive effects of including canines in Regulating Together: A Group Treatment to Address Emotion Dysregulation in youth with autism spectrum disorder

评估将犬类纳入“共同调节：解决患有自闭症谱系障碍的青少年情绪失调的团体治疗”的附加效应

• 批准号: 10531772
• 负责人: Rebecca Shaffer
• 金额: $ 68.36万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10531772
• 关键词: Address; Affect; Age; Animals; Area; Arousal; Attention; Attention deficit hyperactivity disorder; Awareness; Behavior; Behavior Therapy; Canis familiaris; Cardiovascular system; Caregivers; Child; Cognitive; Cognitive Therapy; Colorado; Control Groups; Critiques; Data; Data Collection; Distal; Drops; Educational Curriculum; Emotional; Emotions; Employment; Equipment and supply inventories; Evidence based intervention; Family; Feeling suicidal; Funding Opportunities; Heart Rate; Hospitalization; Human; Hyperactivity; Impairment; Intervention; Intervention Studies; Knowledge; Learning; Link; Longevity; Measurement; Measures; Mental Health Services; Methods; Minority Groups; Modality; Modification; Motivation; National Institute of Child Health and Human Development; Outcome; Outcome Measure; Outpatients; Parents; Pediatric Hospitals; Personal Satisfaction; Pharmaceutical Preparations; Physiological; Population; Problem behavior; Process; Public Health; Quality of life; Randomized Clinical Trials; Randomized Controlled Trials; Role; School-Age Population; Schools; Site; Symptoms; Techniques; Testing; Therapeutic; Training; Treatment Efficacy; Work; Youth; adolescent with autism spectrum disorder; animal efficacy; autism spectrum disorder; autistic children; base; caregiver stress; college; data standards; dysphoria; emotion dysregulation; emotion regulation; executive function; experience; flexibility; follow-up; heart rate variability; hospitalization rates; improved; individuals with autism spectrum disorder; learning materials; mindfulness; minority children; negative affect; outpatient programs; patient population; peer; post intervention; programs; psychologic; satisfaction; secondary outcome; skills; social skills; success; treatment group

Project Summary/Abstract The primary objective of this R01 application is to evaluate the potential additive effect of animal-assisted intervention (AAI) on a manualized behavioral treatment targeting emotion dysregulation (ED) in children with autism spectrum disorder (ASD). ED in youth with ASD has been linked to significantly higher rates of psychiatric hospitalizations, suicidal ideation, use of psychotropic medications, school disciplinary actions, peer rejection, failed college and employment transitions, and poorer quality of life. Our group developed Regulating Together (RT), an intensive group-based treatment with a concurrent parent group that employs evidence-based intervention techniques of cognitive behavioral therapy, parent training, and mindfulness and acceptance-based therapy. Preliminary evidence for its feasibility and efficacy has been demonstrated, including reductions in emotional reactivity and dysphoria and increases in heart rate variability and cognitive flexibility at 10-weeks following intervention. Despite this, change did not occur immediately post intervention. Animal Assisted Interventions (AAI) have emerged as a promising approach for youth with ASD, demonstrating improvements in irritability, hyperactivity, positive affect, and quality of life. AAI also has shown to increase in-session engagement and learning. Yet, AAI has not yet been utilized to systematically target ED in ASD nor has it been examined in conjunction with a manualized intervention. In the current study, we propose a multi-site randomized clinical trial of RT with and without a canine present to evaluate its immediate and longer-term efficacy. In 240 youth (ages 8-12 years) with ASD, we will assess RT with AAI (RT-Canine) and without AAI (RT-Standard) on primary ED symptom of reactivity, and secondary outcomes, including dysphoria, caregiver stress, cognitive flexibility, mindfulness awareness, and emotion regulation skills knowledge. We hypothesize that the canines will increase therapeutic engagement measured through alliance, motivation, and improved behavior, which will then increase intervention session level learning, and ultimately immediate and long-term intervention outcomes. Furthermore, based on our preliminary evidence, we also will explore an objective outcomes measure of heart rate/heart rate variability and its relationship to engagement, learning, and ED symptom outcomes. This proposal is relevant to the NICHD Human-Animal Interaction funding opportunity by addressing the critical public health issue of ASD through examination of AAI efficacy by utilizing standardized data collection outcome methods. In addition, we closely address protection for both the canines and the youth with ASD throughout the proposal. Finally, we will make a concerted effort to include youth from minority groups, as emphasized in the FOA. Ultimately, findings from our study have the potential to expand both ASD and AAI research, with immense impact on the well-being and outcomes of youth with ASD as evidence-based interventions for ED in this population is a critical gap in mental health care.

项目概要/摘要 该 R01 应用的主要目的是评估动物辅助的潜在累加效应 针对儿童情绪失调（ED）的手动行为治疗干预（AAI） 自闭症谱系障碍（ASD）。患有自闭症谱系障碍 (ASD) 青少年的 ED 与显着较高的精神病发病率有关 住院治疗、自杀意念、使用精神药物、学校纪律处分、同伴排斥、 大学和就业转型失败，生活质量较差。我们小组开发了“共同监管” (RT)，一种基于小组的强化治疗，同时有一个家长小组，采用基于证据的方法 认知行为疗法、家长培训、正念和接受为基础的干预技术 治疗。其可行性和有效性的初步证据已经得到证实，包括减少 10 周时情绪反应和烦躁不安，心率变异性和认知灵活性增加 干预后。尽管如此，干预后并没有立即发生变化。动物辅助 干预措施 (AAI) 已成为治疗自闭症谱系障碍 (ASD) 青少年的一种有前途的方法，显示出在 烦躁、多动、积极情绪和生活质量。 AAI 还显示出可以提高会议参与度 和学习。然而，AAI 尚未被用于系统性地针对自闭症谱系障碍 (ASD) 的 ED，也未在 与手动干预相结合。 在当前的研究中，我们提出了一项有或没有犬的多中心随机放疗临床试验 评估其近期和长期疗效。在 240 名患有自闭症谱系障碍 (ASD) 的青少年（8-12 岁）中，我们将 评估使用 AAI (RT-Canine) 和不使用 AAI (RT-Standard) 的 RT 对主要 ED 反应性症状的影响，以及 次要结果，包括烦躁不安、照顾者压力、认知灵活性、正念意识和 情绪调节技能知识。我们假设犬齿会增加治疗参与度 通过联盟、动机和改进行为来衡量，这将增加干预次数 水平学习，以及最终的即时和长期干预结果。此外，根据我们的 初步证据，我们还将探索心率/心率变异性的客观结果测量，以及 它与参与、学习和 ED 症状结果的关系。 该提案通过解决以下问题，与 NICHD 人与动物互动资助机会相关： 通过利用标准化数据收集来检查 AAI 的功效，从而解决自闭症谱系障碍 (ASD) 的关键公共卫生问题 结果方法。此外，我们还密切关注对患有自闭症谱系障碍 (ASD) 的犬科动物和青少年的保护 贯穿整个提案。最后，我们将共同努力，让少数群体青年参与其中， FOA 中强调。最终，我们的研究结果有可能扩展 ASD 和 AAI 研究，对​​自闭症谱系障碍青少年的福祉和结果产生巨大影响 针对这一人群的 ED 干预措施是精神卫生保健领域的一个重大缺口。