Language Functioning in Optimal Outcome Children with a History of Autism

有自闭症史的儿童的最佳结果的语言功能

基本信息

批准号：
7244244
负责人：
Deborah A. Fein
金额：
$ 50.55万
依托单位：
UNIVERSITY OF CONNECTICUT STORRS
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-07-01 至 2010-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7244244
关键词：
Address Adolescence Age Anxiety Anxiety Disorders Area Attention deficit hyperactivity disorder Autistic Disorder Behavior Behavior assessment Behavioral Biological Neural Networks Brain Broca&apos s area Child Cognition Cognitive Competence Complex Data Development Dimensions Documentation Early Diagnosis Early Intervention Employee Strikes Eye Face Face Processing Frequencies Functional Magnetic Resonance Imaging Gender Hand Head circumference Impairment Intervention Language Language Development Language Tests Link Magnetic Resonance Imaging Measures Mediating Memory Mental Depression Mental disorders Minority Neural Pathways Only Child Outcome Paper Participant Pathway interactions Pattern Performance Process Purpose Range Recording of previous events Recovery Recruitment Activity Relative (related person)Reporting Research Research Personnel Residual state Score Silicon Dioxide Social Behavior System Task Performances Testing Uncertainty Wernicke Area Work age group autism spectrum disorder brain volume central coherence clinically significant executive function fusiform face area improved interest language processing morphometry neuromechanism outcome forecast programs relating to nervous system remediation sample fixation skills social cognition social skills syntax white matter

项目摘要

DESCRIPTION (provided by applicant): Prognosis for children with Autism Spectrum Disorder (ASD) receiving intensive early intervention has improved substantially. A minority of these children appear to reach what may be called "optimal outcome", in which cognitive and adaptive functioning are within normal limits and they no longer meet criteria for any ASD. Little or no rigorous documentation of such children or their status has been attempted and some recent papers have suggested that such an outcome is not a realistic aim for ASD children; therefore, even the existence of the optimal outcome group remains controversial. None of these children has been studied in detail, or followed into adolescence, so the extent to which their functioning has truly normalized is not known. Since language difficulties in ASD are so pervasive and central, residual language difficulties might be expected to persist even in children with optimal outcomes. Preliminary studies on a group of such children suggest that they show many areas of normalized language functioning as well as specific areas in which impairment is still demonstrated. We propose to study a group of these children in early to mid- adolescence and fully assess their language, cognitive, and adaptive competence. One important question naturally arises from our preliminary results: what are the underlying neural mechanisms of the striking improvement of cognitive processes in these optimal outcome children? It could be hypothesized that their atypical acquisition of early language resulted in an atypical neural representation of language processes, even with normal behavioral performance. This would imply that alternative neural pathways and networks may be recruited to perform a task to behaviorally normal levels, suggesting the existence of multiple developmental pathways to successful functioning. On the other hand, the optimal outcome children with normal performance levels might show typical patterns of brain activation, suggesting that only remediation that normalizes the use of neural networks can result in normal task performance; this would have implications for the importance of very early intervention. fMRI tasks of syntax and face processing will be administered to address this question, and exploratory analysis of selected structural variables will be examined to see if the most successful intervention appears to operate on a structurally normal brain.

描述（由申请人提供）：接受强化早期干预的自闭症谱系障碍 (ASD) 儿童的预后已得到显着改善。这些儿童中的少数似乎达到了所谓的“最佳结果”，其中认知和适应功能处于正常范围内，并且不再符合任何自闭症谱系障碍的标准。很少或根本没有对这些儿童或其状况进行严格的记录，最近的一些论文表明，这样的结果对于自闭症谱系障碍儿童来说并不是一个现实的目标；因此，即使是最佳结果组的存在也仍然存在争议。这些孩子都没有被详细研究过，也没有进入青春期进行跟踪调查，因此他们的功能真正正常化的程度尚不清楚。由于自闭症谱系障碍患者的语言困难是如此普遍和重要，因此即使在具有最佳结果的儿童中，残余的语言困难也可能会持续存在。对一组此类儿童的初步研究表明，他们的语言功能在许多方面都正常，但在某些特定方面仍然存在障碍。我们建议研究一组处于青春期早期到中期的儿童，并全面评估他们的语言、认知和适应能力。我们的初步结果自然而然地提出了一个重要问题：这些最佳结果儿童的认知过程显着改善的潜在神经机制是什么？可以假设，即使行为表现正常，他们对早期语言的非典型习得导致了语言过程的非典型神经表征。这意味着可以招募替代神经通路和网络来执行行为正常水平的任务，这表明存在多种成功发挥功能的发育途径。另一方面，具有正常表现水平的最佳结果儿童可能会表现出典型的大脑激活模式，这表明只有使神经网络的使用正常化的补救措施才能导致正常的任务表现；这将对非常早期干预的重要性产生影响。将进行语法和面部处理的功能磁共振成像任务来解决这个问题，并对选定的结构变量进行探索性分析，以了解最成功的干预措施是否适用于结构正常的大脑。