EARLY INTENSIVE BEHAVIORAL INTERVENTION AND AUTISM

早期强化行为干预和自闭症

• 批准号: 6671038
• 负责人: RAFAEL KLORMAN KLORMAN
• 金额: $ 32.13万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-07-01 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6671038
• 关键词: autism; behavior test; behavior therapy; behavioral /social science research tag; child behavior disorders; child mental disorders; child psychology; clinical research; cognition; cooperative study; early experience; gene expression; genetic screening; genetic susceptibility; genotype; human subject; language development; preschool child (1-5); verbal learning

Early intensive behavioral intervention is the only treatment for autism spectrum disorders for which a substantial number of studies have demonstrated efficacy. However, not all children respond to this treatment, and recent evidence suggests that success and failure are determined more by variations among patients than by variations among intensive intervention programs. To choose the best treatment for each child, it is important to determine which characteristics of children with ASDs predict their response to behavioral intervention. Further, since it is likely that responders and non-responders differ in etiology, successful categorization on this dimension could provide a way of stratifying children with ASDs into genetically meaningful subsets. Thus, successful prediction would serve both an important public health goal and an important basic science goal. Because many children in early intervention programs in our region receive very similar programs of ABA therapy at public expense, we have a population in which this question can be addressed at a reasonable cost. Over the first 2 years of intervention, response to treatment will be measured by change in four domains: behaviors related to autism, language, cognition, and adaptive behavior. Measures of four possible predictor variables will be tested for their correlation with change. These are: aloof social style, obsessive self stimulation of the senses, rudimentary receptive language, and imitation. The hypothesis is that the first two will predict low levels of response, and the last two will predict high levels of response to treatment. Each participant will be genotyped for alleles of six candidate genes (HOXA1, HOXBI, RELN, WNT2, HOXD1, GBX2), to determine whether either scores on the predictor variables or change scores are correlated with suspected genetic susceptibility factors for ASDs.

早期强化行为干预是自闭症谱系障碍的唯一治疗方法，大量研究表明了有效性。但是，并非所有儿童都对这种治疗做出反应，并且最近的证据表明，成功和失败的决定性和失败是由患者之间的变化所决定的，而不是密集干预计划之间的变化。为了为每个孩子选择最佳治疗方法，重要的是确定ASD的儿童的哪些特征可以预测他们对行为干预的反应。此外，由于响应者和非反应者的病因可能会有所不同，因此在此维度上的成功分类可以提供一种将ASD的儿童分为遗传意义的子集的方法。因此，成功的预测将既服务于重要的公共卫生 目标和重要的基本科学目标。由于我们地区早期干预计划中的许多儿童都以公共费用获得了非常相似的ABA治疗计划，因此我们有一个人口，可以以合理的成本解决这个问题。在干预的前两年中，对治疗的反应将通过四个领域的变化来衡量：与自闭症，语言，认知和适应性行为有关的行为。将测试四个可能的预测变量的度量，以确保它们与变化的相关性。这些是：超然的社会风格，对感官的强迫性自我刺激，基本的接受语言和模仿。假设是前两个将预测较低的反应水平，最后两个将预测对治疗的高度反应水平。每个参与者将针对六个等位基因进行基因分型 候选基因（Hoxa1，Hoxbi，Reln，Wnt2，Hoxd1，GBX2），以确定预测变量上的分数还是变化得分上的任何一个分数与ASD的可疑遗传易感因子相关。