Pilot Study to Improve Access to Early Intervention for Autism in Africa

改善非洲自闭症早期干预的试点研究

• 批准号: 8959281
• 负责人: Lauren Franz
• 金额: $ 18.36万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-07 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8959281
• 关键词: Adaptive Behaviors; Address; Africa; Africa South of the Sahara; African; Autistic Disorder; Award; Caregiver Burden; Caregivers; Caring; Child; Child Language; Child Mental Health; Child Psychiatry; Childhood; Clinical; Clinical Research; Cognitive; Collaborations; Communication; Communities; Country; Data; Development; Disease; Early Intervention; Educational Intervention; Effectiveness of Interventions; Evidence based intervention; Family; Foundations; Goals; Health Priorities; Healthcare; Improve Access; Income; Individual; Institutes; Intervention; Intervention Studies; Intervention Trial; K-Series Research Career Programs; Language; Learning; Letters; Life; Location; Low Literacy Population; Low income; Manuals; Mediating; Mental Health; Mentors; Mentorship; Methods; Mind; Modeling; Modification; National Institute of Mental Health; Neurodevelopmental Disorder; Nursery Schools; Outcome; Parent-Child Relations; Parents; Performance; Pilot Projects; Procedures; Protocols documentation; Quality of life; Research; Research Ethics; Research Infrastructure; Research Personnel; Resources; Services; Severities; Staging; Strategic Planning; Structure; Symptoms; Time; Training; Training Support; Universities; Work; aged; autism spectrum disorder; base; burden of illness; career; community setting; cost; cost effective; developmental disease; effective intervention; evidence base; experience; global health; implementation science; improved; innovation; intervention program; language comprehension; neuropsychiatry; programs; public health relevance; social; success

 DESCRIPTION (provided by applicant): A significant global challenge is to develop scalable, feasible, early interventions for autism spectrum disorders (ASD) that can be implemented in diverse and low resource communities. There is growing excitement around innovative caregiver-mediated early intervention strategies, for example the Parent Early Start Denver Model (P-ESDM) co-developed by Dr. Geraldine Dawson, my primary advisor on this application. Caregiver-mediated interventions have been shown to improve parent-child interactions and child language comprehension, and reduce the severity of ASD. Importantly, engagement of caregivers promises new ways to address the capacity barrier globally. My planned research career trajectory is to become a leader in the development and implementation of caregiver-mediated interventions for ASD and other childhood neuropsychiatric disorders in diverse and low resource communities. The highly structured mentorship and training plan outlined in this proposal would set the foundation for achieving this goal. Importantly, this work is closely aligned with 2 of the top Grand Challenges in Global Mental Health priorities: 1) to reduce the duration of untreated illness by developing culturally-sensitive early interventions, and 2) to improve child access to evidence-based mental health care (11). In addition, this work aligns with an objective of the Federal Interagency Autism Coordinating Committee Strategic Plan: to support community-based studies that assess the effectiveness of interventions and services in broader community settings including scalable early intervention programs for implementation in underserved, low-resource, and low-literacy populations (12). I plan to: 1) train in implementation science and community participatory research, 2) train in clinical research and research ethics, and 3) obtain hands-on experience by conducting an ASD intervention trial using a culturally adapted version of the original evidence-based intervention in a low resource African setting. I have brought together an outstanding team of advisors with expertise in ASD (Dr. Dawson (Duke), Dr. de Vries (University of Cape Town), Dr. Rogers (UC Davis Mind Institute)), global health (Dr. de Vries, Dr. Sikkema (Duke)), child psychiatry (Dr. Egger (Duke), Dr. de Vries), intervention research (Dr. Dawson, Dr. Rogers, Dr. Sikkema), and community participatory research (Dr. Sikkema). Working in collaboration with the Center for Autism Research in Africa, I propose to adapt the Parent Early Start Denver Model (P-ESDM) treatment manual, and training approach, and conduct a pilot study to explore the acceptability, feasibility, and impact of this adapted intervention on child and caregiver outcomes in an African setting. In addition, I will capitalize on existing research infrastructure supported by the NIMH through the University of Cape Town AFFIRM Hub (see Lund letter of support). The foundational mentorship, training and experience gained through this award will set the stage for a career focused on enhancing the quality of life for children wih neurodevelopmental disorders and equip me with the skillset to become an independent clinical researcher.

 描述（由适用提供）：一个重大的全球挑战是针对自闭症谱系障碍（ASD）的可扩展，可行的早期干预措施（ASD），可以在潜水员和资源较低的社区中实施。创新的护理人员介导的早期干预策略，例如，由我的主要顾问Geraldine Dawson博士共同开发了创新的护理人员介导的早期干预策略，例如父母早期丹佛模型（P-ESDM）。护理人员介导的干预措施已被证明可以改善亲子互动和儿童语言理解，并降低ASD的严重程度。重要的是，护理人员的参与有望在全球解决容量障碍的新方法。我计划的研究职业轨迹是成为对潜水员和资源较低的ASD和其他童年神经精神疾病开发和实施干预措施开发和实施干预措施的领导者。该提案中概述的高度结构化的心态和培训计划将为实现这一目标奠定基础。重要的是，这项工作与全球心理健康优先事项中的2个主要挑战紧密相符：1）通过制定对文化敏感的早期干预措施来减少未经治疗的疾病的持续时间，而2）可以改善儿童获得基于证据的心理卫生保健的机会（11）。此外，这项工作符合联邦机构间自闭症协调委员会战略计划的目的：支持基于社区的研究，以评估更广泛的社区环境中干预措施和服务的有效性，包括可扩展的早期干预计划，以实施不足，低位数和低素养人群（12）。我计划：1）培训实施科学和社区参与研究，2）培训临床研究和研究伦理的培训，以及3）通过使用在非洲低资源环境中的原始循证干预措施进行文化适应的原始循证干预措施，通过进行ASD干预试验来获得动手经验。 I have brought together an outstanding team of advisors with expertise in ASD (Dr. Dawson (Duke), Dr. de Vries (University of Cape Town), Dr. Rogers (UC Davis Mind Institute)), global health (Dr. de Vries, Dr. Sikkema (Duke)), child psychiatry (Dr. Egger (Duke), Dr. de Vries), intervention research (Dr. Dawson, Dr. Rogers, Dr. Sikkema), and community参与研究（Sikkema博士）。我建议与非洲自闭症研究中心合作，以适应父母的早期起始丹佛模型（P-ESDM）治疗手册和培训方法，并进行试点研究，以探索这种适应性干预对非洲环境中儿童和护理人员的可接受性，可行性和影响。此外，我将利用NIMH通过开普敦大学确认中心支持的现有研究基础设施（请参阅Lund支持Letter of Support of Support Letter）。通过该奖项获得的基本心态，培训和经验将为专注于增强神经发育障碍的儿童生活质量的职业奠定基础，并为我提供技能，使我成为一名独立的临床研究人员。