CLINICAL PHENOTYPE: TREATMENT RESPONSE CORE

临床表型：治疗反应核心

• 批准号: 7681647
• 负责人: LAURA E SCHREIBMAN
• 金额: $ 20万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7681647
• 关键词: 2 year old; Age; Appendix; Area; Arts; Autistic Disorder; Behavior Therapy; Behavioral; Bioinformatics; Biologic Characteristic; Biological Factors; Biometry; Brain; Characteristics; Child; Clinical; Cognitive; Communities; Data; Development; Educational Curriculum; Educational process of instructing; Effectiveness; Ensure; Evidence based treatment; Floor; Foundations; Funding; Gene Expression; Goals; Human Resources; Intervention; Language; Learning; Length; Methods; Outcome; Outcome Measure; Parenting Education; Participant; Pattern; Population; Rate; Research; Risk; Severities; Social Behavior; Speed; Structure; Symptoms; Time; Toddler; Training; Treatment Protocols; Treatment outcome; Variant; Work; autism spectrum disorder; base; clinical phenotype; cognitive function; genetic profiling; indexing; joint attention; programs; quality assurance; response; social

Research has shown that despite significant rigor and intensity, some children with an autism spectrum disorder fail to make significant gains in response to behavioral treatment (e.g., Sherer & Schreibman, 2005). The behavioral characteristics of children who excel versus those that do not are not well understood. The biological characteristics of such treatment responders and nonresponders are completely unknown. In order to determine what behavioral and biological factors predict treatment responsiveness, consistency regarding various aspects of treatment must be provided. For all children the type of treatment, age at which treatment is administered, and length of treatment must be consistent. Therefore, a Treatment Core (TxC) has been established to implement an evidence-based treatment for toddlers with autism participating in the ACE projects. A specific, manualized treatment, the STAR Program (see Appendix A), has been chosen as the foundation for the treatment. This curriculum incorporates evidence-based behavioral methods, including discrete trial teaching, pivotal response training, and teaching within functional routines, that are of documented effectiveness. This curriculum will be adapted to accommodate 2-year-old children and to include additional social goals and developmental strategies. Recently, a developmental, social-pragmatic intervention that incorporates both developmental and naturalistic behavioral strategies has been examined as a parent education adjunct to the STAR curriculum. This program incorporates early developmental strategies such as Responsive Teaching and Floor Time/DIR, which encourage joint attention, social responsiveness, and engagement in children with autism. We believe, and preliminary data agree, that this combination of curricula and strategies will provide an effective and consistent treatment for children with autism. Overall, the Treatment Core (TxC), has two main goals: The first is to provide state-of-the art behavioral treatment to all participants who meet provisional criteria for autism at 2 years. In order to meet this goal, the TxC will ensure consistent application of treatment practices by training all study personnel in treatment protocol to mastery level. Additionally, the TxC will ensure fidelity of implementation of the treatment protocol throughout the funding period. The second goal is to provide a quantitative index of level of response to treatment for each at-risk toddler for use in predictive analyses in Projects 1-4. As such, the TxC will collect data throughout treatment to assess learning rate and speed of progress in each curriculum area. Finally, the TxC will establish an overall response-to-treatment profile for each study toddler in the domains of symptom severity, cognitive, language, and social behavior. These profiles will be used by each project as well as the Integrated Biostatistics and Bioinformatic Analysis Core to determine the profiles of treatment responders and nonresponders.

研究表明，尽管严格和强度很高，但一些自闭症谱系的儿童 疾病无法响应行为治疗而取得巨大的收益（例如，Sherer＆Schreibman， 2005）。脱颖而出的儿童与不良好的孩子的行为特征 理解。此类治疗反应者和无反应者的生物学特征完全是 未知。为了确定哪些行为和生物学因素可以预测治疗反应能力， 必须提供有关治疗各个方面的一致性。对于所有儿童的治疗类型， 服用治疗的年龄，治疗时间必须保持一致。因此，一种治疗 已经建立了核心（TXC），以对自闭症的幼儿实施基于证据的治疗 参加ACE项目。特定的，手动的治疗，星级计划（请参阅附录A）， 已被选为治疗的基础。该课程结合了循证 行为方法，包括离散试验教学，关键响应培训和内部教学 功能性例程，具有有效性。该课程将适应以适应 2岁的孩子，包括其他社会目标和发展策略。最近， 发展性，社会触发干预措施，既结合发展又自然主义 行为策略已被视为Star课程的父母教育。这 计划结合了早期的发展策略，例如响应式教学和落地时间/dir， 鼓励对自闭症儿童的共同关注，社会响应能力和参与。我们 相信和初步数据同意，这种课程和策略的结合将提供有效的 以及对自闭症儿童的一致治疗。 总体而言，治疗核心（TXC）有两个主要目标：第一个是提供最先进的行为 对满足自闭症临时标准的所有参与者的治疗。为了实现这一目标， TXC将通过培训所有研究人员在治疗中确保持续应用治疗方法 协议到掌握级别。此外，TXC将确保实施治疗的保真度 在整个资金期间的协议。第二个目标是提供一个定量指数 对每个高危幼儿的治疗响应，用于在项目1-4中进行预测分析。因此， TXC将在整个治疗过程中收集数据，以评估每个课程中的学习率和进度速度 区域。最后，TXC将为每个研究的蹒跚学步者建立整体对处理的响应。 症状严重程度，认知，语言和社会行为的领域。这些配置文件将由每个配置文件使用 项目以及综合的生物统计学和生物信息学分析核心，以确定 治疗响应者和无反应者。