Optimal Outcomes in ASD: Adult Functioning, Predictors, and Mechanisms

自闭症谱系障碍 (ASD) 的最佳结果：成人功能、预测因子和机制

• 批准号: 10065523
• 负责人: Inge-Marie Eigsti
• 金额: $ 64.34万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-01-01 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10065523
• 关键词: 18 year old; 21 year old; Address; Adolescence; Adolescent; Adult; Affect; Age; Anxiety; Attention; Attention deficit hyperactivity disorder; Brain; Brain region; Child; Childhood; Clinical; Cohort Studies; Data; Development; Diagnosis; Dorsal; Early Diagnosis; Early identification; Employment; Face; Financial compensation; Functional Magnetic Resonance Imaging; Functional disorder; Gender; Gold; Grant; Homologous Gene; Image; Impairment; Individual; Intervention; Knowledge; Language; Lead; Left; Life; Magnetic Resonance Imaging; Measures; Methods; Modeling; Motor; Network-based; Occupational; Outcome; Outcomes Research; Participant; Personality; Phobias; Prospective Studies; Research; Residual state; Rest; Risk; Seeds; Social Functioning; Specific qualifier value; Symptoms; System; Task Performances; Teenagers; Testing; Time Study; Work; autism spectrum disorder; autistic children; base; cognitive control; cohort; comorbidity; early childhood; early onset; executive function; experience; follow-up; functional outcomes; graph theory; higher education; information processing; language impairment; language outcome; language processing; lexical; neural circuit; neuroimaging; neuromechanism; novel; peer; prospective; recruit; relating to nervous system; repetitive behavior; research study; segregation; skills; social; social communication; syntax; young adult

Some individuals meet gold-standard clinical criteria for ASD prior to age 5 but end up later in development with no symptoms of ASD, and IQ and adaptive skills in the average range. This study evaluates this “optimal outcome” (OO) in two groups: (1) those who participated in our OO research study as teens, now young adults, allowing us to evaluate how they navigate the difficult transition into independence and young adulthood; and (2) those who were diagnosed by us with ASD at age two and re-evaluated at age four, now in their teens, allowing us to identify which of this cohort has achieved optimal outcome, and thus to identify early predictors of OO. Both cohorts are compared to age-, gender-, and NVIQ-matched individuals with current ASD and with typical development (TD). We hypothesize that the young adults with OO will experience mild delays in adult milestones such as finishing higher education and obtaining competitive employment, along with greater anxiety, especially simple phobias, and ADHD symptoms. We also hypothesize that early childhood predictors of OO will be milder social impairment, higher adaptive skills in social, communication, and motor domains, and fewer repetitive behaviors. We employ fMRI in the second cohort (n=50 per study group, total n=150) to measure the functional connectivity networks that are involved in social and language tasks, and that are observed during resting state, to investigate how neural mechanisms relate to the dramatic symptom change observed in OO. Drawing on prior imaging research, we hypothesize that, compared to both ASD and TD, the OO group will show compensatory (atypical) connectivity of extra-modular prefrontal cognitive control networks and right hemisphere homologues of left-hemisphere language regions during language and social processing and during resting state.

有些人符合5岁之前ASD的金标准临床标准，但最终发展 在平均范围内没有ASD的症状，智商和自适应技能。这项研究评估了这一“最佳 结果”（OO）分为两组：（1）参加我们的OO研究的年轻人，现在是年轻人， 允许我们评估他们如何导航到独立和成年期的艰难过渡； （2）那些被我们诊断为2岁的ASD并在四岁时重新评估的人，现年十几岁， 允许我们识别哪个队列已经取得了最佳结果，从而提早识别 OO的预测因素。将两个队列与年龄，性别和NVIQ匹配的个体进行比较 ASD和典型开发（TD）。我们假设OO的年轻人将经历中间 延迟成人里程碑，例如完成高等教育和获得竞争性就业 焦虑，尤其是简单的恐惧症和多动症症状。我们还假设了 OO的童年预测指标将是Miller社会障碍，社交，沟通方面的较高适应能力， 和运动域，重复行为较少。我们在第二个队列中使用fMRI（每项研究n = 50） 组，总n = 150），以衡量与社交和语言有关的功能连接网络 任务以及在静止状态期间观察到的，以研究神经机制与 在OO中观察到急剧的症状变化。利用先前的成像研究，我们假设这一点， 与ASD和TD相比，OO组将表现出模块化外的代偿性（非典型）连通性 前额叶认知控制网络和右半球语言区域的右半球字体 在语言和社会处理期间以及在休息状态下。