Adapting Cognitive Enhancement Therapy for ASD

采用认知增强疗法治疗自闭症谱系障碍

• 批准号: 7846721
• 负责人: NANCY J MINSHEW
• 金额: $ 20.58万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-01 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7846721
• 关键词: Achievement; Active Learning; Adaptive Behaviors; Address; Adult; Affect; Affective; Age; Arts; Asperger Syndrome; Attention; Autistic Disorder; Behavior; Behavioral; Benchmarking; Biological; Client satisfaction; Clinical; Clinical Trials; Clinical Trials Design; Cognition; Cognition Disorders; Cognitive; Cognitive deficits; Cognitive remediation; Communication; Complex; Computer software; Controlled Study; Data; Development; Diagnosis; Disease; Educational Curriculum; Eligibility Determination; Emotional; Emotions; Employee Strikes; Evaluation; Face Processing; Facial Expression; Failure; Family; Financial cost; Functional disorder; Funding; Gestures; Home environment; Impaired cognition; Impairment; Individual; Intervention; Investigation; Life; Manuals; Measurable; Measures; Memory; Methods; Mind; Neurobiology; Neurocognition; Neurocognitive; Neurodevelopmental Disorder; Nursery Schools; Occupations; Outcome; Patients; Perception; Performance; Persons; Pervasive Development Disorder; Phase; Pilot Projects; Play; Population; Preparation; Psychopathology; Quality of life; Randomized Controlled Trials; Reaction; Rehabilitation therapy; Research; Research Personnel; Schizophrenia; Schools; Short-Term Memory; Social Adjustment; Social Interaction; Socialization; Societies; Specific qualifier value; Structure; Techniques; Testing; Therapeutic; Training; Treatment Efficacy; Universities; Work; aged; autism spectrum disorder; base; behavioral impairment; central coherence; cognitive enhancement; cognitive function; cognitive rehabilitation; control trial; daily functioning; design; disability; early childhood; effective therapy; efficacy testing; efficacy trial; emotion regulation; evidence base; executive function; experience; functional outcomes; gaze; improved; information processing; innovation; interest; meetings; neuroimaging; novel; patient handout; professor; programs; psychoeducational; randomized trial; remediation; response; satisfaction; skills; social; social cognition; social communication; success; theories; treatment as usual; treatment effect; treatment program; young adult

DESCRIPTION (provided by applicant): Autism spectrum disorders (ASD) are defined by specific behavioral impairments in social interactions, verbal and non-verbal (gaze, face expression, gestures, prosody) communication, imaginative play, and by restricted and repetitive interests and behavior. Underlying these behaviors are deficits in social and non- social cognition and information processing. Interventions for autism have largely focused on the preschool years and behavioral methods. Few interventions are available for adults with ASD, and even fewer focus on the remediation of cognitive and social-emotional deficits in a way designed to improve complex adaptive behavior essential for success and achievement in adult life. As a consequence, many verbal adults with ASD experience substantial lifetime disability resulting in great personal and family suffering and great financial cost. In response to RFA-MH-09-021, "Novel Interventions for Neurodevelopmental Disorders," we propose the first step in adapting, piloting and preliminarily testing of the efficacy of Cognitive Enhancement Therapy (CET) for young transitional age high functioning adults with ASD to improve adaptive functioning and adult life achievement in this population. CET is a neurodevelopmentally-based, social-cognitive and neurocognitive rehabilitation program originally developed for schizophrenia that has demonstrated significant improvements in cognition and important functional outcomes. Many of the social, communication, and cognitive impairments experienced by persons with ASD (e.g., impaired theory of mind, deficient emotion perception, poor emotion regulation and expression, inflexibility, executive dysfunction) are also shared by individuals with schizophrenia. These impairments are directly targeted by CET, suggesting that CET may confer substantial benefits to verbal individuals with ASD who often do poorly as adults and for whom few interventions exist. This project will consist of two phases. In the first (R21) phase, adaptations to the CET treatment reflecting the uniqueness of autism will be made through the development of a supplement to the existing CET treatment manual. Clinical experts in autism and schizophrenia will collaborate to adapt CET, and then conduct an uncontrolled pilot study of these adaptations with 12 young adults with ASD to demonstrate feasibility, identify the need for additional adaptations, and provide an initial evaluation of the potential social-emotional and cognitive effects of the approach. In the second (R33) phase, a small-scale randomized trial with 55 young adults with ASD will be conducted to obtain initial efficacy data on a broad range of cognitive, functional, and neurobiological outcomes to support the feasibility of a larger and more definitive trial of CET for ASD. The proposed R21-R33 will result in the completion of the first rigorous clinical trial of a proven cognitive rehabilitation approach with verbal adults with ASD. If successful, this project will result in a major step forward in available interventions for adults with ASD, and have implications for both younger individuals with autism and other neurodevelopmental disorders that share similar cognitive, affective and social impairments.

描述（由申请人提供）：自闭症谱系障碍（ASD）是由社交互动，言语和非语言和非语言（目光，面部表情，手势，韵律）交流，富有想象力的游戏以及受限制和重复的利益和行为和行为和行为的特定行为障碍定义的。这些行为的基础是社会和非社会认知和信息处理中的缺陷。自闭症的干预措施主要集中在学前班和行为方法上。对于ASD的成年人来说，很少有干预措施，甚至更少关注对认知和社会情感缺陷的补救，旨在改善成人生活中成功和成就必不可少的复杂适应性行为。结果，许多ASD的口头成年人经历了终身残障，导致了巨大的个人和家庭苦难以及巨大的经济成本。为了响应RFA-MH-09-021，“神经发育障碍的新干预措施”，我们提出了对认知增强疗法（CET）对年轻年龄高的成年人的认知能力增强疗法（CET）的疗效的适应，试验和初步测试的第一步，以提高适应性的成人生活和成人生活的成果成就，以提高适应性的运作成果。 CET是一种基于神经发育的，社会认知和神经认知康复计划，最初是针对精神分裂症制定的，该计划在认知和重要功能结果方面表现出显着改善。患有ASD的人（例如，心理理论，情绪不良，情绪不良，情绪调节和表达，僵化，执行功能障碍）所经历的许多社会，沟通和认知障碍也被精神分裂症患者共享。这些障碍是由CET直接针对的，这表明CET可能会给ASD的言语人士带来可观的好处，而ASD通常会像成年人一样做得不好，而对他们的干预很少。该项目将由两个阶段组成。在第一阶段（R21）阶段，将通过开发现有CET治疗手册的补充来对CET治疗进行改编，以反映自闭症的独特性。自闭症和精神分裂症的临床专家将合作调整CET，然后对12名ASD的年轻人进行了不受控制的试点研究，以证明可行性，确定需要进行额外的适应，并对方法的潜在社会情感和认知效应提供初步评估。在第二阶段（R33）阶段，将进行一项针对55名患有ASD的年轻人的小规模随机试验，以获取有关广泛的认知，功能和神经生物学结果的初始疗效数据，以支持CET对ASD的更大和更明确的试验的可行性。拟议的R21-R33将导致对患有ASD的言语成年人进行了经过验证的认知康复方法的第一次严格临床试验。如果成功的话，该项目将导致对患有ASD的成年人的可用干预措施迈出重要的一步，并对患有自闭症和其他具有相似认知，情感和社会障碍的神经发育障碍的年轻人产生影响。