Child-Initiated Communicative Interactions and Autism Intervention

儿童发起的交流互动和自闭症干预

• 批准号: 7930537
• 负责人: ROBERT L KOEGEL
• 金额: $ 32.11万
• 依托单位: UNIVERSITY OF CALIFORNIA SANTA BARBARA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-11 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7930537
• 关键词: Adaptive Behaviors; Affect; Area; Asses; Autistic Disorder; Behavioral; Centers for Disease Control and Prevention (U.S.); Child; Clinic; Clinical Research; Communication; Competence; Diagnostic; Disease; Effectiveness; Effectiveness of Interventions; Environment; Epidemic; Exhibits; Generic Drugs; Growth; Heterogeneity; Intervention; Interview; Journals; Laboratories; Language; Literature; Measurable; Measures; National Research Council; Normalcy; Outcome; Parents; Procedures; Publishing; Randomized Clinical Trials; Research; Sampling; Schedule; Semantics; Sparrows; Specific qualifier value; Speech; Staging; Symptoms; Time; United States National Institutes of Health; Verbal Behavior; Videotape; Writing; behavior rating scale; comparison group; cooking; improved; post intervention; public health relevance; reinforcer; response; social; social communication; syntax; treatment as usual

DESCRIPTION (provided by applicant): Literature and clinical research suggest that improvements in communicative initiations are associated with widespread improvements in communication and in related core symptoms of autism (communicative, social, and behavioral domains), as well as in generalized improvements in the condition of autism as a whole. However, there are three major limitations to the current research in this area. Before important large scale randomized clinical trials can be conducted, it is first necessary to conduct preliminary research to show that: (1) improvements in communicative initiations can be measured in generalized socially significant contexts; (2) measureable collateral gains in related core symptoms of autism will occur; and (3) growth curves can be calculated to assess the rate of change. This study will use a manualized language intervention using motivational procedures of child choice and direct response-reinforcer relationships, which is built upon previous NIH research and recognized by the National Research Council (2000) as effective for language intervention for children with autism. To assess the effectiveness of intervention for communicative initiations, the proposed study will use a wide range of assessments, including objective measures such as the Autism Diagnostic Observation Schedule-Generic (ADOS-G; Lord, Risi, Lambrecht, Cook, Leventhal, DiLavore, et al., 2000; Gotham, Risi, Pickles, & Lord, 2007) and the Autism Diagnostic Interview- Revised (ADI-R; Lord, Rutter, and LeCouteur,1994; LeCouteur, Lord, & Rutter, 2003), language samples in children's natural environments to specifically and carefully assess speech acts (e.g., Dore's primitive speech acts; Dore, 1974), semantic intent, and syntax that should appear in primitive question forms during Stage I and early Stage II and be quite sophisticated by early Stage IV. In addition, standardized parent measures such as the Vineland Adaptive Behavior Scales II (VABS-II; Sparrow et al., 2005) and behavioral rating scales of normalcy of communicative interactions during videotaped language samples with a parent or clinician will be utilized. The effect sizes for changes from pre to post intervention will be calculated on all measures and a growth curve analysis will be conducted by collecting measures every two months. Additionally, the results from the experimental group will be compared with a comparison group of children who receive treatment as usual, focusing on communicative responsiveness rather than on communicative initiations. Fidelity of implementation measures will be taken for all clinicians in both conditions across time. Results will be written up and published in journals focusing on research on the widespread significance of communication improvements for children with autism. PUBLIC HEALTH RELEVANCE: The Center for Disease Control has declared autism as an epidemic affecting 1 in 150 children, and is an NIH priority area. The proposed project will examine specific intervention components during language intervention and social communication. The study will assess improvements on the condition of autism.

描述（由申请人提供）：文献和临床研究表明，改善交流启动与自闭症（交流，社会和行为领域）的沟通和相关核心症状的广泛改善以及整个自闭症状况的广泛改善有关。但是，该领域的当前研究有三个主要局限性。在可以进行重要的大规模随机临床试验之前，首先有必要进行初步研究以表明：（1）可以在广义上具有社会意义的环境中测量沟通性启动的改进； （2）将发生相关自闭症核心症状的可衡量的附带收益； （3）可以计算生长曲线以评估变化率。这项研究将使用儿童选择的动机和直接反应 - 强制性关系的动机程序使用手动的语言干预，该程序建立在先前的NIH研究之上，并被国家研究委员会（2000年）认可，可对自闭症儿童的语言干预有效。为了评估干预措施进行交流启动的有效性，拟议的研究将采用广泛的评估，包括客观措施，例如自闭症诊断观察时间表 - 基因（ADOS-G； Lord，Risi，Risi，Lambrecht，Cook，Leventhal，Leventhal，Dilavore，Dilavore，et al。 Rutter和Lecouteur，1994年；此外，将利用标准化的母体措施，例如Vineland自适应行为量表II（VABS-II； Sparrow等，2005）和在录像带语言样本中与父母或临床医生的互动相互作用正常的行为评级量表。从前到干预后变化的效果大小将根据所有措施计算，并且将每两个月收集措施来进行生长曲线分析。此外，将将实验组的结果与像往常一样接受治疗的儿童的比较组进行比较，专注于沟通响应能力，而不是交流性启动。在两种情况下，所有临床医生都将采取实施措施的保真度。结果将写在期刊上，重点介绍有关自闭症儿童沟通改善的广泛意义的研究。 公共卫生相关性：疾病控制中心已宣布自闭症为一种流行病，影响150名儿童中的1个，并且是NIH的优先领域。拟议的项目将在语言干预和社会交流期间检查特定的干预组件。该研究将评估自闭症状况的改进。