Treatment of Autism Symptoms in Children (TASC): Initial RCT with Active Control

儿童自闭症症状的治疗 (TASC)：主动控制的初始随机对照试验

• 批准号: 9023593
• 负责人: Jeffrey James Wood
• 金额: $ 38.5万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-03-15 至 2018-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9023593
• 关键词: Address; Affect; Aftercare; Age; American Psychological Association; Attention; Autacoids; Autistic Disorder; Behavior; Behavioral; Belief; Benchmarking; California; Centers for Disease Control and Prevention (U.S.); Characteristics; Child; Childhood; Clinical; Cognitive; Cognitive Therapy; Collaborations; Communities; Consumer Satisfaction; Diagnosis; Emotional; Evidence based treatment; Goals; Guidelines; Home environment; Impaired cognition; Individual; Intervention; Joints; Language Disorders; Literature; Los Angeles; Maintenance; Measures; Methods; Modality; Modeling; Outcome; Outcome Measure; Outpatients; Patients; Placebos; Population; Prevalence; Procedures; Public Health; Randomized; Randomized Controlled Trials; Research; Research Design; Resistance; School-Age Population; Schools; Services; Severities; Social Environment; Strategic Planning; Symptoms; Syndrome; Techniques; Time; Treatment Efficacy; Treatment Protocols; Treatment outcome; Universities; Wood material; Work; Youth; active control; age group; aged; arm; associated symptom; autism spectrum disorder; base; behavior observation; behavioral response; efficacy testing; evidence base; flexibility; follow-up; functional disability; improved; individual patient; individualized medicine; intervention effect; meetings; memory retrieval; novel strategies; outcome forecast; peer; personalized care; personalized intervention; primary outcome; programs; psychosocial; response; satisfaction; semantic processing; skills training; social; social skills; standard of care; symptomatology; treatment effect; treatment responders

DESCRIPTION (provided by applicant): Autism spectrum disorders (ASDs) are among the most common childhood neurodevelopmental syndromes. A fundamental goal in the field is the discovery of methods that mitigate core autism symptoms. Greater severity of autism symptoms is associated with increased functional impairment, while lower levels of symptoms are associated with better prognosis. Core autism symptoms span from social-cognitive impairments, to pragmatic language deficits, to repetitive and rigid behaviors. The core symptoms tend to be stable and resistant to intervention. While behavioral and talk-based therapies are common for school-aged youth with ASD, with the average child using about $6,000 of outpatient services annually, the current evidence base is weak. Most treatments involve group-based social skills training, with limited external validity and durability of effect. No psychosocial treatment for core autism symptoms in school-aged children with ASD meets American Psychological Association guidelines for possible efficacy. Cognitive behavioral therapy (CBT) offers a novel approach for addressing core autism symptoms in higher functioning school-age youngsters. CBT has been successfully adapted to treat emotional problems in school-aged children with ASD (e.g., Wood et al., 2009a). Initial results suggest that CBT may also be promising for reducing core autism symptoms (Wood et al., 2009b; Drahota, Wood et al., 2011). The treatment is based on a contemporary model of memory retrieval competition, employing strategies for enhancing the retention of adaptive conceptual and behavioral responses and the suppression of idiosyncratic beliefs and behaviors in daily social contexts (e.g., school, home), emphasizing the use of deep semantic processing to enhance memory retrieval. We are proposing a randomized controlled trial to examine the efficacy of CBT relative to the standard of care in the community, social skills training (SST), in youngsters with ASD. The CBT program has been tailored over the last five years to the characteristics and clinical needs of high-functioning youth with ASD. In response to the 2009 Interagency Autism Coordinating Committee (IACC) Strategic Plan, a modular treatment approach is employed to personalize the intervention. The primary outcome measure is the Playground Observation of Peer Engagement scale, an independent evaluator-rated school playground observational measure of joint engagement, which is a psychometrically valid measure of core autism symptoms with established treatment sensitivity. The proposed research will (1) examine the short term efficacy of CBT relative to SST on autism symptom severity, (2) evaluate the durability of observed treatment gains in CBT responders, (3) cross-validate the ADOS, ADI-R, and SRS as measures of treatment outcome against the primary outcome measure (school observations of joint engagement), and (4) identify predictors of treatment outcome. A total of 80 youth (ages 7-12 years) with ASD will be randomly assigned to CBT or SST. Given the lack of evidence-based treatments for core autism symptoms in the school age-group, positive findings from this trial could have considerable public health significance.

描述（由申请人提供）：自闭症谱系障碍（ASDS）是最常见的儿童神经发育综合症之一。该领域的基本目标是发现减轻核心自闭症症状的方法。自闭症症状的严重程度更大与功能障碍增加有关，而较低的症状水平与更好的预后有关。核心自闭症症状涉及从社会认知障碍，务实的语言缺陷到重复和僵化的行为。核心症状往往是稳定的，并且对干预有抵抗力。虽然行为和基于谈话的疗法对于ASD的学龄性青年来说很常见，而普通儿童每年使用约6,000美元的门诊服务，但当前的证据基础却很弱。大多数治疗涉及基于团体的社交技能培训，外部有效性和效果持久性有限。 ASD的学龄儿童没有针对核心自闭症症状的心理自闭症症状，符合美国心理学会的指南，以实现疗效。认知行为疗法（CBT）提供了一种解决较高功能较高的学龄儿童核心自闭症症状的新方法。 CBT已成功地适应了ASD的学龄儿童的情绪问题（例如Wood等，2009a）。最初的结果表明，CBT也可能有望减少核心自闭症症状（Wood等，2009b； Drahota，Wood等，2011）。该处理基于当代记忆检索竞争的模型，采用策略来增强自适应概念和行为反应的保留，以及在日常社会环境（例如，学校，家庭）中抑制特质的信念和行为，强调对深层语义处理的使用来增强记忆的使用。我们提出了一项随机对照试验，以检查CBT相对于社区中的CBT相对于ASD年轻人的社区，社交技能培训（SST）的功效。在过去的五年中，CBT计划已针对ASD高功能的年轻人的特征和临床需求进行了量身定制。为了回应2009年机构间自闭症协调委员会（IACC）战略计划，采用模块化治疗方法来个性化干预措施。主要结果措施是对同伴参与量表的游乐场观察，这是一种独立的评估者等级的学校游乐场观察量度，这是对核心自闭症症状具有既定治疗敏感性的心理有效量度。拟议的研究将（1）研究CBT相对于自闭症症状严重程度的SST的短期功效，（2）评估CBT响应者观察到的治疗增长的耐用性，（（3）跨性ADO，ADI-R和SRS作为治疗结果的测量结果，以抗治疗措施的治疗方法（违反治疗量）的治疗方法（识别关节的识别）和（4）预测者（4）。 ASD共有80名青年（7-12岁）将随机分配给CBT或SST。鉴于缺乏对学院年龄段核心自闭症症状的循证治疗，该试验的积极发现可能具有相当大的公共卫生意义。

项目成果

Modular cognitive behavioral therapy for autism-related symptoms in children: A randomized controlled trial.

• DOI: 10.1037/ccp0000621
• 发表时间: 2021-03
• 期刊: Journal of consulting and clinical psychology
• 影响因子: 5.9
• 作者: Wood JJ;Sze Wood K;Chuen Cho A;Rosenau KA;Cornejo Guevara M;Galán C;Bazzano A;Zeldin AS;Hellemann G
• 通讯作者: Hellemann G

Social functioning and the presentation of anxiety in children on the autism spectrum: A multimethod, multiinformant analysis.

• DOI: 10.1037/abn0000724
• 发表时间: 2022-03
• 期刊: JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE
• 作者: Hunsche, Michelle C;Cervin, Matti;Storch, Eric A;Kendall, Philip C;Wood, Jeffrey J;Kerns, Connor M
• 通讯作者: Kerns, Connor M

Home-based video assessment of children's autism-related behaviours: Psychometric analysis and linkages with parental responsiveness and context.

对儿童自闭症相关行为的家庭视频评估：心理测量分析以及与父母反应和背景的联系。

• DOI: 10.1111/bjc.12449
• 发表时间: 2024
• 期刊: The British journal of clinical psychology
• 作者: Wood,JeffreyJ;Danial,John;Wolpe,Samara
• 通讯作者: Wolpe,Samara