2009 — 2010 |
Soorya, Latha V Wang, A. Ting |
R21Activity Code Description: To encourage the development of new research activities in categorical program areas. (Support generally is restricted in level of support and in time.) |
Neural and Behavioral Outcomes of Social Skills Groups in Children With Asd @ Icahn School of Medicine At Mount Sinai
DESCRIPTION (provided by applicant): Profound impairment in social interaction is a hallmark of autism spectrum disorders (ASD). Although improvement in social functioning is widely considered to be a crucial target for intervention, social skills treatments for school-age children have been the subject of few controlled investigations. The available literature suggests that cognitive behavioral (CBT) techniques are commonly used and may improve targeted social skills in the short term in individuals with ASD. However, drawing firm conclusions about the efficacy of CBT social skills training remains difficult, particularly with respect to maintenance of skills and generalization to natural settings, owing to methodological limitations of extant studies (e.g., lack of random assignment to groups, small sample size, lack of manual-based curricula, minimal assessment of generalization or maintenance). Several neuroimaging studies have found that individuals with ASD underactivate key brain regions involved in social cognition. However, there is also evidence to suggest that activity in normative neural networks can be increased significantly by providing high-functioning children with ASD with explicit instructions to pay attention to important social cues, such as a speaker's facial expression and tone of voice. This suggests that a cognitive behavioral approach to social skills treatment may increase social responsiveness at both the behavioral and neural levels. The purpose of this investigation is to examine the acute and sustained effects of a CBT-based social skills treatment on social cognition and the neural architecture that supports it. High-functioning children with ASD (8-11 years old) will be randomly assigned to a 12-week cognitive behavioral social skills group or a social play comparison group to control for non-specific therapeutic effects. Functional MRI scans as well as behavioral assessments of social cognition, adaptive functioning, and symptom severity will be acquired at baseline, immediately following treatment, and at a 3- month follow-up. We hypothesize that children in the CBT group will show greater improvement in social functioning and increased activation of key brain regions, relative to children in the social play comparison group, both post-treatment and at follow-up. This study aims to address some of the earlier methodological limitations to provide much needed information about the short-term efficacy and durability of a CBT approach to social skills treatment, as well as the neural events that accompany and/or predict response to treatment. PUBLIC HEALTH RELEVANCE: Cognitive behavioral therapy (CBT) social skills groups are commonly used with high functioning children with ASDs;however, the efficacy and durability of these treatments are unknown. With the economic burden of ASD estimated in the range of $30 billion annually in the U.S alone, evaluation of efficacious treatments targeting core deficits in social skills is imperative. Toward this effort, the proposed study is a randomized controlled investigation designed to evaluate short-term effects and maintenance of skills taught in CBT-based social skills groups, at both the behavioral and neural levels.
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0.916 |
2015 — 2019 |
Soorya, Latha V |
K23Activity Code Description: To provide support for the career development of investigators who have made a commitment of focus their research endeavors on patient-oriented research. This mechanism provides support for a 3 year minimum up to 5 year period of supervised study and research for clinically trained professionals who have the potential to develop into productive, clinical investigators. |
Integrated Treatments For Core Deficits in Autism Spectrum Disorder @ Rush University Medical Center
? DESCRIPTION (provided by applicant): Despite progress in efficacious treatments for individuals with autism spectrum disorder (ASD), few interventions are available for disease-specific impairments. The complexity and heterogeneity of ASD suggests interventions targeting multiple domains are more likely to have a therapeutic impact. This Mentored Patient-Oriented Research Career Development Award supports the candidate's long-term goals of building effective interventions for core symptoms in ASD with capacity to integrate the rapidly evolving findings from both behavioral intervention and drug discovery research. The training program and supervised activities will focus on gaining expertise in the molecular and neural mechanisms underlying phenotypic diversity in ASD, interrogating active ingredients from combination therapies, and investigating mechanisms underlying both behavioral and pharmacological treatments. The award is will be based at the Rush University Medical Center under the mentorship of Dr. Mark Pollack and co-mentorship of Drs. Ed Cook, Luan Phan, and Don Hedeker at the University of Illinois-Chicago; and with consultation from national experts including Drs. Connie Kasari (University of California, Los Angeles), Linmarie Sikich (University of North Carolina-Chapel Hill), and Kevin Pelphrey (Yale School of Medicine). The candidate's immediate focus is to study a novel, behavioral- pharmacological therapy targeting higher-order social information processing impairments in youth with ASD. The research plan proposes a proof-of-concept, combination intervention designed to address individual treatment targets presumed to influence social learning in school aged children with ASD. This proposal builds upon data from the applicant's randomized, comparative trial of a targeted cognitive-behavioral intervention (CBI) for nonverbal communication, emotion recognition, and theory of mind deficits in youth with ASD. We will evaluate the safety, tolerability, and efficacy of combining the neuropeptide oxytocin (OT) with the targeted CBI group curriculum. The research plan will randomize 8-11 year old youth with ASDs (n=50), into a 12- session, randomized, parallel group design of CBI+OT or a control social group condition (facilitated play). It is hypothesized that targeted, intranasal OT dosing immediately prior to CBI group activities will serve enhance social cognition during group and homework activities, facilitate behavioral rehearsal of target skills, and yield changes in both behavioral and cognitive domains supporting social learning during childhood. In collaboration with the mentorship team, the research plan will investigate a candidate task battery drawing from neuroscience measurement strategies of brain-behavior relationships underlying social cognition and affective regulation. The candidate task battery will be used refine treatment targets and identify potential social cognitive mechanisms predicting treatment response from the combined social cognitive intervention.
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0.925 |