1985 — 1990 |
Fein, Deborah A. |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Social Comprehension in Infantile Autism @ University of Connecticut Storrs
Pervasive Developmental Disorder (PDD) are a spectrum of serious disorders of childhood, affecting all areas of development and leading to severe lifelong functional impairment. Recent theory about these disorders suggests that the social deficit may be a primary feature, making its investigation central to progress in understanding etiology and intervention. Furthermore, the PDD children are a heterogeneous group, so that investigation of clinical subtypes is also a key to progress in understanding these disorders. The proposed project is one of a series by the present investigator which attempt to elucidate key questions about the social deficit in PDD children, the current project, two subtypes of PDD children are identified: those will specific social-cognative deficits and those whose social cognition is consonant with their mental age; the subtypes differed in social behavior but not in mental age. The proposed project will extend this investigation of the relationship between social behavior: and social cognition, and address other key issues, such as cross- situational variability and delay vs. deviance, in PDD social behavior. Subjects will be 40 PDD subjects currently enrolled in the study, forming a longitudinal sample, to investigate the stability of the social-cognitive subtypes, and 40 new PDD subjects, forming a cross-validation sample. Controls will be 80 children matched for mental age and IQ, and 40 normal children matched for Socialization Age. Subjects will be given a battery of standardized neuropsychological tests, a battery of social cognitive tests developed by the investigators, and a set of observational and interview measures of social behavior derived from the developmental, primate, clinical literatures. Behavior in the areas of social initiations, responses, attention, and affect will be studied. Data analysis will focus on the relationships between aspects of social cognition and social behavior, on clinical subtypes within the PDD groups, and on comparisons of social cognition and social behavior in the PDD and control groups.
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0.958 |
2002 — 2013 |
Fein, Deborah A. |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Early Detection of Pervasive Developmental Disorders @ University of Connecticut Storrs
DESCRIPTION (provided by applicant): Early detection of Autism Spectrum Disorders (ASD) has come to be recognized as a crucial activity in promoting the best possible outcome for affected children. In our current NICHD-funded Early Detection (ED) study, for which this application is a competing continuation, we have developed an effective screening instrument, the Modified Checklist for Autism in Toddlers (M-CHAT), which is now widely used in the US, and is being studied in translation in other countries and cultures, including Japan, China, Spain, the Netherlands, France, Iceland, Ireland, Germany, Egypt, Puerto Rico and Turkey. It is being used by the Indian Health Service and is included in the American Academy of Pediatrics screening tool kit. In addition to studying the properties of this screening instrument, studying our current cohort of 16-30 month old children detected with the M-CHAT and diagnosed with ASD, has allowed us to address other questions of great theoretical and practical importance concerning early detection and development, including: characteristics of children with ASD screened from high risk vs. unselected samples, characteristics of younger siblings of children with ASD detected at age 1.5 to 2, early predictors of outcome, the application of DSM-IV symptoms to very young children, diagnostic stability through early childhood, validity of diagnostic instruments in 2-year-olds, growth parameters in early development and their relationships to outcome, and whether general developmental screening is sufficient to detect ASD. The overarching goal of this continuation is to validate a final shortened revision of the M-CHAT. This final version will be (a) brief and user-friendly, (b) easy for pediatricians to score in their offices, (c) valid for diverse populations of children, (d) valid for younger siblings, who are at high risk, and (e) ready to be recommended for universal pediatric use in the US, as well as in multiple translations in other countries. Disseminating a finalized, valid screener for early detection of ASD, which is parent- and pediatrician-friendly, will allow a large number of children to have earlier access to intervention and optimize their developmental outcomes. PUBLIC HEALTH RELEVANCE: The goal of this project is to validate a final shortened revision of the M-CHAT, a screener for autism in toddlers. This final version will be (a) brief and user-friendly, (b) easy for pediatricians to score in their offices, (c) valid for diverse populations of children, (d) valid for younger siblings, who are at high risk, and (e) ready to be recommended for universal pediatric use in the US, as well as in multiple translations in other countries. Disseminating a finalized, valid screener for early detection of ASD, which is parent- and pediatrician-friendly, will allow a large number of children to have earlier access to intervention and optimize their developmental outcomes.
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0.958 |
2006 |
Fein, Deborah A. |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Language Functioning Optimal Outcome Children--Autism @ University of Connecticut Storrs
[unreadable] DESCRIPTION (provided by applicant): Prognosis for children with Autism Spectrum Disorder (ASD) receiving intensive early intervention has improved substantially. A minority of these children appear to reach what may be called "optimal outcome", in which cognitive and adaptive functioning are within normal limits and they no longer meet criteria for any ASD. Little or no rigorous documentation of such children or their status has been attempted and some recent papers have suggested that such an outcome is not a realistic aim for ASD children; therefore, even the existence of the optimal outcome group remains controversial. None of these children has been studied in detail, or followed into adolescence, so the extent to which their functioning has truly normalized is not known. Since language difficulties in ASD are so pervasive and central, residual language difficulties might be expected to persist even in children with optimal outcomes. Preliminary studies on a group of such children suggest that they show many areas of normalized language functioning as well as specific areas in which impairment is still demonstrated. We propose to study a group of these children in early to mid- adolescence and fully assess their language, cognitive, and adaptive competence. One important question naturally arises from our preliminary results: what are the underlying neural mechanisms of the striking improvement of cognitive processes in these optimal outcome children? It could be hypothesized that their atypical acquisition of early language resulted in an atypical neural representation of language processes, even with normal behavioral performance. This would imply that alternative neural pathways and networks may be recruited to perform a task to behaviorally normal levels, suggesting the existence of multiple developmental pathways to successful functioning. On the other hand, the optimal outcome children with normal performance levels might show typical patterns of brain activation, suggesting that only remediation that normalizes the use of neural networks can result in normal task performance; this would have implications for the importance of very early intervention. fMRI tasks of syntax and face processing will be administered to address this question, and exploratory analysis of selected structural variables will be examined to see if the most successful intervention appears to operate on a structurally normal brain. [unreadable] [unreadable] [unreadable]
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0.958 |
2007 — 2009 |
Fein, Deborah A. |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Language Functioning in Optimal Outcome Children With a History of Autism @ University of Connecticut Storrs
[unreadable] DESCRIPTION (provided by applicant): Prognosis for children with Autism Spectrum Disorder (ASD) receiving intensive early intervention has improved substantially. A minority of these children appear to reach what may be called "optimal outcome", in which cognitive and adaptive functioning are within normal limits and they no longer meet criteria for any ASD. Little or no rigorous documentation of such children or their status has been attempted and some recent papers have suggested that such an outcome is not a realistic aim for ASD children; therefore, even the existence of the optimal outcome group remains controversial. None of these children has been studied in detail, or followed into adolescence, so the extent to which their functioning has truly normalized is not known. Since language difficulties in ASD are so pervasive and central, residual language difficulties might be expected to persist even in children with optimal outcomes. Preliminary studies on a group of such children suggest that they show many areas of normalized language functioning as well as specific areas in which impairment is still demonstrated. We propose to study a group of these children in early to mid- adolescence and fully assess their language, cognitive, and adaptive competence. One important question naturally arises from our preliminary results: what are the underlying neural mechanisms of the striking improvement of cognitive processes in these optimal outcome children? It could be hypothesized that their atypical acquisition of early language resulted in an atypical neural representation of language processes, even with normal behavioral performance. This would imply that alternative neural pathways and networks may be recruited to perform a task to behaviorally normal levels, suggesting the existence of multiple developmental pathways to successful functioning. On the other hand, the optimal outcome children with normal performance levels might show typical patterns of brain activation, suggesting that only remediation that normalizes the use of neural networks can result in normal task performance; this would have implications for the importance of very early intervention. fMRI tasks of syntax and face processing will be administered to address this question, and exploratory analysis of selected structural variables will be examined to see if the most successful intervention appears to operate on a structurally normal brain. [unreadable] [unreadable] [unreadable]
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0.958 |
2011 — 2013 |
Fein, Deborah A. |
R34Activity Code Description: To provide support for the initial development of a clinical trial or research project, including the establishment of the research team; the development of tools for data management and oversight of the research; the development of a trial design or experimental research designs and other essential elements of the study or project, such as the protocol, recruitment strategies, procedure manuals and collection of feasibility data. |
Teaching Skills to Toddlers: a Program For Caregivers @ University of Connecticut Storrs
DESCRIPTION (provided by applicant): The application of behavioral and developmental principles to early teaching can dramatically alter the developmental trajectory of children with early-diagnosed and treated Autism Spectrum Disorders (ASD). Furthermore, although parent training is part of many early intervention programs, there are few standardized or manualized training packages for parents. Our aim is to create an effective, video enriched, teaching program, to train caregivers in basic behavioral and developmental principles, and in the application of these principles to young children with ASD. We are proposing to develop and pilot test "Teaching Skills to Toddlers: A Program for Caregivers," a set of video programs that will deliver high quality instruction in basic principles and applications of evidence-based therapies for caregivers of young children with Autism Spectrum Disorder (ASD). In contrast to available training materials, which are generally in the form of written manuals and require substantial education, literacy and sophistication, as well as close professional supervision, in addition to including a financial cost to parents, we plan to develop our series so that it is 1.) user-friendly to a wide range of people with different levels of education, 2.) possible to use with a minimum of direct expert supervision, and 3.) provided free of charge on the internet. Although the final product will be broader in scope, the pilot materials to be developed in this project will focus on communication and social interaction. For this pilot project, we will focus on the use of the materials as a supplement to early intervention, although other applications are envisioned for the future. In the project period, we will, with ongoing input from parents and health care providers, create the first 4 of the projected 8 programs, test the acceptability and clarity of the program to parents, and conduct a pilot test of the effect of the programs on parent stress and self-efficacy. PUBLIC HEALTH RELEVANCE: Children with Autism Spectrum Disorders can have improved outcomes if they obtain early and intensive intervention, but available early intervention is often not intensive or not evidence-based in its methods. Our aim is to create a set of video programs that will deliver high quality instruction in basic principles and applications of evidence-based behavioral and naturalistic therapy techniques to parents of young children with ASD, enabling them to implement intervention early, and improve outcomes for their children. Concepts will be explained clearly and simply, in non-technical language, to maximize the range of parents who can use the material, and the usefulness of the material as an adjunct to early intervention services will be assessed in a pilot study.
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0.958 |
2018 — 2021 |
Eigsti, Inge-Marie [⬀] Fein, Deborah A. |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Optimal Outcomes in Asd: Adult Functioning, Predictors, and Mechanisms @ University of Connecticut Storrs
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.
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0.958 |