Acute and Sustained Effects of Social Skills Intervention on Neural and Behavioral Outcomes in Children With ASD
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Autism
- Sponsor
- Icahn School of Medicine at Mount Sinai
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- Diagnostic Analysis of Nonverbal Accuracy-2* (DANVA2)
- Status
- Completed
- Last Updated
- 13 years ago
Overview
Brief Summary
The purpose of this study is to compare two different treatment approaches to social skills groups for high-functioning children with Autism Spectrum Disorder (ASD). This project will examine changes in both behavior and the brain following treatment.
Detailed Description
Despite the fact that social skills impairments are the most persistent and pervasive symptoms affecting individuals with ASD, treatments targeting social skills have been the subject of few controlled investigations. The available literature suggests that cognitive behavioral techniques are commonly used and may improve targeted social skills in individuals with ASD. However, drawing firm conclusions about the efficacy of social skills treatment remains difficult, particularly with respect to maintenance of skills and generalization to natural settings, owing to methodological limitations of extant studies (e.g., 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 factors that increase attention to or interest in social stimuli are associated with more normal brain activity. The purpose of this investigation is to examine the acute and sustained effects of social skills treatment on social cognition and the neural architecture that supports it. High-functioning children with ASD will be randomly assigned to a 12-week cognitive behavioral social skills group or a social play-based therapy group. For both types of groups, a parent session will be held concurrently. 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.
Investigators
Eligibility Criteria
Inclusion Criteria
- •8 to 11 years of age
- •Meets criteria for ASD according to psychiatric interview (DSM-IV), the Autism Diagnostic Observation Schedule-Generic, and the Autism Diagnostic Interview-Revised
- •Verbal IQ ≥ 70, as measured by the Wechsler Intelligence Scale for Children-Fourth Edition or Wechsler Abbreviated Scale of Intelligence
Exclusion Criteria
- •History of psychiatric or neurological disorders other than ASD (e.g., schizophrenia, depression, seizure disorder)
- •Within 30 days prior to the initial evaluation, beginning any new psychotropic medication or other therapeutic intervention (e.g., behavior, speech, physical/occupational, cognitive, nutritional therapy) that would confound the evaluation of the social skills groups
- •Gross structural abnormality present in the brain (e.g., aneurysm)
- •History of head trauma or loss of consciousness
- •For any reason the child or parents appear unable to participate in study procedures
Outcomes
Primary Outcomes
Diagnostic Analysis of Nonverbal Accuracy-2* (DANVA2)
Time Frame: Week 24
Assesses emotion recognition from facial expression, tone of voice, and posture. This instrument allows for the assessment of basic emotions conveyed by both adult and child models at high and low intensity. Nowicki and Carton \[50\] have shown that the DANVA2 has acceptable internal consistency for school age children and good test-retest reliability.
Reading the Mind in the Eyes Task - Child Version
Time Frame: Week 24
The computerized children's version of the Eyes test is a reduced battery of 28-items measuring an individual's ability to interpret intentions and 'mentalizing' abilities, a hallmark social cognitive deficit in ASD. The adult RMET has shown sensitivity to change in clinical trials and the child version showed promising results in our preliminary analyses (see Preliminary Studies).
Functional Magnetic Resonance Imaging (fMRI)
Time Frame: Week 24
We previously developed two activation tasks that tap different aspects of social cognition: 1) Interpreting Communicative Intent: Participants will view cartoon drawings of children while listening to short vignettes ending with a potentially ironic remark. Participants decide whether the speaker really meant what s/he said. 2) Affect and eye contact: Participants will view full-face pictures of people displaying happy, angry, fearful, or neutral affect. For each emotion, half of the faces show a direct gaze and half show a gaze aversion.
Secondary Outcomes
- Social Responsiveness Scale (SRS)(Week 24)
- Strange Stories Task(Week 24)
- Vineland Adaptive Behavior Scales, Second Edition (Vineland II)(Week 12)
- Autism Diagnostic Observation Schedule (ADOS)(Week 12)
- Direct Observation(12 weeks (during treatment sessions))
- Peer generalization assessment(Week 12)