Autism Spectrum Disorders (ASD) affect 1 in 88 children in the United States. Individuals without intellectualdisabilities comprise the fastest-growing subgroup of ASD and account for two-thirds of the total population.Impaired executive functions (EF) occur as a result of abnormal prefrontal cortex function and are related topoor adult outcome. EF problems are pivotal targets for intervention because they are common, linked toindependence, and responsive to treatment. The proposed study will test the effectiveness of a school-basedcognitive behavioral EF intervention, called Flexible Futures (FF), for college-bound youth with ASD andevaluate the neural correlates of treatment outcome. FF is a targeted, phenotype-specific intervention focusedon the domains of EF that are most impaired in ASD – flexibility and planning skills. This K23 MentoredPatient-Oriented Career Development Award application is to request support for the candidate's developmentas an independent investigator specializing in the development and implementation of innovative interventionspersonalized for specific cognitive profiles that are transportable for mass usage in school-settings.This K23 Mentored Patient-Oriented Career Development Award will provide focused research experience andtheoretical training in the development of evidence-based treatments that support transition to adulthood inASD. The award will also provide training and experience in the investigation of neural predictors andcorrelates of treatment outcome using neuroimaging methods. In accordance with these goals, the trainingaims of this proposal are to: 1) develop an understanding of causal models of developmental disabilities andexpertise in measurement of key outcomes at the behavioral, cognitive, and neural levels; 2) acquire expertisein the development of treatments for transition-age youth within the school setting; and 3) gain competencies inthe methodology, design, and implementation science of pragmatic community-partnered effectiveness trials.The proposed research aims for this project are to: 1) refine the treatment manual for Flexible Futures and testits acceptability, feasibility, and effectiveness in a school setting, 2) identify neural correlates of treatmentchange using fMRI, and 3) identify biomarkers of EF outcomes at the behavioral, cognitive, and neural level.The treatment manual will be iteratively refined with input from experts in the field of ASD research and testedfor effectiveness against a social skills intervention within an educational setting. Flexible Futures is anticipatedto result in changes at the behavioral, cognitive, and neural level. Specifically, it is hypothesized thatparticipants in Flexible Futures will demonstrate greater gains in flexibility and planning compared to those insocial skills treatment. Significant changes in behavior and brain activity as a result of Flexible Futures couldhave profound implications for the development and refinement of psychological treatments for ASD.
Interagency Autism Coordinating Committee (IACC)
Autism Research Database (AFD)
