This application for an NIMH Mentored Research Scientist Career Development (K01) award seeks support to develop a program of research focused on the roles of biological stress response, behavioral functioning, and environmental resources in promoting a successful transition to adulthood for youth with autism spectrum disorders (ASD). Exiting high school is a challenging time for these youth, given the loss of services through the school system. Because the hypothalamic-pituitary-adrenal (HPA) axis modulates an individual's ability to react emotionally and physiologically to challenging environments, its dysfunction is a promising biological factor that might exacerbate poor outcomes for these young adults. Thus, a central component of the training plan is mentorship in HPA axis functioning and stress response as it relates to ASD. The second key component of the training plan is mentoring in clinical research skills. The candidate is a developmental psychologist with no clinical training, and thus she has relied on clinicians to recognize autism symptoms and diagnose ASD in her research. Furthermore, comorbid psychiatric disorders are extremely common in youth with ASD but can be difficult to recognize because their symptoms often overlap with symptoms of ASD. Because the absence of comorbid psychiatric disorders is an important component of positive adult outcomes, it is important to recognize their occurrence. The candidate will also pursue training in: 1) Measuring the quality and availability of disability-related services in the school and adult-service systems;2) Conducting longitudinal research among families of youth with ASD;3) Developing additional methodological and statistical expertise to analyze complex diurnal cortisol and longitudinal data;and 4) Behavioral intervention research. Together, this training will allow for the identification of risk factors for poor transition that are malleable (such as stress response or family environment). As part of the candidate's career development plan, she proposes a longitudinal study of youth with ASD who are preparing to exit high school. This project aims to: 1) Investigate the changes in and inter-relations among stress response profiles, behavioral profiles, and environmental resources as youth with ASD transition to adulthood;and 2) Investigate how adult outcomes are predicted by baseline measures (collected while in high school) and changes in stress response profiles, behavioral profiles, and environmental resources. Youth will be recruited during their final year of high school, with data collection at approximately 6 months before they exit school as well as 6 and 18 months after exit. At each time point, semi-structured observations will be used to examine autism symptoms and diagnosis, and diurnal cortisol will be collected. Mothers will report on their son or daughter's autism symptoms, behavior problems, daily activities, disability-related services, family warmth and criticism, and their own mental health. At the second time point (6 months after exit), a social stressor paradigm will be used (along with cortisol collection) to measure acute biological stress response among these youth. As a result of this research, the candidate will be able to identify malleable risk factors, that when aided could promote positive adult outcomes and better transitions to adulthood. So far, poor outcomes for adults with ASD have been linked only to static, unchanging risk factors such as low IQ and poor early language. Yet due to the surge of children with ASD exiting school systems and the high public costs of ASD, it is critical to examine risk factors that are amenable to intervention. The candidate plans to use the expertise gained through this award to develop an R01 grant proposal investigating long-term patterns of biological, behavioral, and family risk and resiliency following high school exit for youth with ASD compared to peers without ASD, with the long-term goal of developing and studying interventions to promote transition success.

Public Health Relevance

Using longitudinal data collected at 3 time points over a 2-year time span, this project will examine how biological stress response combines with behavioral functioning and environmental resources to influence the transition to adulthood and positive outcomes for young adults with autism spectrum disorders (ASD). So far, poor outcomes for these adults have been linked only to static, unchanging risk factors such as low IQ and poor early language. Yet due to the surge of children with ASD exiting school systems and the high public costs of ASD, there is an urgent public health and scientific need to understand the range of malleable factors that influence the adaptation of young adults with ASD during the """"""""transition years"""""""" and beyond.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
1K01MH092598-01A1
Application #
8189725
Study Section
Child Psychopathology and Developmental Disabilities Study Section (CPDD)
Program Officer
Churchill, James D
Project Start
2011-06-16
Project End
2015-02-28
Budget Start
2011-06-16
Budget End
2012-02-29
Support Year
1
Fiscal Year
2011
Total Cost
$142,193
Indirect Cost
Name
Vanderbilt University Medical Center
Department
Pediatrics
Type
Schools of Medicine
DUNS #
004413456
City
Nashville
State
TN
Country
United States
Zip Code
37212
Taylor, Julie Lounds; Muscatello, Rachael A; Corbett, Blythe A (2018) Differences in anticipatory versus reactive stress to social evaluative threat in adults versus adolescents with autism. Autism Res 11:1276-1285
Taylor, Julie Lounds; DaWalt, Leann Smith (2017) Brief Report: Postsecondary Work and Educational Disruptions for Youth on the Autism Spectrum. J Autism Dev Disord 47:4025-4031
Lounds Taylor, Julie; Adams, Ryan E; Bishop, Somer L (2017) Social participation and its relation to internalizing symptoms among youth with autism spectrum disorder as they transition from high school. Autism Res 10:663-672
Fisher, Marisa H; Taylor, Julie Lounds (2016) Let's talk about it: Peer victimization experiences as reported by adolescents with autism spectrum disorder. Autism 20:402-11
Anderson, Kristy A; McDonald, T A; Edsall, Deirdre et al. (2016) Postsecondary Expectations of High-School Students With Autism Spectrum Disorders. Focus Autism Other Dev Disabl 31:16-26
Taylor, Julie Lounds; Gotham, Katherine O (2016) Cumulative life events, traumatic experiences, and psychiatric symptomatology in transition-aged youth with autism spectrum disorder. J Neurodev Disord 8:28
Gotham, Katherine; Marvin, Alison R; Taylor, Julie Lounds et al. (2015) Characterizing the daily life, needs, and priorities of adults with autism spectrum disorder from Interactive Autism Network data. Autism 19:794-804
Taylor, Julie Lounds; Henninger, Natalie A; Mailick, Marsha R (2015) Longitudinal patterns of employment and postsecondary education for adults with autism and average-range IQ. Autism 19:785-93
Taylor, Julie Lounds; Henninger, Natalie A (2015) Frequency and correlates of service access among youth with autism transitioning to adulthood. J Autism Dev Disord 45:179-91
Davis, Alaina M; Brown, Rebekah F; Taylor, Julie Lounds et al. (2014) Transition care for children with special health care needs. Pediatrics 134:900-8

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