A key objective of the Interagency Autism Coordinating Committee (IACC) strategic plan is to better understand the impact of co-occurring conditions in youth with ASD. Chronic childhood trauma is a major risk factor for physical and mental illness as well as many leading causes of death, yet it has been understudied in youth with ASD. Research has been impeded by a lack of instruments designed or validated to account for the different ways in which youth with ASD may experience and respond to trauma. The overarching goal of this award is to provide the applicant with the tools and skills necessary to become an independent investigator with a unique research program devoted to improving our ability to recognize, characterize, prevent and treat - through community settings - the adverse consequences of trauma in ASD populations.
Three research aims are also proposed to develop and validate two measures: (1) a brief questionnaire and (2) a semi-structured interview of potentially traumatic events and related symptoms in ASD.
Aim 1 : a literature review, Delphi poll of experts and qualitative study of youth with ASD (14-22 yrs) and parents (N=20) will be used to develop both measures.
Aim 2 : psychometric properties (e.g., construct and predictive validity, convergent/discriminant validity) of the trauma questionnaire as well as predictors/outcomes of trauma will be assessed in in 800 cognitively-able youth (14-22 years) with ASD recruited online (n=725) and locally (n=75).
Aim 3 : comprehensive evaluations with local participants from Aim 2 (n=75) will assess the psychometric properties (e.g., criterion, convergent/divergent validity; inter-rater reliability) of the trauma interview as well as the criterion validity and retest reliability of the questionnaire. Consistent with NICHD's scientific vision of improving community-based healthcare options for individuals with developmental differences, these measures will support the applicant's longer-term research goals of estimating the prevalence and effects of trauma in ASD as well as testing and implementing high-impact screening and prevention programs. The applicant is a clinical psychologist with expertise in the assessment and treatment of co-occurring anxiety and ASD. Under the principal direction of Dr. Newschaffer, a leader of ASD public health science, and an expert team of co-mentors and consultants, she will broaden her training in psychiatric comorbidity and measure development and gain skills in the conduct of epidemiologic and community health and prevention research. Training (with mentors/consultants listed) will incorporate mentorship, coursework, and supervised research and clinical activities in (Goal 1) the assessment and treatment of child trauma and ASD (Berkowitz; Deblinger); (Goal 2) measure development and validation (Robins; Mazefksy, Lecavalier); and (Goal 3) public health and epidemiologic research methods (Newschaffer; Shattuck; Lankenau). These experiences will allow the applicant to integrate clinical science and public health strategies to understand how individuals with ASD experience and cope with trauma and develop broadly implementable guidelines for the ethical assessment and management of these difficulties.
Over two thirds of children in the US will experience a traumatic event before adulthood, and, although one in 68 children in the US has autism spectrum disorder (ASD), the prevalence of potentially traumatic experiences and trauma-related symptoms in youth with ASD is unknown. The proposed work seeks to develop an empirically supported approach (including survey, screening and evaluation tools) for assessing the occurrence and psychosocial consequences of trauma in youth with ASD as part of both community-based research studies and clinical practice. The development of these tools will facilitate subsequent epidemiological studies to determine the scope of this public health risk and inform the design of prevention and intervention initiatives for trauma-related difficulties among individuals with ASD.
