The overarching goal of this application is to evaluate the feasibility of a newly developed school and home-based intervention that targets impaired non-social cognitive skills in children with high-functioning Autism Spectrum Disorders (e.g., Asperger's Syndrome and High- Functioning Autism;AS/HFA). Children with AS/HFA struggle with aspects of executive function: flexible thinking and behavior, integration, planning, and being organized. These poor executive functioning (EF) abilities in school-age children with AS/HFA interfere with learning and behavior in the classroom, preventing otherwise capable children from working independently, following group instruction, making transitions from one activity to another, and adhering to classroom and social rules and routines. The Enhanced Flexibility Intervention (EFI) aims to increase the ability of children with AS/HFA to think and behave flexibly through a staged approach of cognitive instruction, guided practice, and generalization. Further, the EFI provides support for these increased flexibility skills with other EF skills, such as planning, coping/self-regulation, and self-evaluation.] This line of research is innovative and important for four reasons. First, it tests a novel intervention designed specifically for school-age children with AS/HFA, a population whose unique needs have not yet been systematically addressed in the intervention literature. Second, the EFI specifically targets the third domain of the autism diagnostic triad (repetitive behaviors, activities and interests and insistence on sameness), an area that is not often targeted by other interventions but significantly interferes with learning and social interactions. Third, the EFI focuses on addressing a well-documented neuropsychological weakness in AS/HFA by adapting an intervention that has been empirically demonstrated to improve EF in children with traumatic brain injury. Fourth, because classroom teachers, school staff and parents developed the EFI through a participatory framework and will deliver this intervention in the child's school and home, the EFI techniques are infused into real-life contexts in which flexibility and other EF skills are in high demand.

Public Health Relevance

Children with Asperger's Syndrome and High-Functioning Autism (AS/HFA) are bright, caring people who have much to offer society, but have problems with aspects of executive function (EF): flexible thinking and behavior, integration, planning, and being organized. These EF problems in children with AS/HFA interfere with learning and behavior in the classroom, and relate to the repetitive behaviors and social difficulties characteristic of the disorder. This project will develop an innovative intervention that uses multimodal context- based learning to improve children's flexibility skills through a participatory research framework that may help children with AS/HFA better access mainstream educational, social and employment opportunities.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Planning Grant (R34)
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Interventions Committee for Disorders Involving Children and Their Families (ITVC)
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Gilotty, Lisa
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Children's Research Institute
United States
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Kenworthy, Lauren; Anthony, Laura Gutermuth; Naiman, Daniel Q et al. (2014) Randomized controlled effectiveness trial of executive function intervention for children on the autism spectrum. J Child Psychol Psychiatry 55:374-83
Anthony, Laura Gutermuth; Kenworthy, Lauren; Yerys, Benjamin E et al. (2013) Interests in high-functioning autism are more intense, interfering, and idiosyncratic than those in neurotypical development. Dev Psychopathol 25:643-52