This application is submitted in response to RFA-MH-14-102 (Pilot Studies of Services Strategies for Adults with ASD), and seeks support to develop and test a service strategy to enhance social functioning in adults with autism spectrum disorder (ASD). Social cognition and social interaction difficulties, the hallmark deficits of ASD, usually persist into adulthood, markedly impairing the ability of individuals to function in family, educational, work, and community settings, and resulting in a host of negative outcomes. Little work has been done in developing service strategies to enhance social functioning in autistic adults beyond their early twenties. We propose to address these problems by developing a novel, integrated, three-part intervention strategy to enhance social functioning in adults with ASD that includes the following components: 1) a component to develop motivation and capacity to participate in social cognition/social skills training, which will be adapted from evidence-based programs used in community medical settings (the Pathways program) and in children with ASD (schedules);2) a component to develop social cognition and social skills in a protected setting based on an evidence-based social cognition training program and a video modeling program;and 3) a component to help participants generalize these skills in the context of community-based, philanthropic volunteer work team, which builds on the literature on the beneficial effects of volunteer work for socially isolated individuals.
Specific Aim 1 : To adapt an integrate existing interventions to develop a novel, integrated, three-part service and intervention strategy to enhance social functioning in adults with ASD.
Specific Aim 2 : To pilot the three-part service strategy in order to assess feasibility, acceptability, and preliminary effet sizes in preparation for a larger trial.
Specific Aim 3 : To refine the three-part intervention base on the results from completion of Specific Aim 2 and user input. The proposed study will build an integrated service strategy that spans from screening and diagnosis of adults with ASD in mental health systems, to development of motivation and capacity to participate in an intervention, to social cognition and skill training, to generalization of this new knowledge and skill to useful work and functioning in the community. This project will generate the methods and feasibility of this strategy, and sufficient preliminary data to apply for an R01 to test the stratgy in a randomized, controlled trial. The development and testing of this integrated intervention will fill a critically important need for services to enhance social functioning and well-being in adult with ASD.

Public Health Relevance

Social cognition and social interaction difficulties persist into adulthood in most individuals with ASD and there is a lack of service strategies to improve social functioning in autistic adults. This project will address this by developing a novel, integrated service strategy that spans from building motivation and capacity to engage socially, to social cognition and social skill building, to generalization and application of these skills to community settings.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Planning Grant (R34)
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Special Emphasis Panel (ZMH1-ERB-K (05))
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Juliano-Bult, Denise M
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University of Pennsylvania
Schools of Medicine
United States
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Ferri, Sarah L; Abel, Ted; Brodkin, Edward S (2018) Sex Differences in Autism Spectrum Disorder: a Review. Curr Psychiatry Rep 20:9
Pallathra, Ashley A; Calkins, Monica E; Parish-Morris, Julia et al. (2018) Defining behavioral components of social functioning in adults with autism spectrum disorder as targets for treatment. Autism Res 11:488-502