Friday, April 19, 2024 4/19/2024

A hybrid effectiveness-implementation trial of a school based executive function treatment for transition age youth with autism

Award Number: R01MH124772
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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PROJECT SUMMARY The proposed study is highly relevant to the 2017 Interagency Autism Coordinating Committee priorities to improve transition to adulthood in autism spectrum disorders (ASD). It also advances NIMH’s mission to develop interventions that: 1) assess the mechanisms through which an intervention produces therapeutic change (Strategy 3.1); and 2) have been tested for effectiveness through pragmatic community-based trials that examine implementation factors to improve the fit of the intervention (Strategy 3.3). Caring for transition- age youth with ASD is a significant public health concern and the exit from high school is a period of amplified risk. Individuals without intellectual disabilities (ID) comprise the fastest-growing subgroup of ASD and account for two-thirds of the total population. Due to rising prevalence, there will be a 123% increase in the number of youth with ASD exiting secondary school in the next decade. The educational system is increasingly the primary service access point for youth with ASD, with as many of 90% served in public school settings. As such, the transition from high school is often characterized as “falling over a cliff,” as youth with ASD lose these educational and social supports. As few as 9% of autistic individuals without ID reach full functional independence as adults, resulting in a loss to society, as well as to the youth and their families. Impaired executive functions (EF) in ASD occur as a result of abnormalities in neural networks involving prefrontal cortex, and are related to poor adult outcome. EF problems are pivotal targets for intervention because they are common, linked to independence, and responsive to treatment. The proposed study will test the effectiveness of a school-based cognitive behavioral EF intervention, Flexible Futures (FF), for transition- age youth with ASD (AIM 1) and evaluate mechanisms of treatment change (AIM 2). FF targets flexibility and planning skills and focuses on key functions needed for adult success: understanding one’s own thinking style and advocating for accommodations; flexible problem-solving; time management; goal setting; developing plans; monitoring progress. FF was designed from inception to be embedded in high schools and delivered by school staff to improve generalization of skills, increase access to mental health care, and fill a gap in a lack of evidence-based approaches to support postsecondary transition. A small, pilot randomized controlled trial found students receiving FF made greater gains in planning, flexibility, adaptive, and classroom behavior when compared to students receiving the usual ASD supports at school. This project capitalizes on the opportunity to utilize pragmatic community trials to probe mechanisms of treatment change and explore barriers and facilitators to implementation (AIM 3) to improve sustainable adoption and implementation of effective, generalizable, evidence-based interventions. If successful, the proposed project will demonstrate the widespread effectiveness and feasibility of an accessible intervention to improve transition outcomes for youth with ASD that can be rapidly disseminated and implemented by schools across the nation.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $556,621 )
2024	2024	CHILDREN'S RESEARCH INSTITUTE	111 MICHIGAN AVE NW	WASHINGTON	DC	20010	DISTRICT OF COLUMBIA	USA	Mental Health Research Grants	001	4	3/11/2024	NON-COMPETING CONTINUATION	$0
2024	2024	CHILDREN'S RESEARCH INSTITUTE	111 MICHIGAN AVE NW	WASHINGTON	DC	20010	DISTRICT OF COLUMBIA	USA	Mental Health Research Grants	000	4	11/20/2023	NON-COMPETING CONTINUATION	$556,621
														Subtotal = $556,621

Issue Date FY: 2023 ( Subtotal = $671,005 )
2023	2023	CHILDREN'S RESEARCH INSTITUTE	111 MICHIGAN AVE NW	WASHINGTON	DC	20010	DISTRICT OF COLUMBIA	USA	Mental Health Research Grants	001	3	1/19/2023	NON-COMPETING CONTINUATION	$67,098
2023	2023	CHILDREN'S RESEARCH INSTITUTE	111 MICHIGAN AVE NW	WASHINGTON	DC	20010	DISTRICT OF COLUMBIA	USA	Mental Health Research Grants	000	3	11/16/2022	NON-COMPETING CONTINUATION	$603,907
														Subtotal = $671,005

Issue Date FY: 2022 ( Subtotal = $660,403 )
2022	2022	CHILDREN'S RESEARCH INSTITUTE	111 MICHIGAN AVE NW	WASHINGTON	DC	20010	DISTRICT OF COLUMBIA	USA	Mental Health Research Grants	000	2	11/10/2021	NON-COMPETING CONTINUATION	$594,364
2022	2022	CHILDREN'S RESEARCH INSTITUTE	111 MICHIGAN AVE NW	WASHINGTON	DC	20010	DISTRICT OF COLUMBIA	USA	Mental Health Research Grants	001	2	6/21/2022	NON-COMPETING CONTINUATION	$66,039
														Subtotal = $660,403

Issue Date FY: 2021 ( Subtotal = $593,049 )
2021	2021	CHILDREN'S RESEARCH INSTITUTE	111 MICHIGAN AVE NW	WASHINGTON	DC	20010	DISTRICT OF COLUMBIA	USA	Mental Health Research Grants	000	1	1/21/2021	NEW	$593,049
														Subtotal = $593,049

Grand Total All Awards = $2,481,078

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A hybrid effectiveness-implementation trial of a school based executive function treatment for transition age youth with autism

Award Number: R01MH124772

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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