Cognitive Enhancement Therapy for Adults With Autism Spectrum Disorders

• Cognitive Assessment Battery, including the NIMH-Measurement and Treatment Research to Improve Cognition in Schizophrenia (NIMH-MATRICS) Battery and the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) [ Time Frame: Measured at baseline and at 9 and 18 months ] [ Designated as safety issue: No ]
  

• Functional Assessment Battery (Social, Role, Vocational) [ Time Frame: Measured at baseline and at 9 and 18 months ] [ Designated as safety issue: No ]
  

Autism, Asperger's syndrome, and pervasive developmental disorder are all autism spectrum disorders (ASD), which are characterized by specific impairments in social interactions, communication, and imaginative play and by restricted and repetitive interests and behavior. These impairments stem from problems in underlying cognition and information processing. ASDs are often treated in childhood, but no attempt has been made to improve cognition and brain deficits in adults with ASDs, who often experience difficulty in understanding social situations, thinking abstractly, and taking the perspective of others. Cognitive enhancement therapy (CET) is a treatment that has proved effective in improving cognition in individuals with schizophrenia. This study will compare the benefits of CET on cognition and brain function in adults with ASDs to Enriched Supportive Therapy (EST), an intervention designed to improve emotion management and regulation.

Participation in this study will last 18 months. Potential participants must be able to attend weekly treatment sessions in Pittsburgh, PA. The first 12 participants will be assigned to receive CET. All other participants will be randomly assigned to receive either CET or EST. Some participants will also be selected to complete a magnetic resonance imaging (MRI) assessment, which will involve performing tasks while undergoing a brain scan.

Participants assigned to receive CET will complete three different weekly study visits: a group, an individual, and a computer visit. Participants will receive training in attention, memory, and problem solving abilities through computer training and will develop problem solving and communication skills through the group sessions. The CET treatment will require approximately 3 to 3.5 hours a week for up to 18 months.

Participants assigned to receive EST will meet individually with a therapist to learn about their condition, manage their emotions and stress, improve their social skills, and cope with everyday problems. Participants will also learn about the impact of stress on their lives, and how to identify their own early cues of distress and apply effective coping strategies. The EST treatment will require approximately 1 hour a week for up to 18 months.

All participants will complete assessments at baseline and after 9 and 18 months. Assessments will include a cognitive testing session, in which participants complete a reading and intelligence test; an interview with a researcher, in which participants will be asked about the symptoms of their disorder; and an interview with a family member or close friend of the participant, which will involve questions about the participant's disorder. Participants assigned to MRI will undergo the procedure at baseline and 18 months.