Improving Early Identification and Intervention for Children at Risk for Autism Spectrum Disorder
Improving Early Identification and Intervention for Children at Risk for Autism Spectrum Disorder
复制标题
提高对有患自闭症谱系障碍风险儿童的早期识别与干预水平
DOI：
10.1542/peds.2016-1061
复制
发表时间：
2017-02-01
期刊：
影响因子：
8
通讯作者：
Charles, Jane
中科院分区：
文献类型：
--
作者：
Rotholz, David A.;Kinsman, Anne M.;Charles, Jane
目的：提供一个成功的、新颖的全州范围的努力，以增加自闭症谱系障碍(ASD)高危儿童的早期抽象识别，通过加强质量评估、机构间政策合作和协调的两级筛查过程。方法：南卡罗来纳州法案早期小组(SCAET)在代表州机构、大学、医疗保健系统、私人组织和家庭的领导人之间提供有针对性的合作，以提高ASD儿童的生活质量。具体的重点是实施政策变化和培训，以导致对有自闭症风险的幼儿进行更早的识别和基于家庭的行为干预。结果：完成了政策变化、培训和修改国家机构的做法。在两级筛查程序的基础上，推定资格是由BabyNet(南卡罗来纳州早期干预方案)与发展残疾服务牵头机构合作实施的。在没有等待ASD诊断的情况下，有资格接受早期强化行为干预的儿童增加了五倍，避免了长时间等待诊断评估。只有16名儿童(2.5%)后来在综合评估中被发现没有ASD。结论：通过合作政策改变，改进早期识别和干预是可行的。南卡罗来纳州法案早期小组及其主要利益攸关方致力于改善这一群体的结果，以新的方式利用现有工具和方法改进自闭症儿童的早期识别，并提供循证干预服务。这一范例应在其他州推广，主要利益攸关方应为自闭症儿童的利益而共同努力。
OBJECTIVES: To provide an example of a successful, novel statewide effort to increase early abstract identification of young children at risk for autism spectrum disorder (ASD) using a 2-tiered screening process with enhanced quality assessment, interagency policy collaboration and coordination.METHODS: The South Carolina Act Early Team (SCAET) provided focused collaboration among leaders representing state agencies, universities, health care systems, private organizations, and families to improve quality of life for children with ASD. Specific focus was on implementing policy changes and training to result in earlier identification and home-based behavioral intervention for young children at risk for ASD.RESULTS: Policy changes, training, and modified state agency practices were accomplished. Presumptive eligibility, on the basis of a 2-tiered screening process was implemented by BabyNet (South Carolina's Early Intervention Program) in collaboration with the lead agency for developmental disability services. There was a fivefold increase in children eligible for early intensive behavioral intervention without waiting for a diagnosis of ASD, avoiding long waits for diagnostic evaluations. Only 16 children (2.5%) were later found not to have ASD from a comprehensive evaluation.CONCLUSIONS: Improvements in early identification and intervention are feasible through collaborative policy change. The South Carolina Act Early Team and its key stakeholders committed to improving outcomes for this population used existing tools and methods in new ways to improve early identification of children with ASD and to make available evidence-based intervention services. This example should be replicable in other states with key stakeholders working collaboratively for the benefit of young children with ASD.