Autism Access Link for Early Referral and Treatment

摘要： 虽然大量的研究工作集中在孤独症谱系障碍(ASD)的筛查上，但关注较少。 一直致力于优化对后来被确定为高危儿童的后续行动。尽管价格上涨 在自闭症筛查率方面，许多患有自闭症的儿童在被怀疑患有自闭症的小学之间等待了数年 护理环境以及确诊诊断和治疗开始的时间。延误和漏诊的情况尤其严重 对于美国的低收入和种族/少数民族儿童来说，这是一个问题，他们经历了更高的这种情况 不利的结果。在这个项目中，我们建议对自闭症访问链接进行试点测试，以进行早期转诊和治疗 (自闭症警报)，这是一项全州范围的监测和病例管理计划，可加快ASD诊断的获取 在初级保健环境中对疑似自闭症儿童进行治疗。该系统将减少时间 在初级保健环境中识别疑似ASD和建立ASD诊断和 治疗服务，通过减少家庭护理障碍，减少初级保健计划负担，并简化转诊 流程。该计划将适用于俄勒冈州任何12-54个月的儿童，无论卫生系统或 付款人类型。自闭症警报将成为Help Me Growth全国网络的一部分，这使其有可能 在全州和全国范围内传播。在这项拟议的研究中，我们将通过将自闭症警报与 俄勒冈州6个初级保健诊所的现有ASD筛查干预。该试点项目的主要目标 评估初级保健提供者和家庭的自闭症警报的可行性和可接受性，以测试 自闭症警报的作用机制，以试点测试在缩短自闭症诊断和治疗时间方面的有效性 处理，并测试协议执行的保真度。如果成功，这个项目将扩展为一个 实施/有效性R01，该计划将在俄勒冈州全州进行测试。在 从长远来看，这项研究将在全州范围内并最终在全国范围内产生可持续的、以证据为基础的 疑似自闭症儿童的监测系统。

ABSTRACT: Though significant research effort has focused on autism spectrum disorder (ASD) screening, less attention has been devoted to optimizing follow-up of children who are subsequently identified as at-risk. Despite increases in ASD screening rates, many children with ASD wait years between when autism is suspected in the primary care setting and when definitive diagnosis and treatment begin. Delayed and missed diagnoses are particularly problematic for low-income and racial/ethnic minority children in the US, who experience higher rates of these adverse outcomes. In this project, we propose to pilot test Autism Access Link to Early Referral and Treatment (Autism ALERT), a statewide monitoring and case management program to accelerate access to ASD diagnosis and treatment among children with suspected ASD the primary care setting. The system will reduce the time between identification of suspected ASD in the primary care setting and establishment of ASD diagnosis and treatment services, by reducing family barriers to care, decreasing PCP burdens, and simplifying referral processes. The program will be available to any Oregon child age 12-54 months, regardless of health system or payor type. Autism ALERT will become part of the Help Me Grow national network, which gives it potential for statewide and national spread. In this proposed research, we will pilot test Autism ALERT by comparing it to an existing ASD screening intervention in 6 Oregon primary care practices. Primary goals of this pilot project are to assess feasibility and acceptability of Autism ALERT for primary care providers and families, to test the mechanism of action of Autism ALERT, to pilot test efficacy in reducing time to autism diagnosis and treatment, and to test fidelity of protocol implementation. If successful, this project will be expanded into an implementation/effectiveness R01 in which the program will be tested throughout the state of Oregon. In the long term, this research will result in a sustainable, evidence-based statewide and ultimately national monitoring system children with suspected ASD.