Autism Access Link for Early Referral and Treatment

摘要： 虽然大量的研究工作集中在自闭症谱系障碍（ASD）筛查上，但对自闭症谱系障碍的关注较少。 一直致力于优化对后来被确定为有风险的儿童的后续行动。尽管有所增加 在ASD筛查率方面，许多ASD儿童在最初被怀疑患有自闭症之间等待了数年， 护理环境以及明确诊断和治疗开始的时间。延误和漏诊尤其是 对于美国低收入和种族/少数民族儿童来说，这是一个问题，他们的这些经历率更高。 不良后果。在这个项目中，我们建议试点测试自闭症访问链接到早期转诊和治疗 （自闭症警报），全州范围内的监测和病例管理计划，以加快获得ASD诊断 在初级保健环境中对疑似ASD的儿童进行治疗。该系统将减少时间 在初级保健环境中识别疑似ASD与建立ASD诊断之间的关系， 通过减少家庭护理障碍、减轻PCP负担和简化转诊， 流程.该计划将提供给任何俄勒冈州儿童年龄12-54个月，无论卫生系统或 付款人类型。自闭症警报将成为帮助我成长国家网络的一部分，这使它有可能 在全国和全国范围内传播。在这项拟议的研究中，我们将通过将自闭症警报与 在6个俄勒冈州初级保健实践中进行的ASD筛查干预。该试点项目的主要目标 评估自闭症警报对初级保健提供者和家庭的可行性和可接受性， 自闭症警报的作用机制，以试点测试在缩短自闭症诊断时间方面的疗效， 治疗，并测试协议实施的保真度。如果成功，该项目将扩大到一个 实施/有效性R 01，其中该计划将在整个俄勒冈州进行测试。在 从长远来看，这项研究将导致一个可持续的，以证据为基础的全州范围内，并最终国家 疑似ASD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.