Early Detection of Pervasive Developmental Disorders

早期发现广泛性发育障碍

• 批准号: 6773296
• 负责人: Deborah A. Fein
• 金额: $ 64.42万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-01 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6773296
• 关键词: autism; behavioral /social science research tag; child psychology; developmental disease /disorder; diagnosis design /evaluation; diagnostic tests; disease /disorder proneness /risk; early diagnosis; family structure /dynamics; human subject; infant human (0-1 year); interview; longitudinal human study; outcomes research; patient oriented research; pediatrics; personality; preschool child (1-5); psychological tests; questionnaires; siblings; socioeconomics; statistics /biometry; telemedicine

DESCRIPTION (provided by applicant): Autism and other pervasive developmental disorders (PDD) are severe disorders of development, often leading to life-long disability. Early detection and intervention can substantially improve prognosis; however, with available screening instruments early detection is difficult. Diagnosis and intervention often follow initial suspicion by as much as three years or more, and the nature of effective interventions is not well understood. The proposed study involves the validation of a parent checklist for 24-month-olds which is under current development. Pilot data on 1293 two year olds, 59 of whom were evaluated and 38 of whom were diagnosed as autistic or PDD, demonstrates excellent promise of effectiveness. Small grants from NAAR, the U.S. Department of Education, and the University of Connecticut Research Foundation, and an NIMH/NRSA individual predoctoral fellowship, have allowed the investigators to begin preparing for large-scale screening and to begin a follow-up study of the current participants. In the current application, 33,400 children will be screened, 30,000 from an unselected sample of pediatric visits, and 3,400 from high risk samples of siblings of children with autism and children referred for early intervention. A projected 140 with PDD (and approximately 35 false positives) will be evaluated at 24 months and again at 42 months. Evaluations will include psychiatric diagnoses and assessment of cognitive, language, and adaptive functioning; reliability of diagnoses (by ADOS and ADI-R) will be confirmed by a child psychiatrist. Analyses at both time points will use signal detection and discriminant function analyses to determine the optimal set of items to detect PDD, and will assess the sensitivity and specificity of the instrument. Data on interventions received during the 18 months between the initial and follow-up evaluations will also be collected. Using clinical status variables at 42 months as outcome measures, and controlling for child and family characteristics, intervention variables such as intensity, type, setting, and parent involvement will be studied for their relationship to outcome. The proposed study should greatly advance the development of an effective early screening tool for autism and related disorders. Although not a randomized trial of different interventions, the proposed research will also provide important information on the nature of effective interventions for children with autism and PDD. Planned future studies include replication in other states and other countries (e.g., Japan).

描述（由申请人提供）：自闭症和其他广泛的发展 发育障碍（PDD）是严重的发育障碍，通常导致终身 残疾。早期发现和干预可以大大改善 预后;然而，利用现有的筛查工具， 难诊断和干预往往遵循最初的怀疑， 三年或更长时间，有效干预措施的性质不好 明白拟议的研究涉及家长检查表的验证 24个月大的婴儿，目前正在开发中。1293两个试点数据 其中59人接受了评估，38人被诊断为自闭症 或PDD，表现出良好的有效性承诺。的小额赠款 NAAR，美国教育部和康涅狄格大学 研究基金会和NIMH/NRSA个人博士前奖学金， 使研究人员开始准备大规模筛查， 开始对现有参与者进行后续研究。在当前 申请，33，400名儿童将接受筛查，其中30，000人来自一个随机样本 的儿科就诊，3,400例来自儿童兄弟姐妹的高风险样本 自闭症患者和需要早期干预的儿童。预计140人， 将在24个月时评价PDD（以及约35个假阳性）， 42个月时再次出现。评估将包括精神病诊断， 认知、语言和适应功能的评估; 诊断（通过ADOS和ADI-R）将由儿童精神科医生确认。 两个时间点的分析将使用信号检测和判别分析 功能分析，以确定检测PDD的最佳项目集，并将 评估仪器的灵敏度和特异性。干预措施数据 在初次评价和后续评价之间的18个月内收到的 也将被收集。使用42个月时的临床状态变量作为结局 措施，控制儿童和家庭特征，干预 变量，如强度，类型，设置和家长参与将是 研究了它们与结果的关系。这项研究将大大 推动开发有效的自闭症早期筛查工具， 相关疾病。虽然不是不同干预措施的随机试验， 拟议中的研究还将提供关于 对自闭症和PDD儿童进行有效干预。计划今后开展 研究包括在其他州和其他国家的复制（例如，日本）。