Early Detection of Pervasive Developmental Disorders

早期发现广泛性发育障碍

• 批准号: 6910749
• 负责人: Deborah A. Fein
• 金额: $ 63.06万
• 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/6910749
• 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）：自闭症和其他普遍发育障碍 障碍（PDD）是严重的发育障碍，通常会导致终生 残疾。早期发现和干预可以显着改善 预后；然而，利用现有的筛查仪器，早期检测是可行的 难的。诊断和干预通常是在最初怀疑之后进行的 三年或更长时间，有效干预措施的性质并不好 明白了。拟议的研究涉及家长清单的验证 适合 24 个月大的婴儿，目前正在开发中。 1293 试点数据二 岁儿童，其中 59 人接受评估，其中 38 人被诊断为自闭症 或 PDD，展现了卓越的有效性承诺。小额赠款来自 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 允许研究人员开始准备大规模筛查并 开始对当前参与者进行后续研究。在当前 申请中，将筛选 33,400 名儿童，其中 30,000 名来自未选择的样本 的儿科就诊，以及 3,400 个来自儿童兄弟姐妹的高风险样本 患有自闭症和转介进行早期干预的儿童。预计 140 PDD（以及大约 35 个误报）将在 24 个月时进行评估，并且 42个月时再次出现。评估将包括精神科诊断和 认知、语言和适应性功能的评估；的可靠性 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 函数分析以确定检测 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 初次评价和后续评价之间 18 个月内收到的信息 也将被收集。使用 42 个月时的临床状态变量作为结果 措施、控制儿童和家庭特征、干预 诸如强度、类型、环境和家长参与等变量 研究它们与结果的关系。拟议的研究应该大大 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， 拟议的研究还将提供有关其性质的重要信息 对患有自闭症和PDD的儿童进行有效的干预。计划的未来 研究包括在其他州和其他国家（例如日本）进行复制。