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）：自闭症和其他普遍的发展 疾病（PDD）是严重的发展疾病，通常导致终身 残疾。早期检测和干预可以大大改善 预后；但是，随着可用的筛选仪器的早期检测是 难的。诊断和干预通常遵循最初的怀疑 三年或更长时间，有效干预的性质不好 理解。拟议的研究涉及父核对清单的验证 针对当前发展的24个月大的人。 1293的试点数据 一岁的孩子，其中59人接受了评估，其中38人被诊断为自闭症 或PDD，表现出极好的有效性前景。来自 Naar，美国教育系和康涅狄格大学 研究基金会和NIMH/NRSA个人奖学金的个人奖学金 允许调查人员开始准备大规模筛查和 开始对当前参与者的后续研究。在电流中 申请将筛选33,400名儿童，未选择样本中的30,000个儿童 小儿拜访，来自儿童兄弟姐妹的高风险样本3,400 自闭症和儿童提前干预。预计的140 PDD（大约35个假阳性）将在24个月进行评估，并且 再次在42个月。评估将包括精神病诊断和 评估认知，语言和自适应功能；可靠性 诊断（通过ADO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 功能分析以确定要检测PDD的最佳项目集，并将 评估仪器的灵敏度和特异性。有关干预措施的数据 在初始和随访评估之间的18个月内收到 也将收集。在42个月时使用临床状态变量作为结果 措施和控制儿童和家庭特征，干预 强度，类型，设置和父涉及等变量将是 研究了他们与结果的关系。拟议的研究应大大 开发自闭症和自闭症的有效的早期筛查工具 相关疾病。尽管不是对不同干预措施的随机试验，但 拟议的研究还将提供有关性质的重要信息 自闭症和PDD儿童的有效干预措施。计划的未来 研究包括在其他州和其他国家（例如日本）的复制。