Evaluation of Diagostic and Services Practices in Autism

自闭症诊断和服务实践的评估

• 批准号: 6914919
• 负责人: NATACHA AKSHOOMOFF
• 金额: $ 16.33万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6914919
• 关键词: autism; behavioral /social science research tag; child mental health service; child psychology; clinical research; community mental health services; diagnosis design /evaluation; diagnosis quality /standard; education evaluation /planning; health care policy; health care professional practice; health care service evaluation; health services research tag; health surveys; human subject; interview; mental disorder diagnosis; mental health education; middle childhood (6-11); neuropsychological tests; preschool child (1-5); questionnaires; remedial /special education; schools; statistics /biometry; teacher

DESCRIPTION (provided by applicant): The clinical complexities of proper diagnosis and assessment of children with ASD, together with federal and state mandates to provide services, present significant challenges to local schools and public service providers. Autism is increasingly conceptualized to encompass a spectrum of disorders rather than a unitary, classically defined developmental disorder. Given the large number of behaviors that define the "autistic spectrum disorders" (ASD) and the variability seen across individual children even within the same diagnostic category, proper identification and assessment requires experienced clinicians and educators. It appears that better identification and broader categorization have contributed to the increasing numbers of children who are being identified with ASD. Standardized diagnostic instruments that have been demonstrated to be reliable and valid are now widely used in ASD research. While comprehensive, valid assessments are essential for educational planning, the direct clinical or educational benefits of diagnostic distinctions within the autism spectrum are a matter of debate. The applicant proposes to evaluate the range of diagnostic distinctions that are present in children who are receiving educational interventions under the autism category. The nature of diagnostic and educational assessments used by service delivery systems for children with autism will be investigated. These data will be used to determine how the broader definition of autism used by schools compares with a diagnosis based on the use of research-based standardized test instruments by experienced professionals. The applicant is requesting a Career Development Award (K23) to obtain the advanced training in services research she needs to address these issues. The applicant's strong background of academic, research, and clinical training in diagnostic and neuropsychological assessment in children, research design and statistics, and autism specific issues will provide an excellent foundation for this work. The proposed training goals, including becoming familiar with statistics and longitudinal techniques used in services research, and obtaining greater knowledge about schools and school-based assessment services, in conjunction with the research plan, will allow the applicant to pursue innovative approaches to implementing research-based diagnostic and assessment methods for children with autism in community settings.

描述（由申请人提供）：ASD儿童的正确诊断和评估的临床复杂性，以及联邦和州提供服务的任务，对当地学校和公共服务提供者提出了重大挑战。自闭症越来越多地被概念化为包括一系列障碍，而不是单一的、经典定义的发育障碍。鉴于定义“自闭症谱系障碍”（ASD）的大量行为以及即使在同一诊断类别中也可以在单个儿童中看到的变异性，正确的识别和评估需要经验丰富的临床医生和教育工作者。似乎更好的识别和更广泛的分类有助于越来越多的儿童被确定患有ASD。标准化的诊断仪器已被证明是可靠和有效的，现在广泛用于ASD研究。虽然全面、有效的评估对教育规划至关重要，但自闭症谱系内诊断区分的直接临床或教育益处是一个有争议的问题。申请人建议评估在自闭症类别下接受教育干预的儿童中存在的诊断区别的范围。将调查自闭症儿童服务提供系统使用的诊断和教育评估的性质。这些数据将用于确定学校使用的自闭症更广泛的定义与经验丰富的专业人员使用基于研究的标准化测试仪器进行诊断的比较。申请人正在申请职业发展奖（K23），以获得她需要解决这些问题的服务研究方面的高级培训。申请人在儿童诊断和神经心理学评估，研究设计和统计以及自闭症具体问题方面的学术，研究和临床培训背景将为这项工作提供良好的基础。拟议的培训目标，包括熟悉服务研究中使用的统计和纵向技术，并获得更多关于学校和校本评估服务的知识，结合研究计划，将使申请人能够采用创新方法，在社区环境中为自闭症儿童实施基于研究的诊断和评估方法。