Detection of ASD at the 1st birthday as standard of care: The Get SET Early Model

在 1 岁生日时检测 ASD 作为护理标准：Get SET Early 模型

• 批准号: 9611999
• 负责人: Karen L Pierce
• 金额: $ 5.63万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-25 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9611999
• 关键词: 1 year old; Age; Americas; Autistic Disorder; Biological Models; CDC2 gene; Centers for Disease Control and Prevention (U.S.); Characteristics; Child; Childhood; Cities; Clinic; Clinical; Data; Databases; Detection; Development; Developmental Delay Disorders; Diagnosis; Diagnostic; Early Diagnosis; Early Intervention; Early treatment; Ensure; Evaluation; Guidelines; Habits; Household; Income; Life; Los Angeles; Measures; Medical; Modeling; Notification; Online Systems; Outcome Measure; Parents; Performance; Reporting; Research; Risk; Schedule; Screening procedure; Sensitivity and Specificity; Services; Site; Speed; Standardization; Surveys; System; Telephone; Testing; Toddler; Treatment outcome; United States Dept. of Health and Human Services; base; brain cell; catalyst; checkup examination; clinical practice; cohort; data sharing; design; digital; early screening; follow-up; improved; innovation; medical specialties; member; pediatrician; primary outcome; programs; prospective; provider networks; public health relevance; research study; satisfaction; screening; standard of care

DESCRIPTION (provided by applicant): We previously demonstrated that our early intervention model system, which was centered on using the CSBS to screen all babies at the 1-year check-up as standard of care, resulted in a mean age of 12 months for screening, 14 months for evaluation, and 18 months for treatment participation. These are far younger ages than is common in the U.S. Our 3-stage model system, Get SET (S=Screen; E=Evaluate; T=Treat) Early, screened >10,000 1 year olds in our first trial run1 detecting over 100 ASD and other developmental delayed toddlers. We will build on this highly effective model by implementing a new version in two major cities: San Diego and Phoenix; Los Angeles, Irvine, and Phoenix will provide baseline control data. In Phoenix, we test the feasibility of establishing the Get SET Early model in a city with one of the lowest median incomes and oldest age of first diagnosis in America. In AIM #1, the Screen and Refer Early stage, we will create a Pediatrician Network with 100 members. In San Diego we will utilize our existing Pediatrician Network and test new innovations such as a repeat triple screen at 12, 18, and 24 months to ensure that no toddlers are missed. Speed of referral for evaluation will be compared and contrasted using parent (self) and automatic (referral i- Pad App) options. We will track every toddler with an eventual ASD diagnosis within circumscribed medical groups to determine the true sensitivity and specificity of the screening tool and the percentage of ASD toddlers detected by our model. Anonymous survey data regarding screening habits will be administered to parents and pediatricians. AIM #2 implements the Evaluate and Refer Early stage. Its key attribute is an ASD Early Evaluation Clinic that specializes in the rapid scheduling and evaluation of every referred screened positive toddler. Toddlers will enter the program at the age they fail the screen (i.e., 12, 18 or 24 months) and will be thoroughly diagnostically evaluated and tracked once per year until they turn 3 years. This specialty Clinic is at our Autism Center in San Diego and will be developed at SARRC in Phoenix. Automated versus optional self-referral for treatment will be tested and compared. AIM #3 implements the Treat Early stage. Its key attributes are a network of providers of empirically based treatment and the innovative use of an inexpensive and readily available web-based treatment tracking system to document engagement. Treatment Networks will be created in San Diego and Phoenix. Primary outcome measures include rates and ages of screening and referral, evaluation and referral, and treatment engagement; sustainability across years; diagnostic, clinical and demographic characteristics of subjects; professional and parent satisfaction at each stage. We hypothesize that providing screening tools with clear cut-off scores and guidelines for automatic referral for evaluation and treatment, will result in dramatically lowering mean age of diagnosis and treatment in Phoenix from 4-5 years down to 1-2 years; San Diego will likewise have mean ages of 1-2 years for diagnosis and treatment making them significantly earlier than Los Angeles and Irvine control sites.

描述（由申请人提供）：我们之前证明了我们的早期干预模型系统，该系统以使用CSBS在1岁检查时对所有婴儿进行筛查为中心，作为标准护理，结果显示筛查的平均年龄为12个月，评估的平均年龄为14个月，参与治疗的平均年龄为18个月。这些孩子的年龄比美国的普遍年龄要小得多。我们的三阶段模型系统Get SET （S=筛查；E=评估；T=治疗）早期，在我们的第一次试验中筛查了100多万名1岁儿童，发现了100多名ASD和其他发育迟缓的幼儿。我们将在这一高效模式的基础上，在两个主要城市实施新版本：圣地亚哥和凤凰城；洛杉矶、尔湾和凤凰城将提供基线控制数据。在凤凰城，我们测试了建立的可行性