Connecting the Dots: An RCT Integrating Standardized ASD Screening, High-Quality Treatment, and Long-Term Outcomes
连接点:整合标准化 ASD 筛查、高质量治疗和长期结果的随机对照试验
基本信息
- 批准号:10205984
- 负责人:
- 金额:$ 221.38万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2017
- 资助国家:美国
- 起止时间:2017-09-07 至 2023-11-30
- 项目状态:已结题
- 来源:
- 关键词:2 year old4 year oldAcademyAddressAdvisory CommitteesAffectAgeAge of OnsetAmericanAttitudeBehavior TherapyBeliefCaliforniaChildChildhoodClinicalCognitionCommunitiesConflict (Psychology)ConnecticutControl GroupsCoupledDataDetectionDevelopmentDiagnosisDiagnosticEarly DiagnosisEarly InterventionEarly identificationEarly treatmentEducational InterventionEligibility DeterminationEnrollmentEthicsEvaluationGeographic LocationsGoalsGuidelinesHappinessHealth Services AccessibilityHeterogeneityInstitutesInterventionKnowledgeLiteratureLongevityMeasuresMedicalMethodsMonitorOutcomeOutcome MeasureParent-Child RelationsParentsPediatricsPersonal SatisfactionPhysiciansPositioning AttributePreventive serviceProcessProductivityPublishingRandomizedRandomized Controlled TrialsReadinessRecommendationResearchRiskSamplingScience PolicyScreening procedureSeveritiesSiteSocial FunctioningSocioeconomic StatusStandardizationStressSymptomsSystemTestingToddlerTrainingUniversitiesWorkautism spectrum disorderautistic childrenbasecognitive abilitycognitive functiondisabilityearly onsetearly screeningempowermentevidence baseexperienceexperimental groupimprovedimproved outcomeindividuals with autism spectrum disorderintervention effectkindergartenprimary outcomesatisfactionscreeningscreening guidelinessecondary outcomeservice deliverysocial engagementsocial reciprocitysocietal coststargeted treatmenttreatment as usualtreatment responsetrial designvisual tracking
项目摘要
A growing body of evidence demonstrates that younger age of onset for ASD treatment improves outcomes. Universal toddler
screening for autism spectrum disorder (ASD) has been shown to lower the age of ASD diagnosis by two years compared to
the national median; this in turn lowers the age of access to ASD-specific treatment. Yet on February 17, 2016, the US
Preventive Services Task Force (USPSTF) published a final statement on autism screening in JAMA, in which they found
insufficient evidence to recommend universal ASD screening. One of the primary gaps they identified was a lack of
randomized controlled trials (RCTs) in which children detected through screening received treatment for ASD, with their
outcomes compared to those of children not screened. The current proposal aims to fill this gap, connecting the dots
between the screening and treatment literatures, and demonstrating that standardized, high-fidelity, universal
screening lowers the age of diagnosis and treatment onset, leading to improved short- and long-term outcomes. The
intervention in this RCT is supported deployment of such screening, with immediate evaluation of at-risk children, compared
to a control group receiving usual care approaches to early detection of ASD, namely physician surveillance and/or
unstandardized screening. In a sample of 8,000 toddlers enrolled through participating pediatric practices near Drexel
University, the University of Connecticut, and the University of California Davis MIND Institute, we expect that cognitive
functioning and ASD symptom severity will show greater improvements in the experimental group, in which most children
will be detected at 18 m screening, compared to the control group, in which children are expected to be detected significantly
later. In both groups, missed ASD cases will be detected through screening at 48 m. Across both groups, all children identified
as at risk for ASD will receive a diagnostic evaluation, and all children diagnosed with ASD will be enrolled in one year of
manualized early intensive behavioral treatment (EIBI). In addition to the primary outcome measures of cognition and
symptom severity, exploratory outcomes will include group differences in adaptive functioning, kindergarten readiness, and
social reciprocity as measured by experimental eye tracking and parent-child interaction ratings. We also will examine the
impact of the screening intervention on physician attitudes and on parent empowerment and stress. Finally, we will examine
potential moderators of group differences, to determine whether initial symptom severity, cognitive ability, or SES affects the
expected superior response to treatment in the experimental group. Our Autism Centers of Excellence Network is uniquely
positioned to carry out this study; our prior work demonstrates our extensive experience and productivity in the field of early
screening and treatment in ASD. This study will be the first RCT of toddler ASD screening, and will use rigorous methods
that have provided evidence for universal screening protocols in other medical fields. This study will have a significant impact
on science, policy, and practice. By demonstrating that universal early screening leads to earlier treatment and better
outcomes, this project will provide evidence for the benefits of universal ASD screening, including better social and
cognitive functioning, mitigating lifespan disability, reducing societal costs, and improving personal well-being and
productivity of individuals with ASD.
越来越多的证据表明,自闭症谱系障碍的发病年龄越小,治疗效果越好。通用蹒跚学步的孩子
项目成果
期刊论文数量(7)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Does Treatment Fidelity of the Early Start Denver Model Impact Skill Acquisition in Young Children with Autism?
- DOI:10.1007/s10803-021-05371-4
- 发表时间:2021-12
- 期刊:
- 影响因子:3.9
- 作者:Ashley Zitter;Hezekiah Rinn;Ž. Szapuová;Vanessa M Avila-Pons;Kirsty L Coulter;Aubyn C. Stahmer;D. Robins;G. Vivanti
- 通讯作者:Ashley Zitter;Hezekiah Rinn;Ž. Szapuová;Vanessa M Avila-Pons;Kirsty L Coulter;Aubyn C. Stahmer;D. Robins;G. Vivanti
Connecting the Dots: a cluster-randomized clinical trial integrating standardized autism spectrum disorders screening, high-quality treatment, and long-term outcomes.
连接点:一项集群临床试验,整合了标准化的自闭症谱系筛查,高质量治疗和长期结局。
- DOI:10.1186/s13063-021-05286-6
- 发表时间:2021-05-02
- 期刊:
- 影响因子:2.5
- 作者:McClure LA;Lee NL;Sand K;Vivanti G;Fein D;Stahmer A;Robins DL
- 通讯作者:Robins DL
The Toddler Autism Symptom Inventory: Use in diagnostic evaluations of toddlers.
幼儿自闭症症状量表:用于幼儿的诊断评估。
- DOI:10.1177/13623613211021699
- 发表时间:2021-11
- 期刊:
- 影响因子:0
- 作者:Coulter KL;Barton ML;Boorstein H;Cordeaux C;Dumont-Mathieu T;Haisley L;Herlihy L;Jashar DT;Robins DL;Stone WL;Fein DA
- 通讯作者:Fein DA
Initial diagnostic impressions of trainees during autism evaluations: High specificity but low sensitivity.
受训者在自闭症评估过程中的初步诊断印象:特异性高,但敏感性低。
- DOI:10.1002/aur.2933
- 发表时间:2023
- 期刊:
- 影响因子:0
- 作者:deMarchena,Ashley;Wieckowski,AndreaTrubanova;Algur,Yasemin;Williams,LashaeN;Fernandes,Sherira;Thomas,RebeccaP;McClure,LeslieA;Dufek,Sarah;Fein,Deborah;Stahmer,AubynC;Robins,DianaL
- 通讯作者:Robins,DianaL
The first five minutes: Initial impressions during autism spectrum disorder diagnostic evaluations in young children.
- DOI:10.1002/aur.2536
- 发表时间:2021-09
- 期刊:
- 影响因子:0
- 作者:Wieckowski AT;de Marchena A;Algur Y;Nichols L;Fernandes S;Thomas RP;McClure LA;Dufek S;Fein D;Adamson LB;Stahmer A;Robins DL
- 通讯作者:Robins DL
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Diana L Robins其他文献
Diana L Robins的其他文献
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{{ truncateString('Diana L Robins', 18)}}的其他基金
Sensitivity of toddler screening: Integrating concurrent and prospective strategies to detect ASD
幼儿筛查的敏感性:整合同步和前瞻性策略来检测 ASD
- 批准号:
10680190 - 财政年份:2023
- 资助金额:
$ 221.38万 - 项目类别:
Public Health and Autism Science advancing Equitable Strategies across the life course (PHASES)
公共卫生和自闭症科学在整个生命过程(阶段)中推进公平策略
- 批准号:
10523859 - 财政年份:2022
- 资助金额:
$ 221.38万 - 项目类别:
Strategies to Facilitate Early Detection of Autism in Primary Care
促进初级保健中自闭症早期发现的策略
- 批准号:
10523863 - 财政年份:2022
- 资助金额:
$ 221.38万 - 项目类别:
Leveraging Claims Data to Compare Disparities in Health Outcomes for Autistic People and People With Down Syndrome
利用理赔数据比较自闭症患者和唐氏综合症患者的健康结果差异
- 批准号:
10853581 - 财政年份:2022
- 资助金额:
$ 221.38万 - 项目类别:
Strategies to Facilitate Early Detection of Autism in Primary Care
促进初级保健中自闭症早期发现的策略
- 批准号:
10698136 - 财政年份:2022
- 资助金额:
$ 221.38万 - 项目类别:
Public Health and Autism Science advancing Equitable Strategies across the life course (PHASES)
公共卫生和自闭症科学在整个生命过程(阶段)中推进公平策略
- 批准号:
10698124 - 财政年份:2022
- 资助金额:
$ 221.38万 - 项目类别:
Connecting the Dots: An RCT Integrating Standardized ASD Screening, High-Quality Treatment, and Long-Term Outcomes
连接点:整合标准化 ASD 筛查、高质量治疗和长期结果的随机对照试验
- 批准号:
9975220 - 财政年份:2017
- 资助金额:
$ 221.38万 - 项目类别:
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