Development of a Telehealth Screener and Assessment for Infants at-risk for ASD in Diverse Communities.

项目摘要 该提案的总体目标是开发一种用于筛查6-12岁婴儿的远程保健程序。 自闭症谱系障碍（ASD）的早期症状。虽然一些有前途的 生物标志物已经确定了这个年龄段的婴儿，神经生物学方法还没有 可广泛实施，特别是在农村和资源匮乏的服务系统。 有早期担忧的家庭面临着很长的等待评估的名单，并且经常必须旅行 在具有适当专业知识的中心进行评估的距离较远。远程保健已被用于 作为一种具有成本效益的方法，增加获得跨学科服务的机会， 在ASD中有一些远程医疗治疗方法的初步使用，但目前没有 建立了远程保健筛查程序，以筛查婴儿是否患有自闭症。发展远程保健 筛查方案将为家庭提供接触训练有素的临床医生的机会， 具有专业知识的研究人员在承担费用和努力之前进行初步筛选 需要前往中心。前六个月的资金将用于开发，完善， 在6-12个月的不同婴儿的样本中对这种父母管理的方案进行了初步测试（目标1）。 家长和专家的反馈将为最终的调整提供信息。由此产生的协议将 随后在试点可行性阶段通过远程保健进行测试（目标2）。30名6-12个月婴儿 患有早期ASD症状的患者及其护理人员将在全国范围内招募，并将完成 远程保健筛查季刊，为期一年。我们将检查远程医疗衍生的可靠性， 连续管理的婴儿行为的措施，并比较这些措施 现有的家长报告措施，以评估其有效性。家长的可接受性和可行性 还将评估这种远程保健筛查方法的可行性。该项目的总体目标是 制定一项系统筛查、评估和监测症状的方案， 婴儿从远处。这样做将增加家庭获得专门评估的机会， 减少父母首先关心和婴儿首先关心之间的等待时间 评价它还将为今后开展筛查和干预工作奠定基础 试验，并最终将有助于增加获得高质量的干预措施，并改善 更多未得到充分服务的ASD儿童的发展结果。

Project Summary The overall goal of this proposal is to develop a telehealth procedure for screening infants 6-12 months of age for early autism spectrum disorder (ASD) symptoms. While some promising biomarkers have been identified for infants in this age range, neurobiological methods are not feasible for widespread implementation, especially in rural and low-resource service systems. Families with early concerns are faced with long waitlists for an evaluation and often must travel long distances for evaluations at centers with appropriate expertise. Telehealth has been used as a cost-effective approach for increasing access to services across many disciplines, and there is some initial use of telehealth treatment approaches in ASD, but there are currently no established telehealth screening procedures to screen infants for ASD. Developing a telehealth screening protocol would provide families an opportunity to access highly trained clinicians and researchers with specialized expertise for initial screening before undertaking the cost and effort required to travel to a center. The first six months of funding will be used to develop, refine, and pilot test this parent-administered protocol in a sample of diverse infants 6-12 months (Aim 1). Feedback from parents and experts will inform final adaptations. The resulting protocol will subsequently be tested via telehealth in a pilot feasibility phase (Aim 2). 30 infants 6-12 months with early ASD symptoms and their caregivers will be recruited nationally, and will complete the telehealth screener quarterly for one year. We will examine the reliability of telehealth-derived measures of infant behavior across consecutive administrations, and compare these measures to existing parent-report measures to assess their validity. Acceptability to parents and feasibility of this telehealth approach to screening will also be evaluated. The overall goal of this project is to develop a protocol for systematically screening, assessing, and monitoring symptomatic infants from a distance. Doing so will increase families' access to specialized evaluations and decrease the significant waiting time between parents' first concerns and infants' first evaluation. It will also lay the groundwork for future efforts to conduct screening and intervention trials and will ultimately help to increase access to high-quality interventions and improve the developmental outcomes of many more underserved children with ASD.