Autism Screening in Childcare Settings
儿童保育机构中的自闭症筛查
基本信息
- 批准号:10606070
- 负责人:
- 金额:$ 22.73万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-01-20 至 2024-12-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAgeAgreementBlack raceChildChild BehaviorChild CareChild DevelopmentChild SupportChildhoodCommunitiesDataDecision MakingDevelopmentDiagnosisDisabled ChildrenDisadvantagedDisparityDisparity in diagnosisEarly DiagnosisEarly InterventionEarly identificationEarly treatmentEducationEnrollmentEthnic OriginEvaluationExposure toFamilyGoalsHIVHomeHourImprove AccessIncomeInterventionInterviewLinkMeasuresMedicalMental HealthMethodsOutcomeParentsPerceptionPerformancePilot ProjectsPlayPovertyPrimary CareProcessPrognosisProviderQualitative MethodsQuestionnairesRecommendationReportingResearchResourcesRiskScreening ResultScreening procedureSociologyStructureSymptomsTestingThickTimeToddlerTrustVisitWell Child Visitsaccess disparitiesautism spectrum disordercare providerscheckup examinationcommunity settingdesigndisorder riskdisparity reductionearly childhoodearly screeningexperiencefollow-uphealth care availabilityimplementation facilitatorsimprovedimproved outcomeinformantinnovationinsightlower income familiesminority childrennovelnovel strategiespediatricianpeerracial disparityresearch clinical testingsatisfactionscreeningsocial stigmasocioeconomic disparitytheoriesunderserved communityuptake
项目摘要
Early detection of autism spectrum disorder (ASD) facilitates early intervention, which improves lifelong
prognosis. Universal screening in the medical home during toddler check-ups is successful at detecting many
cases of ASD, yet uptake remains low, in part due to many barriers to successful ASD screening by
pediatricians, including limited time and resources during the well-child visits, and low confidence in the
screening process. In addition, underserved children from minority and low-income families are less likely to be
screened compared to their White and middle-class peers, exacerbating the known disparities in access to
early diagnosis and ASD intervention. The current proposal aims to expand beyond screening at pediatric well-
visits, by developing and evaluating novel strategies to successfully screen for ASD in childcare centers, where
many children spend more than 30 hours per week. Although there have been screening studies conducted in
childcare centers, the feasibility of routinely using this alternate setting has not been widely addressed yet, and
preliminary findings indicate that primary care strategies are not acceptable in childcare settings. Early
Childhood Education Providers (ECEPs) have extensive exposure to normative child behavior and many hours
of engagement with children, including many in underserved communities, enrolled in childcare. Thus,
engagement of ECEPs in toddler screening could present an opportunity for significant improvement in ASD
early identification and reduction of disparities in age of diagnosis and early treatment. However, there are
existing barriers to autism screening in childcare centers, including low parental acceptance, which is critical to
identify and address. Therefore, the goal of this pilot study is to explore barriers and facilitators of systematic
screening by ECEPs, including cultural hesitancy, and using the strategies identified, examine the performance
of the illustrated Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F) paired with
the Ages and Stages Questionnaires in childcare centers. The specific aims are to: (1) utilize qualitative
methods (field observations and semi-structured interviews) with ECEPs to investigate organizational barriers
and facilitators for implementation of ASD screening in childcare setting, (2) utilize qualitative methods (semi-
structured interviews) with disadvantaged parents of children attending childcare centers to investigate familial
and cultural barriers and facilitators for parent engagement in screening for ASD in childcare centers serving
underserved families, and (3) pilot novel strategies for ASD screening in childcare centers, informed by the
qualitative findings, to evaluate agreement between parents and ECEPs, accuracy of childcare screening, and
acceptability of ASD screening in childcare centers. Results of this proposed study will directly address a gap
in universal ASD screening, particularly for underserved families. Screening in childcare centers provides a
complementary strategy to existing screening at pediatric well-visits, which will improve access of children from
all backgrounds to early interventions and supports, critical for improved outcomes.
自闭症谱系障碍(ASD)的早期发现有助于早期干预,
预后在幼儿检查期间,医疗之家的普遍筛查成功地发现了许多
ASD的病例,但摄取率仍然很低,部分原因是成功的ASD筛查存在许多障碍,
儿科医生,包括有限的时间和资源,在良好的儿童访问,和低信心,
筛选过程。此外,来自少数民族和低收入家庭的得不到充分服务的儿童也不太可能得到教育。
与他们的白色和中产阶级同龄人相比,
早期诊断和ASD干预。目前的提案旨在扩大儿科筛查范围,
访问,通过开发和评估新的战略,成功地筛选ASD在托儿中心,其中
许多儿童每周花30多个小时。虽然已经进行了筛选研究,
儿童保育中心,常规使用这种替代设置的可行性尚未得到广泛解决,
初步调查结果表明,初级保健战略在儿童保育环境中是不可接受的。早期
儿童教育提供者(ECEP)有广泛的接触规范的儿童行为和许多小时
与儿童的接触,包括许多在服务不足的社区,登记参加托儿服务。因此,在本发明中,
ECEP参与幼儿筛查可能为ASD的显著改善提供机会
早期发现和减少诊断和早期治疗年龄的差异。但有
儿童保育中心自闭症筛查的现有障碍,包括父母接受度低,这对
标识和地址。因此,本试点研究的目标是探索系统性的障碍和促进因素,
筛选由ECEP,包括文化犹豫,并使用所确定的战略,检查性能
说明的幼儿自闭症改良量表,修订版,随访(M-CHAT-R/F)配对,
儿童保育中心的年龄和阶段表。具体目标是:(1)利用定性
方法(实地观察和半结构化访谈)与ECEP调查组织障碍
和促进者在儿童保育环境中实施ASD筛查,(2)利用定性方法(半
结构化访谈)与儿童进入托儿中心的弱势父母进行家庭调查,
和文化障碍和促进者,父母参与筛查ASD在托儿中心服务
服务不足的家庭,以及(3)在儿童保育中心进行ASD筛查的试点新策略,由
定性调查结果,以评估父母和ECEP之间的协议,儿童保育筛查的准确性,
在托儿中心进行ASD筛查的可接受性。这项拟议研究的结果将直接解决一个差距
在普遍的ASD筛查中,特别是对于服务不足的家庭。儿童保育中心的筛查提供了
补充战略,以现有的筛查在儿科井访问,这将改善儿童的访问,
早期干预和支持的所有背景,对改善结果至关重要。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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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:
$ 22.73万 - 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:
$ 22.73万 - 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:
$ 22.73万 - 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:
$ 22.73万 - 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:
$ 22.73万 - 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:
$ 22.73万 - 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:
$ 22.73万 - 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:
10205984 - 财政年份:2017
- 资助金额:
$ 22.73万 - 项目类别:
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