Early Detection of Pervasive Developmental Disorders

描述(由申请者提供)：自闭症和其他普遍的发育 发育障碍(PDD)是一种严重的发育障碍，通常导致终生 残疾。及早发现和干预可以显著改善 预后；然而，有了可用的筛查工具，早期检测是 很难。诊断和干预往往在最初的怀疑之后进行 三年或更长时间，有效干预的性质并不好 明白了。建议的研究包括验证父母核对表 对于24个月大的婴儿来说，目前正在开发中。1293-2号航班的试点数据 其中59人接受了评估，38人被诊断为自闭症 或PDD，展示了极好的有效性前景。来自中国的小额赠款 NAAR、美国教育部和康涅狄格大学 研究基金会和NIMH/NRSA个人博士前奖学金，拥有 允许调查人员开始准备大规模筛查，并 开始对当前参与者进行后续研究。在当前 申请，33,400名儿童将被筛查，其中30,000名来自未被选中的样本 儿科就诊中，有3400人来自儿童兄弟姐妹的高危样本 自闭症和转诊为早期干预的儿童。预计140人，其中 PDD(和大约35个假阳性)将在24个月和 同样是在42个月的时候。评估将包括精神诊断和 对认知、语言和适应功能的评估；可靠性 诊断(由ADOS和ADI-R)将由儿童精神病学家确认。 在这两个时间点的分析将使用信号检测和判别 功能分析，以确定检测PDD的最佳项目集，并将 评估仪器的灵敏度和特异度。关于干预措施的数据 在初次评价和后续评价之间的18个月期间收到 也将被收集。使用42个月的临床状态变量作为结果 采取措施，控制儿童和家庭特征，干预 诸如强度、类型、设置和家长参与等变量将是 研究了它们与结果的关系。拟议的研究应极大地 推动开发有效的自闭症早期筛查工具和 相关的障碍。尽管不是不同干预措施的随机试验， 拟议的研究还将提供有关 对患有自闭症和PDD的儿童进行有效干预。规划好的未来 研究包括在其他州和其他国家(例如日本)复制。

DESCRIPTION (provided by applicant): Autism and other pervasive developmental disorders (PDD) are severe disorders of development, often leading to life-long disability. Early detection and intervention can substantially improve prognosis; however, with available screening instruments early detection is difficult. Diagnosis and intervention often follow initial suspicion by as much as three years or more, and the nature of effective interventions is not well understood. The proposed study involves the validation of a parent checklist for 24-month-olds which is under current development. Pilot data on 1293 two year olds, 59 of whom were evaluated and 38 of whom were diagnosed as autistic or PDD, demonstrates excellent promise of effectiveness. Small grants from NAAR, the U.S. Department of Education, and the University of Connecticut Research Foundation, and an NIMH/NRSA individual predoctoral fellowship, have allowed the investigators to begin preparing for large-scale screening and to begin a follow-up study of the current participants. In the current application, 33,400 children will be screened, 30,000 from an unselected sample of pediatric visits, and 3,400 from high risk samples of siblings of children with autism and children referred for early intervention. A projected 140 with PDD (and approximately 35 false positives) will be evaluated at 24 months and again at 42 months. Evaluations will include psychiatric diagnoses and assessment of cognitive, language, and adaptive functioning; reliability of diagnoses (by ADOS and ADI-R) will be confirmed by a child psychiatrist. Analyses at both time points will use signal detection and discriminant function analyses to determine the optimal set of items to detect PDD, and will assess the sensitivity and specificity of the instrument. Data on interventions received during the 18 months between the initial and follow-up evaluations will also be collected. Using clinical status variables at 42 months as outcome measures, and controlling for child and family characteristics, intervention variables such as intensity, type, setting, and parent involvement will be studied for their relationship to outcome. The proposed study should greatly advance the development of an effective early screening tool for autism and related disorders. Although not a randomized trial of different interventions, the proposed research will also provide important information on the nature of effective interventions for children with autism and PDD. Planned future studies include replication in other states and other countries (e.g., Japan).