California Monitoring of Early Childhood Autism (CA-MECA)

描述(由申请人提供)： 为响应CDC RFA-DD-07-007(实施监测以确定自闭症谱系障碍(ASD)在幼儿人群中的患病率)，我们建议CA-MECA在加州卫生服务部(DHS)的领导下进行，并与北加州Kaiser Permanente(KPNC)和加利福尼亚州圣克拉拉县(SCC)的多家卫生和服务提供商合作进行。我们的主要目标是建立一个科学严谨的、多来源的监测系统，以准确地确定SCC两个出生队列年(2005-2006年)中年幼儿童(&lt；4岁)中基于人口的ASD患病率，SCC每年出生约26,000人，人口非常多样化。这样做与疾控中心预防出生缺陷和发育障碍、改善残疾人健康的目标相关。Cameca提案有三个部分反映了我们的具体目标：1)为了在两个目标年出生的县识别可能或明确患有自闭症的幼儿(&lt；48个月)，我们将与当地发育障碍人士区域中心、社区诊所和专科提供者合作。将提取记录以收集数据，以通过专家审查确定最终的监测病例状态，并描述患有自闭症儿童的特征。其他数据将从出生证明中获得。将计算当前和出生居住地流行率估计数。2)为了找出监测系统中可能存在的漏洞，并接触到服务不足的人口部分，我们将对2006年出生的18-30个月大的儿童进行常规的发育障碍和自闭症筛查，这两个儿科诊所为较低收入人群(主要是西班牙裔人口)提供服务，并适当转介进行临床评估。在与监测系统连接后，我们将比较筛查亚组中的流行率与2005年出生的、在相同诊所就诊但未进行筛查的人，以评估总体流行率估计的完整性，并提供更准确的西班牙裔人口流行率估计。3)为了提高自闭症评估的意识和及早转介，我们将向普通儿科医生和其他相关社区团体进行外展和教育，召集和召集一个社区咨询委员会来协助我们。这两个数据收集部分包括持续的质量控制，将对其完整性、准确性和更广泛应用的可行性进行评估。报告将广泛分发。CA-MECA项目的数据将有助于获得患有自闭症的幼儿的准确计数，以跟踪随时间的变化，为受影响的儿童及其家庭规划和提供服务，揭示自闭症的风险因素，确定未得到充分服务的群体，以及提供信息以改进早期筛查和诊断做法。

DESCRIPTION (provided by applicant): In response to CDC RFA-DD-07-007 (Implementing Surveillance to Determine Prevalence of the Autism Spectrum Disorders (ASD)...in Early Childhood Populations), we propose CA-MECA, to be conducted under the leadership of the California Department of Health Services (DHS) and in partnership with Kaiser Permanente of Northern California (KPNC), and multiple health and service providers in Santa Clara County (SCC), California. Our primary goal is to establish a scientifically rigorous, multi-source surveillance system to accurately determine the population-based prevalence of ASD in young children (<4 years old) for two birth cohort years (2005-2006) in SCC, which has ~26,000 births/year and a very diverse population. Doing so is relevant to CDC's goal to prevent birth defects and developmental disabilities and improve the health of people with disabilities. There are three components to the CAMECA proposal that reflect our specific aims: 1) To identify young children (<48 months) with possible or definite autism in the county born in the two target years, we will work with the local regional center for the developmentally disabled, community clinics, and specialty providers. Records will be abstracted to collect data to determine final surveillance case status by expert review and to describe characteristics of the children with ASD. Additional data will be obtained from birth certificates. Both current and birth residence prevalence estimates will be calculated. 2) To identify possible gaps in the surveillance system and to reach an under-served segment of the population, we will conduct routine screening for developmental disabilities and ASD in 18-30 month old children born in 2006 at two pediatric clinics that serve a lower income, primarily Hispanic population, with appropriate referrals for clinical evaluation. After linkage to the surveillance system, we will compare prevalence in the screened sub-group to those born in 2005 and seen at the same clinics but not screened, to evaluate completeness of overall prevalence estimates and to provide a more accurate estimate of prevalence in a Hispanic population. 3) To increase awareness and early referrals for autism evaluations, we will conduct outreach and education to general pediatricians and other relevant community groups, assembling and convening a community advisory board to assist us. The two data collection components include on-going quality control, and will be evaluated for completeness, accuracy and feasibility of wider application. Reports will be widely distributed. Data from the CA-MECA project will be valuable for obtaining accurate counts of young children with ASD to track changes over time, to plan and deliver services for affected children and their families, to uncover risk factors for ASD, and to identify underserved groups, as well as providing information to improve early screening and diagnostic practices.