Early Detection of Pervasive Developmental Disorders

描述（由申请人提供）：自闭症谱系障碍（ASD）的早期检测已经被认为是促进受影响儿童获得最佳结果的关键活动。在我们目前由nichd资助的早期检测（ED）研究中，这个应用程序是一个竞争性的延续，我们开发了一种有效的筛查工具，即修改后的幼儿自闭症检查表（M-CHAT），目前在美国广泛使用，并正在其他国家和文化中进行翻译研究，包括日本、中国、西班牙、荷兰、法国、冰岛、爱尔兰、德国、埃及、波多黎各和土耳其。它被印第安人卫生服务局使用，并被列入美国儿科学会的筛查工具包。除了研究这种筛查工具的特性，研究我们目前用M-CHAT检测并诊断为ASD的16-30个月大的儿童队列，使我们能够解决关于早期发现和发展的其他具有重要理论和实践意义的问题，包括：从高风险样本和未选择样本中筛选出的ASD儿童的特征，1.5至2岁时发现的ASD儿童的弟弟妹妹的特征，结果的早期预测因素，DSM-IV症状在幼儿中的应用，儿童早期诊断的稳定性，2岁儿童诊断工具的有效性，早期发育的生长参数及其与结果的关系，以及一般发育筛查是否足以发现ASD。本续的首要目标是验证M-CHAT的最终缩短版本。最终版本将是(a)简短且用户友好，(b)儿科医生在其办公室中易于评分，(c)适用于不同的儿童人群，(d)适用于高风险的弟妹，(e)准备推荐在美国儿科普遍使用，以及在其他国家的多种翻译。传播一种最终确定的、有效的筛查方法，用于ASD的早期检测，这对家长和儿科医生都很友好，将使大量儿童能够更早地获得干预，并优化他们的发展结果。公共卫生相关性：该项目的目标是验证M-CHAT的最终缩短版本，这是一种幼儿自闭症筛查方法。最终版本将是(a)简短且用户友好，(b)儿科医生在其办公室中易于评分，(c)适用于不同的儿童人群，(d)适用于高风险的弟妹，(e)准备推荐在美国儿科普遍使用，以及在其他国家的多种翻译。传播一种最终确定的、有效的筛查方法，用于ASD的早期检测，这对家长和儿科医生都很友好，将使大量儿童能够更早地获得干预，并优化他们的发展结果。

DESCRIPTION (provided by applicant): Early detection of Autism Spectrum Disorders (ASD) has come to be recognized as a crucial activity in promoting the best possible outcome for affected children. In our current NICHD-funded Early Detection (ED) study, for which this application is a competing continuation, we have developed an effective screening instrument, the Modified Checklist for Autism in Toddlers (M-CHAT), which is now widely used in the US, and is being studied in translation in other countries and cultures, including Japan, China, Spain, the Netherlands, France, Iceland, Ireland, Germany, Egypt, Puerto Rico and Turkey. It is being used by the Indian Health Service and is included in the American Academy of Pediatrics screening tool kit. In addition to studying the properties of this screening instrument, studying our current cohort of 16-30 month old children detected with the M-CHAT and diagnosed with ASD, has allowed us to address other questions of great theoretical and practical importance concerning early detection and development, including: characteristics of children with ASD screened from high risk vs. unselected samples, characteristics of younger siblings of children with ASD detected at age 1.5 to 2, early predictors of outcome, the application of DSM-IV symptoms to very young children, diagnostic stability through early childhood, validity of diagnostic instruments in 2-year-olds, growth parameters in early development and their relationships to outcome, and whether general developmental screening is sufficient to detect ASD. The overarching goal of this continuation is to validate a final shortened revision of the M-CHAT. This final version will be (a) brief and user-friendly, (b) easy for pediatricians to score in their offices, (c) valid for diverse populations of children, (d) valid for younger siblings, who are at high risk, and (e) ready to be recommended for universal pediatric use in the US, as well as in multiple translations in other countries. Disseminating a finalized, valid screener for early detection of ASD, which is parent- and pediatrician-friendly, will allow a large number of children to have earlier access to intervention and optimize their developmental outcomes. PUBLIC HEALTH RELEVANCE: The goal of this project is to validate a final shortened revision of the M-CHAT, a screener for autism in toddlers. This final version will be (a) brief and user-friendly, (b) easy for pediatricians to score in their offices, (c) valid for diverse populations of children, (d) valid for younger siblings, who are at high risk, and (e) ready to be recommended for universal pediatric use in the US, as well as in multiple translations in other countries. Disseminating a finalized, valid screener for early detection of ASD, which is parent- and pediatrician-friendly, will allow a large number of children to have earlier access to intervention and optimize their developmental outcomes.