Early Detection of Pervasive Developmental Disorders

描述(由申请人提供)：自闭症谱系障碍(ASD)的早期检测已被认为是促进受影响儿童获得可能的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，我们已经开发了一种有效的筛查工具--修改后的幼儿自闭症检查表(M-ChAT)，该工具目前在美国得到广泛使用，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。它正被印度卫生服务机构使用，并被包括在美国儿科学会筛查工具包中。除了研究这种筛查工具的特性外，研究我们目前通过M-ChAT检测到并诊断为ASD的16-30个月大的儿童队列，使我们能够解决关于早期检测和发展的其他具有重要理论和实践意义的问题，包括：从高危样本中筛查出的ASD儿童的特征，在1.5岁至2岁时发现的ASD儿童的年幼兄弟姐妹的特征，对非常年幼的儿童应用DSM-IV症状的早期预测因素，儿童早期诊断的稳定性，诊断工具在2岁儿童中的有效性，早期发育中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。这一续写的首要目标是验证M-Chat的最终缩短修订版。这一最终版本将是：(A)简短和用户友好，(B)儿科医生在他们的办公室很容易得分，(C)对不同的儿童群体有效，(D)对处于高危状态的年幼兄弟姐妹有效，以及(E)准备好被推荐在美国和其他国家/地区的儿科普遍使用的多个翻译版本。传播对家长和儿科医生友好的最终有效的ASD早期检测筛查方法，将使大量儿童能够更早地获得干预并优化他们的发育结果。与公共卫生相关：该项目的目标是验证M-Chat的最终缩短修订版，M-Chat是一种用于幼儿自闭症筛查的工具。这一最终版本将是：(A)简短和用户友好，(B)儿科医生在他们的办公室很容易得分，(C)对不同的儿童群体有效，(D)对处于高危状态的年幼兄弟姐妹有效，以及(E)准备好被推荐在美国和其他国家/地区的儿科普遍使用的多个翻译版本。传播对家长和儿科医生友好的最终有效的ASD早期检测筛查方法，将使大量儿童能够更早地获得干预并优化他们的发育结果。

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.