Development of a Telehealth Screener and Assessment for Infants at-risk for ASD in Diverse Communities.

项目摘要 这项提案的总体目标是开发一种远程保健程序，用于筛查6-12岁的婴儿 早期自闭症谱系障碍(ASD)症状的年龄。虽然有些人很有希望 已经为这个年龄段的婴儿确定了生物标志物，但神经生物学方法还没有。 可广泛实施，特别是在农村和低资源服务体系中。 有早期顾虑的家庭面临着等待评估的长长名单，而且经常必须出差 在具有适当专业知识的中心进行远距离评估。远程医疗已被使用 作为一种具有成本效益的方法，以增加获得跨多个学科的服务的机会，以及 在ASD中有一些远程医疗治疗方法的初步使用，但目前还没有 建立远程健康筛查程序，对婴儿进行ASD筛查。开发远程医疗服务 筛查方案将为家庭提供接触训练有素的临床医生和 在承担成本和工作之前，具有初步筛查专业知识的研究人员 被要求去中心旅行。前六个月的资金将用于开发、完善和 在6-12个月的不同婴儿样本中试行这种由父母实施的方案(目标1)。 家长和专家的反馈将为最终的改编提供依据。由此产生的协议将 随后在试点可行性阶段通过远程保健进行测试(目标2)。30名6-12个月的婴儿 有早期ASD症状的患者和他们的照顾者将在全国范围内招募，并将完成 每季度远程健康筛查，为期一年。我们将检查远程医疗派生的可靠性 跨连续给药的婴儿行为测量，并比较这些测量 现有的家长报告措施，以评估其有效性。家长的可接受性和可行性 还将评估这种远程保健筛查方法的可行性。这个项目的总体目标是 制定系统筛查、评估和监测症状的方案 婴儿从远处传来。这样做将增加家庭获得专门评估的机会， 减少父母第一件事和婴儿第一件事之间的重要等待时间 评估。它还将为今后进行筛查和干预的努力奠定基础 并最终将有助于增加获得高质量干预措施的机会，并改善 更多未得到充分服务的自闭症儿童的发育结果。

Project Summary The overall goal of this proposal is to develop a telehealth procedure for screening infants 6-12 months of age for early autism spectrum disorder (ASD) symptoms. While some promising biomarkers have been identified for infants in this age range, neurobiological methods are not feasible for widespread implementation, especially in rural and low-resource service systems. Families with early concerns are faced with long waitlists for an evaluation and often must travel long distances for evaluations at centers with appropriate expertise. Telehealth has been used as a cost-effective approach for increasing access to services across many disciplines, and there is some initial use of telehealth treatment approaches in ASD, but there are currently no established telehealth screening procedures to screen infants for ASD. Developing a telehealth screening protocol would provide families an opportunity to access highly trained clinicians and researchers with specialized expertise for initial screening before undertaking the cost and effort required to travel to a center. The first six months of funding will be used to develop, refine, and pilot test this parent-administered protocol in a sample of diverse infants 6-12 months (Aim 1). Feedback from parents and experts will inform final adaptations. The resulting protocol will subsequently be tested via telehealth in a pilot feasibility phase (Aim 2). 30 infants 6-12 months with early ASD symptoms and their caregivers will be recruited nationally, and will complete the telehealth screener quarterly for one year. We will examine the reliability of telehealth-derived measures of infant behavior across consecutive administrations, and compare these measures to existing parent-report measures to assess their validity. Acceptability to parents and feasibility of this telehealth approach to screening will also be evaluated. The overall goal of this project is to develop a protocol for systematically screening, assessing, and monitoring symptomatic infants from a distance. Doing so will increase families' access to specialized evaluations and decrease the significant waiting time between parents' first concerns and infants' first evaluation. It will also lay the groundwork for future efforts to conduct screening and intervention trials and will ultimately help to increase access to high-quality interventions and improve the developmental outcomes of many more underserved children with ASD.