A proposed service model for early identification of autism spectrum disorder in ethnic communities in Southern Israel

2021 ◽  
Author(s):  
Orly Kerub ◽  
Anat Rosenthal ◽  
Eric J. Haas ◽  
Gal Meiri ◽  
Idan Menashe ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Early Identification ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Ethnic Communities ◽  
Service Model

Family navigation to increase evaluation for autism spectrum disorder in toddlers: Screening and Linkage to Services for Autism pragmatic randomized trial

Autism ◽  
2020 ◽  
pp. 136236132097417
Author(s):  
Carolyn DiGuiseppi ◽  
Steven A Rosenberg ◽  
Margaret A Tomcho ◽  
Kathryn Colborn ◽  
Kristina Hightshoe ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Young Children ◽  
Low Income ◽  
Early Identification ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Young Children With Autism ◽  
Low Income Families ◽  
To Receive

The Screening and Linkage to Services for Autism pragmatic trial examined the effect of family navigation on referral and evaluation for autism spectrum disorder in an urban healthcare system serving low-income families. Children aged 16–30 months with initial scores ⩾3 on the Modified Checklist for Autism in Toddlers–Revised with Follow-up (M-CHAT-R/F) were randomized to usual care ( n = 133) or navigation if indicated ( n = 142). Bilingual, bicultural autism family navigators offered navigation to intervention-group families if the completed M-CHAT-R/F indicated the need for autism spectrum disorder diagnostic evaluation. Autism family navigators also assisted families to arrange for completion of the M-CHAT-R/F interview if not done, and then offered navigation if indicated. Of 49 families for whom navigation was indicated, 45% received navigation, including care coordination, education, and practical support. In intention-to-treat analyses, the intervention did not increase referrals for evaluation but more than doubled completed autism spectrum disorder diagnostic evaluations. Intervention children were also more likely to complete the M-CHAT-R/F interview with fidelity. Research is needed to identify effective methods to improve uptake of family navigation. Family navigation may be an important tool for reducing systemic inequalities in the early identification and treatment of young children with autism spectrum disorder ( ClinicalTrials.gov , https://clinicaltrials.gov/ ; NCT02374541). Lay abstract Young children with autism spectrum disorder can benefit from early detection and intervention to moderate autism spectrum disorder’s effect on their development. Routine screening with standardized instruments facilitates early identification. However, many screen-positive children do not receive referrals for evaluation, complete diagnostic evaluations, or engage in services. This is especially true for children of color and those from less educated or low-income families. The Screening and Linkage to Services for Autism trial evaluated the effect of family navigation on referral and evaluation for autism spectrum disorder in screen-positive toddlers. The trial was conducted in an urban, low-income population. It was designed to test “real-world” implementation of family navigation. We randomly assigned 275 children aged 16–30 months with an initial positive autism spectrum disorder screen to receive navigation if indicated or usual care. Navigation increased the number of at-risk toddlers who were evaluated for autism spectrum disorder. It also improved the quality of autism spectrum disorder screening in primary care clinics. However, many children failed to receive indicated referrals for evaluation. Navigation did not improve referral rates. Furthermore, nearly half of families who were potentially eligible for navigation could not be contacted. Other ways of structuring the navigation program may be necessary to improve families’ access to and acceptance of navigation, especially in the setting of financial, cultural, and linguistic barriers. Our trial nevertheless showed that family navigation may be an important tool for reducing systemic inequalities in the early identification and treatment of young children with autism spectrum disorder.

Early Identification of Autism Spectrum Disorder: Recommendations for Practice and Research Supplement

2020 ◽  
pp. 122-152
Author(s):  
Lonnie Zwaigenbaum ◽  
Margaret L. Bauman ◽  
Wendy L. Stone ◽  
Nurit Yirmiya ◽  
Annette Estes ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Early Identification ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Recommendations For Practice
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