Can a novel telemedicine tool reduce disparities related to the identification of preschool children with autism?

新型远程医疗工具能否减少学龄前自闭症儿童识别方面的差异？

• 批准号: 10354317
• 负责人: Zachary E Warren
• 金额: $ 21.63万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-17 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10354317
• 关键词: Address; African American; Age; Age-Months; Agreement; Assessment tool; Attention; Behavior; Behavior Disorders; Behavioral; Blinded; COVID-19; COVID-19 pandemic; Caring; Child; Classification; Clinical; Computer Analysis; Data; Data Set; Decision Making; Development; Diagnosis; Diagnostic; Early Diagnosis; Early Intervention; Engineering; Evaluation; Evidence based intervention; Face; Family; Geography; Gold; Health Services Accessibility; Hispanic; Home; Improve Access; Investigation; Linguistics; Machine Learning; Measures; Methodology; Methods; Mining; Modeling; Nursery Schools; Parents; Performance; Persons; Phenotype; Play; Population; Preschool Child; Procedures; Process; Production; Property; Provider; Psychometrics; Registries; Reporting; Risk; Risk Assessment; Sampling; Scientist; Services; Socioeconomic Status; Specialist; Structural Racism; Structure; Symptoms; System; Target Populations; Techniques; Telemedicine; Testing; Time; Toddler; Translating; Underserved Population; Wait Time; Waiting Lists; Work; aged; aging population; autism spectrum disorder; autistic children; barrier to care; base; community clinic; design; diagnostic tool; disorder risk; disparity reduction; formative assessment; geographic barrier; health disparity; improved; innovation; novel; satisfaction; sound; telehealth; tertiary care; tool; tool development; underserved community; usability

PROJECT SUMMARY Families seeking evaluation for autism spectrum disorder (ASD) often face barriers such as low availability of specialists, lengthy waitlists, and long distances to tertiary care diagnostic centers. This is especially true for children from traditionally underserved groups and communities. Without innovative approaches for enhanced identification of ASD, families and clinicians will continue to struggle with accessing and providing care. Telemedicine offers tremendous potential for addressing this need, but there are few psychometrically sound, validated tools that can be administered remotely, via telehealth platforms, in order to guide service and action. Our team developed and conducted a preliminary evaluation of a novel parent-administered, clinician-guided tele-diagnostic tool, the TAP (TELE-ASD-PEDS), designed specifically for direct-to-home and community clinic use with toddlers. Remote administration of the TAP yielded a very high level of agreement with blinded comprehensive evaluation regarding ASD risk classification. Subsequently, the unanticipated broad dissemination of the TAP during COVID-19 demonstrated its value for traditionally underserved groups, spanning broad geographies. Although promising, this work was limited by its specific focus on toddlers with ASD concerns. A telemedicine tool designed for the unique context and population of preschool-aged children referred for diagnostic assessment could have tremendous value in terms of both accurate identification as well as family engagement with service. In the current work, we propose a computationally informed co-production in which we involve our targeted population as active partners in designing a new telemedicine tool, the TAP– Preschool, for ASD risk assessment in preschoolers. This approach will follow our innovative methodology for fusing advanced computational analyses with stakeholder expertise (1) by mining our large clinical registry to identify key ASD behavior targets and (2) rigorously translating these key behaviors to generate telehealth assessment techniques. With input from our computational experts, clinical scientists, and end-users, we will then evaluate the performance, usability, and utility of the TAP–Preschool. We will gather critical data not only regarding its structure and accuracy, but also its potential deployment across systems responsible for engaging children and families from underserved groups in meaningful service. This work has potential to transform the ASD evaluation process and dramatically improve care access for traditionally underserved groups.

项目摘要 寻求评估自闭症谱系障碍（ASD）的家庭经常面临障碍，例如低可用性 专家，冗长的候补名单和长途护理诊断中心。 传统上服务不足的群体和社区的孩子。 识别ASD，家庭和临床医生，继续努力获得和提供护理。 远程医疗为满足这一需求提供了巨大的潜力 验证了通过远程医疗平台远程管理的工具，以指导服务和行动。 我们的团队制定并制定了对新型父母管理的初步评估 Tele-degnostic工具，Tap（Tele-ASD-PEDS），专为直接到家和社区诊所设计 与幼儿使用。 有关ASD风险分类的全面评估。 Covid-19期间的水龙头的传播证明了其价值的提示，以实现义务 广泛的地理位置。 关注点。 诊断评估的转介都可以在既有既有的都具有巨大的价值，因为俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩既因为俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩俩既因为俩俩俩俩俩既一 作为当前工作的家庭参与。 在其中，我们将目标人群作为参与者参与设计新的远程医疗工具Tap- 学龄前，对于学龄前儿童的ASD风险评估。 通过将我们的临床注册表挖掘到 确定关键的ASD行为目标，（2）严格翻译这些关键的关键行为 评估技术。 然后评估水龙头的性能，可用性和实用性！ 关于其结构和准确性，以及其在负责参与的系统之间的潜在部署 有意义的服务的儿童和家庭有可能转变。 ASD评估过程，并大大改善了传统未经预防的群体的护理机会。