Validation of the TEDI: A Telehealth Evaluation of Development for Infants.

TEDI 的验证：婴儿发育的远程医疗评估。

• 批准号: 10805226
• 负责人: Meagan Ruth Talbott
• 金额: $ 3.06万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-20 至 2024-03-19
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10805226
• 关键词: Affect; Assessment tool; Attention deficit hyperactivity disorder; Behavior; Behavior assessment; Binding; Clinical; Development; Early Intervention; Early identification; Enrollment; Evaluation; Family; Future; Geography; Goals; Incidence; Individual; Infant; Infant Development; Informal Social Control; Intervention; Intervention Trial; Investigation; Laboratories; Measures; Mediating; Mental disorders; Modeling; Neurodevelopmental Disorder; Outcome; Parents; Pattern; Recurrence; Research; Resource-limited setting; Risk; Risk Marker; Route; Rural; Services; Siblings; Site; Structure; Symptoms; Testing; Toddler; United States National Institutes of Health; Universities; Validation; autism spectrum disorder; autistic children; cohort; diagnostic strategy; early screening; health assessment; high risk population; improved; improved outcome; insight; longitudinal, prospective study; non-verbal; prospective; screening; social communication; standardize measure; telehealth; tool; verbal

Project Summary Maximizing the benefits of early intervention for improving outcomes of individuals with neurodevelopmental disorders (NDD) such as autism spectrum disorder (ASD) requires widespread and efficacious early screening and identification practices. Despite decades of effort to identify early risk markers, there remain significant gaps in the identification-to-treatment pipeline. Prospective longitudinal studies of infant siblings of children with ASD have provided critical insights into the early symptoms, recurrence rate, and developmental trajectories of at-risk infants. However, the field remains limited by the near exclusive focus on infant siblings of children with ASD, despite similar patterns of familial inheritance within other neurodevelopmental and mental health disorders. One potential route to expanding the scope of early risk studies is the development of reliable and valid telehealth-based assessment tools. This would allow for prospective longitudinal investigation of infants living beyond the geographical bounds of University research sites as well as infants belonging to low incidence high-risk groups. There is supportive evidence for the efficacy of telehealth approaches for diagnostic evaluation and parent-mediated treatment for toddlers with ASD. Currently, there exist no valid and reliable tools for conducting behavioral assessments of infants' development via telehealth. This project directly compares a promising telehealth assessment tool, the TEDI, to gold-standard laboratory- based assessment tools. The TEDI utilizes a parent-coaching model to engage parents and infants in a specific set of semi-structured interactions from which standardized measures are scored and behavior ratings can be made. The proposed project has two aims, each of which focus on testing the reliability, validity, acceptability, and clinical utility of the TEDI for evaluating infants' development in four domains: 1) social communication; 2) ASD symptoms; 3) verbal and nonverbal development; and 4) affect and self-regulation. We will leverage an existing NIH-supported cohort of well-characterized infants enriched for developmental risk (R01 MH121416, PI: Miller) who will be assessed in the laboratory at 6 or 9, 12, and 18 months. In the current proposal, we will enroll and assess 110 of these infants (41 at familial risk for ASD, 41 at risk for ADHD, and 28 low risk for both) using the TEDI within a week of the laboratory assessments. Establishing the TEDI as a reliable and valid tool for assessing infants at-risk via telehealth has the potential to significantly increase families' access to specialized evaluations and increase the capacity for early identification of infants in need of services. It will also lay the groundwork for future efforts to conduct screening and intervention trials and may ultimately help to increase access to high-quality interventions and improve the developmental outcomes of many more underserved children with ASD and other NDD's.

项目概要 最大限度地发挥早期干预的益处，改善神经发育障碍患者的预后 自闭症谱系障碍 (ASD) 等疾病 (NDD) 需要广泛且有效的早期筛查 和识别实践。尽管几十年来努力识别早期风险标记，但仍然存在巨大差距 在识别到治疗的流程中。自闭症儿童的婴儿兄弟姐妹的前瞻性纵向研究 对高危人群的早期症状、复发率和发展轨迹提供了重要的见解 婴儿。然而，该领域仍然受到限制，因为几乎只关注自闭症儿童的婴儿兄弟姐妹， 尽管其他神经发育和精神健康疾病也有类似的家族遗传模式。 扩大早期风险研究范围的一个潜在途径是开发可靠有效的方法 基于远程医疗的评估工具。这将允许对生活中的婴儿进行前瞻性纵向调查 超出大学研究地点的地理范围以及属于低发病率的婴儿 高危人群。有证据表明远程医疗诊断方法的有效性 对患有 ASD 的幼儿进行评估和家长介导的治疗。目前尚无有效、可靠的 通过远程医疗对婴儿发育进行行为评估的工具。 该项目直接将有前途的远程医疗评估工具 TEDI 与黄金标准实验室进行比较 为基础的评估工具。 TEDI 利用家长辅导模式让家长和婴儿参与 一组特定的半结构化交互，从中对标准化度量进行评分和行为评级 可以制作。该项目有两个目标，每个目标都侧重于测试可靠性、有效性、 TEDI 在四个领域评估婴儿发育的可接受性和临床实用性：1) 社会 沟通; 2）自闭症谱系障碍症状； 3）言语和非言语的发展； 4）影响和自我调节。我们 将利用 NIH 支持的现有婴儿队列，这些婴儿具有丰富的发育风险特征 （R01 MH121416，PI：Miller）将在 6 个月、9 个月、12 个月和 18 个月时在实验室进行评估。在当前 根据提案，我们将招募并评估其中 110 名婴儿（41 名有 ASD 家族风险，41 名有 ADHD 风险，28 名有患 ADHD 风险） 两者风险均较低）在实验室评估后一周内使用 TEDI。将 TEDI 建立为 通过远程医疗评估高危婴儿的可靠且有效的工具有可能显着增加 家庭获得专门评估的机会，并提高早期识别需要帮助的婴儿的能力 服务。它还将为未来进行筛查和干预试验的努力奠定基础，并可能 最终有助于增加获得高质量干预措施的机会并改善儿童的发展成果 更多患有 ASD 和其他 NDD 的儿童得不到充分的服务。