The increased prevalence of autism spectrum disorder (ASD) and its detection during the first 3 years of life have substantial relevance for early intervention. The purpose of this article is to summarize current scientific and policy information on early identification and early intervention for infants and toddlers with ASD and their families. Following a brief overview that provides basic information about ASD, the authors discuss early warning signs of the disorder and available screening and diagnostic tools. Finally, they highlight focused intervention practices and comprehensive treatment models appropriate for infants and toddlers with ASD, as well as issues affecting the delivery of effective early intervention services to children and families.
This study explored North Carolina pediatric healthcare professional's (PHP) perceptions of screening 12-18 month old infants for Autism Spectrum Disorder (ASD). Eight focus groups (66 PHPs) were conducted across practice settings. The purpose was to explore PHP's perspectives to: inform development of ASD screening tools and ultimately impact their use in PHP settings. PHPs reported concerns, barriers, and the need for research to support early ASD screening. Additionally, they expressed the need for: (a) clear "red flags" of ASD for 12-18 month olds; (b) socioculturally sensitive and effective screening tools; (c) effective early interventions; (d) systems to handle potential increases in referrals; and (e) continuing education. PHPs also demonstrated preferences about screening tool characteristics and processes for enhancing screening efforts.
Few psychometrically valid scales exist to assess family outcomes and the helpfulness of early intervention. This article describes the development and psychometric properties of the Family Outcomes Survey—Revised. The revision was prompted by the need to (a) create a new format that would be easier for parents to understand, (b) revise and expand the survey items to provide more information for states to use in planning for program improvement, and (c) demonstrate acceptable psychometric properties. Input from stakeholders and experts was used to identify concepts and develop candidate items. Data from a web-based survey conducted with 265 families in Illinois and Texas were used to assess the psychometric properties of candidate items. These activities produced a revised survey with sound psychometric integrity that can be used to document family outcomes and identify areas for program improvement.
The Early Start Denver Model (ESDM) has been gaining popularity as a comprehensive treatment model for children ages 12 to 60 months with autism spectrum disorders (ASD). This article evaluates the research on the ESDM through an analysis of study design and purpose; child participants; setting, intervention agents, and context; density and duration; and overall research rigor to assist professionals with knowledge translation and decisions around adoption of the practices. Ten research studies are included in this systematic review. Findings indicate variability in methodologies, participant and intervention characteristics, and research rigor. The ESDM shows promise as an evidence-based practice for young children with ASD and there is preliminary evidence to support implementation of the ESDM. Children are progressing with ESDM intervention and fidelity of implementation has been achieved in community-based settings. The extent to which child improvements are due to the ESDM intervention alone is not fully known. Additional studies are needed including replication by independent researchers to determine "active ingredients," level of effectiveness, and whether the ESDM is better than other treatment options. This review highlights research opportunities to expand professionals' knowledge of the ESDM's effectiveness. Clinical decisions around adoption and feasibility of implementation in communities will be enhanced with greater knowledge and understanding.
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