Enhancing early identification and coordination of intervention services for young children with autism spectrum disorders: Report from the Act Early Regional Summit Project
ABSTRACT Increasing prevalence of autism spectrum disorders (ASD) and the merits of early intervention support the importance of early identification and detection. The Act Early Initiative attempts to address the states' capacity to support this process of early identification and early intervention.
The Centers for Disease Control and Prevention (CDC) Health Resources and Services Administration (HRSA) collaborated with the Association of University Centers on Disabilities (AUCD) to develop strategies that will address state capacity for responding to the increasing demand for earlier identification, earlier diagnoses, and coordination of service systems for children with ASDs and other developmental disabilities (DD).
Act Early regional summits were held to engage stakeholders from the early detection and intervention community including parents, state agencies, provider groups, autism and related disability organizations, and academia. The stakeholders then used the Logic Model to facilitate the teams' planning process. The Logic Model enables teams to understand the strengths and gaps within their state resources and plan specific activities to achieve concrete outcomes.
States identified opportunities and challenges in early identification of children with delay. One of the particular challenges identified were low income, rural and non-English speaking populations encountering more challenges than others in accessing diagnosis and early intervention services.
The Summits are a unique model that demonstrates the importance of developing comprehensive state plans to advance the collaboration and coordination of early detection and intervention service systems for children with ASDs and related DDs from all racial, ethnic, geographical, and socioeconomic backgrounds.
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ABSTRACT: Autism spectrum disorders involve a set of clinical phenotypes that mirror an early onset of neurodevelopmental deviations, with core symptoms that can probably be related to a deficiency in the social instinct. Underlying the cognitive impairments there are physiological brain problems, caused by a large number of medical factors. This narrative review of systematic reviews and meta-analyses from the last 5 years (2008-2012) presents aspects from many areas in autism spectrum disorder research, with a particular focus on early intervention and the subsequent impact on prognosis. Other major areas discussed are epidemiology, early symptoms and screening, early diagnosis, neuropsychology, medical factors, and the existence of comorbidities. There is limited evidence that any of the broadband "early intervention" programs are effective in changing the natural long-term outcome for many individuals with an early diagnosis of autism. However, there is some evidence that Early Intensive Behavioral Intervention (EIBI) is an effective treatment for some children with ASD. Nevertheless, there is emerging consensus that early diagnosis and information are needed in order that an autism-friendly environment be "created" around affected individuals.Clinical Epidemiology 02/2013; 5:33-43. DOI:10.2147/CLEP.S41714
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ABSTRACT: Early childhood development typically follows a trajectory of achieving physical, cognitive, communication, social-emotional, and self-help milestones within a specified age range. Although most children reach these milestones within a similar range, others exhibit mild to severe developmental delays that indicate potential developmental disabilities. Developmental disabilities are a group of conditions caused by an impairment in one or more developmental domains (e.g., physical, learning, communication, behavior, or self-help). Developmental disabilities can become evident during the prenatal period through age 22 years, affect day-to-day functioning, and usually are lifelong. Approximately 15% of children aged 3-17 years in 2008 were estimated to have developmental disabilities of varying severity, such as language or learning disorders, intellectual disabilities, cerebral palsy, seizures, hearing loss, blindness, autism spectrum disorder (ASD), or other developmental delays.
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ABSTRACT: Tooth decay is one of the most common chronic conditions among children. Approximately 23% of children aged 2-11 years have at least one primary tooth with untreated decay and 20% of adolescents aged 12-19 years have at least one permanent tooth with untreated decay. Tooth decay, if left untreated, can cause pain and infection, and can lead to problems with eating, speaking, and learning. Risk factors for tooth decay include recent history of cavities, low fluoride exposure, and living in a low-income household. Prevalence of untreated decay in primary or permanent teeth among children from lower-income households is more than twice that among children from higher-income households. Prevalence of untreated tooth decay is also higher among Mexican-American children and non-Hispanic black children than among white non-Hispanic children. By age 15, approximately 60% of all adolescents will have experienced tooth decay. An estimated 51.7 million school hours are missed annually by school-aged children because of a dental problem or visit.