Rotholz David A, Kinsman Anne M, Lacy Kathi K, Charles Jane
Department of Pediatrics, Center for Disability Resources, University of South Carolina School of Medicine, Columbia, South Carolina;
Department of Pediatrics, Children's Hospital, Greenville Health System, Greenville, South Carolina.
Pediatrics. 2017 Feb;139(2). doi: 10.1542/peds.2016-1061. Epub 2017 Jan 12.
To provide an example of a successful, novel statewide effort to increase early identification of young children at risk for autism spectrum disorder (ASD) using a 2-tiered screening process with enhanced quality assessment, interagency policy collaboration and coordination.
The South Carolina Act Early Team (SCAET) provided focused collaboration among leaders representing state agencies, universities, health care systems, private organizations, and families to improve quality of life for children with ASD. Specific focus was on implementing policy changes and training to result in earlier identification and home-based behavioral intervention for young children at risk for ASD.
Policy changes, training, and modified state agency practices were accomplished. Presumptive eligibility, on the basis of a 2-tiered screening process was implemented by BabyNet (South Carolina's Early Intervention Program) in collaboration with the lead agency for developmental disability services. There was a fivefold increase in children eligible for early intensive behavioral intervention without waiting for a diagnosis of ASD, avoiding long waits for diagnostic evaluations. Only 16 children (2.5%) were later found not to have ASD from a comprehensive evaluation.
Improvements in early identification and intervention are feasible through collaborative policy change. The South Carolina Act Early Team and its key stakeholders committed to improving outcomes for this population used existing tools and methods in new ways to improve early identification of children with ASD and to make available evidence-based intervention services. This example should be replicable in other states with key stakeholders working collaboratively for the benefit of young children with ASD.
提供一个成功的、新颖的全州范围努力的示例，该努力旨在通过具有强化质量评估、跨机构政策协作与协调的两级筛查流程，提高对患有自闭症谱系障碍（ASD）风险的幼儿的早期识别率。
南卡罗来纳州早期行动团队（SCAET）在代表州机构、大学、医疗保健系统、私人组织和家庭的领导者之间提供重点协作，以改善患有ASD儿童的生活质量。具体重点是实施政策变革和培训，以便对有ASD风险的幼儿进行更早的识别和基于家庭的行为干预。
完成了政策变革、培训以及州机构实践的改进。BabyNet（南卡罗来纳州的早期干预项目）与发育障碍服务牵头机构合作，基于两级筛查流程实施了推定资格认定。符合早期强化行为干预条件的儿童数量增加了五倍，无需等待ASD诊断，避免了诊断评估的长时间等待。从综合评估来看，只有16名儿童（2.5%）后来被发现没有ASD。
通过协作性政策变革，改善早期识别和干预是可行的。南卡罗来纳州早期行动团队及其关键利益相关者致力于改善这一群体的结局，以新的方式使用现有工具和方法来改善对患有ASD儿童的早期识别，并提供基于证据的干预服务。在其他州，关键利益相关者为了患有ASD的幼儿的利益进行协作，这个示例应该是可复制的。
