Autism Research Consortium - Description of Project: The Developmental-Behavioral Pediatrics Research Network (DBPNet) proposes to utilize its well-established infrastructure and partnerships to develop, evaluate, and incorporate effective interventions into clinical services that improve the physical and behavioral health for children with autism and other developmental disorders across the lifespan and serve the needs of children and families living in low-income communities. For this application, we expand the DBPNet leadership team and utilize our extensive clinical and research resources to conduct multiple studies to address pressing public health needs for individuals with autism and other developmental disorders and their families. Need: Autistic children and those with other developmental disorders have high levels of unmet healthcare needs. These needs include, but are not limited to, difficulties accessing services, difficulties managing commonly co-occurring conditions, and uncertainty about possible developmental trajectories when autism is diagnosed in young children. Due to the small workforce of clinicians trained to diagnose autism, delays in diagnosis are particularly problematic as they may preclude intervention in the early neurodevelopmental window when therapies have the greatest impact. Thus, there is an urgent need to study interventions to expand the workforce that can diagnose autism. Further the Interagency Autism Coordinating Committee has identified co-occurring challenges with communication difficulties, sensory sensitivities, and suicidality as among the challenges that families feel need the most attention. Thus, it is critical that we expand the capacity of clinicians to help families with these challenges. Proposed Projects: The primary study we propose is a cluster randomized trial to determine if training primary care clinicians serving low-income rural and urban communities to diagnose young children with autism decreases time to making, or ruling out, the autism diagnosis and whether the diagnostic conclusions of primary care clinicians concur with those of autism experts. In addition will conduct 2 pilot intervention studies. One seeks to develop a brief intervention implemented by a speech-language pathologist and an occupational therapist that may be a feasible way to provide initial access to interventions that help families begin to address both core autism symptoms and commonly co-occurring symptoms. The other evaluates a suicide safety planning intervention tailored to address the needs of autistic individuals. We will also conduct a follow study in early adolescence for a cohort of children diagnosed with autism at less than 36 months of age to further define the developmental trajectories for young children diagnosed with autism. Target Population: The target population for this proposal are autistic children, youth, and young adults with high levels of unmet healthcare needs and their families. To address the needs of the target population, we seek to expand the workforce and better prepare the workforce to participate in autism diagnostic evaluations, management of co-occurring symptoms, and counseling families of young children diagnosed with autism about potential developmental trajectories.
