Approaches to Screening and Early Identification by States/Jurisdictions

Transcription

1 Approaches to Screening and Early Identification by States/Jurisdictions Shaw, E. (October 30, 2009). The National Early Childhood Technical Assistance Center. Atlanta, GA: Act Early Regional Summit

2 Early Identification of ASD: What We Know Eligibility under Part C of IDEA Rigorous definition of developmental delay (documented delay in one or more areas of development) Physical/mental conditions with a high probably of developmental delay/established conditions - automatically eligible At risk for developmental delay - optional

3 Early Identification of ASD: What We Know State flexibility under federal regulations Developing rigorous definition of developmental delay (how much delay) Adding specific conditions to established conditions (i.e. ASD or atypical development) Determining the policies/procedures for child find, eligibility, and evaluation/assessment

4 Early Identification of ASD: What We Know Federal child find data collected yearly Point in time count of # of infants and toddlers with IFSPs birth to one and birth to three No separate report by eligibility categories No national data on number of children with ASD served under Part C Some states may collect this data

5 Early Identification of ASD: What We Know Eligibility under Preschool Programs for Children with Disabilities Developmental Delay (defined by state aged three through nine or any subset of that range, including ages three through five) All eligibility categories under Part B including autism (defined by IDEA)

6 Early Identification of ASD: What We Know State flexibility under federal regulation preschool programs Age range and definition of developmental delay Definition of autism to include PDD-NOS or Aspergers Developing policies and procedures for determining the presence of a disability.

7 Early Identification of ASD: What We Know Child find data collected yearly Point in time count of 3 to 5 year olds w/ieps Reported by eligibility categories National data on number of preschool children served under the category of autism Preschool children with ASD may also be served under other categories (i.e. DD)

8 NECTAC/NPDC on ASD On Line Survey 40 respondents in 30 states/jurisdictions scattered throughout the US and Pacific. Part C program = 18 respondents Section 619 program = 13 respondents Represented both programs = 9 respondents 12 states had respondents from both Part C and Section 619

9 Survey Question: Screening States were asked to identify which screening measures or tools are used to screen young children for ASD. States could select all that applied from a list of typically used measures.

10 Screening Tools Measure Most respondents indicated that more than one screening tool is being used (N=36, 90%) States/Jurisdictions (N=40) ASQ-SE 33 83% MCHAT 29 73% CHAT 14 35% CHAT % ABC 11 28% PDD ST II 9 23% GARS % CSBS-DP 5 19% % of Participating State/Jurisdictions

11 Screening Tools (cont.) Measure *Other screening tools used: TABS, ESP, GSEGC, SRS, BISCUIT, CARS, and a locally developed screening tool. States/Jurisdictions (N=40) CSBS-DP 6 15% ASDS 5 13% SCQ 4 10% STAT 4 10% GADS 4 10% CAST 2 5% Other* 6 15% % of Participating State/Jurisdictions

12 Survey Question: Diagnostic Procedures/Instruments States were asked to identify the instruments/procedures used to diagnose ASD in children under five years of age. States could select all that applied from a list of typically used instruments or procedures.

13 Dx Instruments/Procedures Measure Most respondents indicated that multiple measures were being used (N= 29, 81%) States/Jurisdictions (N=36) CARS % ADOS 22 61% DSM-IV 18 50% ADI-R 10 28% ICD % Other* 8 22% % of Participating State/Jurisdictions No diagnoses made 3 8% *Other tools and methods: DC: 0-3R, SIB-R, PEP-R, state guidelines and professional observational visits.

14 Campaigns/Initiatives for Early Identification of ASD Survey question asked states if they had a targeted campaign or initiative aimed at screening and early identification of ASD in children under the age of five. Thirteen of the 40 respondents reported having such an initiative (33%).

15 Trends in Diagnosing Respondents were asked for the current trend for the earliest age of diagnosis of ASD in their state. Selected from 7 age groupings: a) <18 months e) months b) months f) months c) months g) >72 months d) months

16 Current Trends: Age of Earliest Diagnosis Trend in diagnoses before age 3 (87.5% of both Part C and Section 619 coord.) <18 months = 3 (7.5%)* Between 18 and 23 months = 17 (42.5%) Between 24 and 35 months = 15 (37.5%) Between 36 and 47 months = 4 (10%)** Between 48 and 59 months = 1 (2.5%)*** *Part C only; ** 3 of 4 Section 619; *** Part C

17 Conclusions Trend toward earlier identification reported by both Part C and Section 619 Programs. Two primary screening tools and three diagnostic measures reported most often Some progress in states initiatives or campaigns for earlier identification.

18 Conclusions Majority of states use multiple tools and diagnostic measures within states Use of multiple tools/procedures used for screening & diagnosis of ASD may lead to inconsistencies within states No national data on number of young children with ASD under the age of three.

19 Shaw, E. & Hatton, D. (Eds.) (2009). Screening and Early Identification of ASD. (Queries: An Occasional Paper Compiling States Approaches to Current Topics). Chapel Hill: The University of North Carolina, FPG Child Development Institute, National Early Childhood Technical Assistance Center. Available at Evelyn F. Shaw