Early Diagnostic Response Model (EDRM)

The objective of this study is to develop, pilot, and evaluate a diagnostic protocol to assess high-risk toddlers for autism spectrum disorder (ASD) diagnosis of families enrolled in the Georgia Babies Can't Wait (BCW) early intervention program. The Early Diagnostic Response Model (EDRM) project will be addressing children who are identified at high risk for ASD according to the BCW screening protocol, which is the M-CHAT-R/F. Community psychologist will be taught the protocol and receive referrals to build capacity and better address the need across the state. Currently, many children who are screening high-risk for ASD in BCW districts are unable to access follow-up evaluations due to limited community resources and long wait times. It is hypothesized that the EDRM will be successful in increasing the number of BCW families that access an ASD evaluation using telehealth tools and testing protocols and that the families and clinicians involved will be satisfied with the streamlined process. The clinicians' conclusions from the EDRM assessment will be based on the Diagnostic and Statistical Manual, 5th edition (DSM-5; American Psychiatric Association \[APA\], 2013) and are hypothesized to be able to provide high-risk children and their families with the same access to services as an in-person assessment.

A secondary objective is to investigate how many high-risk referral assessments can be completed entirely via streamlined telehealth protocol and how many required additional information to be collected to make a final DSM-5 conclusion.

A tertiary objective is to investigate the improvement of the EDRM as an early identification model to assess for ASD by comparing the numbers of families screened high risk for ASD and referred for an evaluation prior to the study to the number of families who received ASD evaluation by the end of the study through the pilot versus other means. These numbers will be analyzed globally as well as by specific BCW district and other child factors.

• Number of high-risk referral assessments that completed entirely via streamlined telehealth protocol [Time frame: Every 3 months (Quarterly) until end of study (approximately one year), Up to 12 weeks post-intervention]
• Number of of high-risk referral by BCW district [Time frame: Every 3 months (Quarterly) until end of study (approximately one year), Up to 12 weeks post-intervention]
• Number of of high-risk referral by child factors [Time frame: Every 3 months (Quarterly) until end of study (approximately one year), Up to 12 weeks post-intervention]
• Number of of high-risk referral by clinician setting [Time frame: Every 3 months (Quarterly) until end of study (approximately one year), Up to 12 weeks post-intervention]
• Number of participants with additional information collected to make a final DSM-5 conclusion [Time frame: Every 3 months (Quarterly) until end of study (approximately one year), Up to 12 weeks post-intervention]
• Parent satisfaction of EDRM assessment survey [Time frame: At completion of EDRM assessment (4 weeks post-intervention)]
• BCW provider(s) Service Coordinator satisfaction with EDRM assessment survey [Time frame: At completion of EDRM assessment (4 weeks post-intervention)]
• Parent satisfaction with access to treatment survey [Time frame: 3 months after completion of EDRM assessment]
• BCW provider(s) Early Intervention Coordinator satisfaction with EDRM pilot survey [Time frame: Every 3 months (Quarterly) until end of study (approximately one year), Up to 12 weeks postintervention]
• Number of families screened high risk for ASD and referred for an evaluation [Time frame: Through study completion, an average of 1 year]
• Number of families who received ASD evaluation by the end of the study through the pilot versus other means [Time frame: Through study completion, an average of 1 year]