Bridging barriers to intervention access for waitlisted children with ASD and their families

This proposal seeks to address health disparities through a robust investigation of a telehealth-enabled early diagnostic and intervention package for children with autism spectrum disorder (ASD) who are waitlisted for diagnostic evaluation or intervention services. Children and families face striking barriers to accessing these critical services resulting in significant delays to ASD diagnosis and early intervention onset. Families who reside in rural areas or are in culturally and linguistically diverse communities often face increased disparities in accessing these services. Our 'Bridging Barriers' proposal aims to conduct a randomized control trial (RCT) with a crossover design and embedded single subject experimental design to investigate how to improve outcomes for these populations through a supplemental telehealth-based evaluation and Naturalistic Developmental Behavioral Intervention (NDBI) delivered by caregivers with remote support from interventionists.

Goals and objectives:

Our proposal aligns directly with the MCHB goal of eliminating health barriers and disparities for children with ASD through the following objectives: 1) improving the effectiveness of evaluation and intervention delivered via telehealth on child outcomes of communication social-communication and challenging behavior 2) improving communication outcomes for children who are not verbally communicating and 3) improving family quality of life caregiver feelings of efficacy caregiver experiences of stress and caregiver use of NDBI strategies.

Proposed activities and target populations:

This proposal will target children ages 1 to 5 on waitlists for either evaluation or intervention for ASD. Recruitment will occur through evaluation clinics and intervention providers with a specific focus on including children residing in rural areas and/or from culturally and linguistically diverse communities. We have efficacy evidence that parent coached interventions via telehealth lead to improvement in child outcomes but an RCT will provide innovative contributions needed to advance the effectiveness evidence and to drive sustainability of this model.

Coordination:

The investigative team will coordinate with community stakeholders for recruitment and dissemination of findings including evaluation and intervention providers interdisciplinary department collaboration and partnership with State agencies.

Products:

The study will yield a minimum of three peer reviewed publications geared for both scientific and practitioner outlets and a minimum of five state regional and/or national refereed conference presentations.

Evaluation:

We expect this work to provide immediate and long-term significant impact through providing earlier and timelier access to intervention particularly for the MCH priority population of families residing in rural areas. Statistical and visual analyses will be used to determine effectiveness of the intervention on child and family outcomes. The team will use a quality improvement cycle of Plan Do Study Act to ensure effective and efficient progress on the study objectives