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A Multistate Trial of an Early Surveillance Program for Autism Within General Practices in Australia
Josephine Barbaro1,2, Anne Masi2,3, Melissa Gilbert1
1Olga Tennison Autism Research Centre, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Bundoora, VIC, Australia.
Insights
Early autism detection in toddlers is crucial for timely support. This study compares a new autism surveillance pathway to usual care in Australian general practice clinics to improve early identification.
Area of Science:
- Developmental Pediatrics
- Autism Spectrum Disorder Research
- Public Health Interventions
Background:
- Early detection of developmental conditions like autism is critical for accessing timely interventions.
- Undetected conditions can lead to cumulative health, developmental, and behavioral issues throughout life.
- General practitioners play a key role in opportunistic child health surveillance.
Purpose of the Study:
- To compare the efficacy of a developmental surveillance pathway for autism against usual care.
- To evaluate the effectiveness of early autism identification through general practice.
- To determine if enhanced surveillance improves the detection of autism in young children.
Main Methods:
- A multi-site, cluster randomized controlled trial involving approximately 2,400 children aged 18-24 months.
- Randomization of 60 general practitioner clinics across New South Wales and Victoria into an autism surveillance pathway (ASP) or surveillance as usual (SaU) group.
- The ASP group utilizes parent/GP reports and observations for primary and secondary screening; all children with concerns receive a developmental assessment at 24 months.
Main Results:
- (Results not yet available as this is a protocol description)
- (Study is ongoing, awaiting data collection and analysis)
- (Efficacy of the autism surveillance pathway is yet to be determined)
Conclusions:
- (Conclusions cannot be drawn until study results are available)
- (The study protocol is registered with ANZCTR and will follow CONSORT guidelines)
- (Findings will inform best practices for early autism detection in primary care settings)
Abstract:
Background: The early detection of developmental conditions such as autism is vital to ensure children can access appropriate and timely evidence-based supports, services, and interventions. Children who have undetected developmental conditions early in life are more likely to develop later health, developmental, learning, and behavioral issues, which in turn can have a cumulative effect over the life course. Methods: The current protocol describes a multi-site, cluster randomized control trial comparing a developmental surveillance pathway for autism to usual care, using opportunistic visits to general practitioners (GPs). Units of randomization are GP clinics across two Australian states (New South Wales and Victoria), with thirty clinics within each state, each of which will aim to recruit approximately forty children aged between ~18- and 24-months, for a total of ~2,400 participants. Children will be randomized to two clusters; namely, an autism surveillance pathway (ASP) or surveillance as usual (SaU). The screening process for the ASP arm involves primary and secondary screenings for developmental concerns for autism, using both parent and GP reports and observations. Children in both arms who show signs of developmental concerns for autism will be offered a full developmental assessment by the research team at 24 months of age to determine the efficacy of developmental surveillance in successfully identifying children with autism. Trial Registration: The trial is registered with ANZCTR (ACTRN12619001200178) and reporting of the trial results will be according to recommendations in the CONSORT Statement.
