Feasibility of Large-Scale Development-Focused EEG Research in a Hospital-Based Primary Care Setting

The age of diagnosis of autism spectrum disorder varies by sociodemographic factors, elevating the need for earlier, unbiased screening and diagnostic measures. Electroencephalography (EEG) is a promising biomarker for early autism detection, but feasibility and validation in primary care settings and in underserved populations remain underexplored. This study evaluates the feasibility of embedding longitudinal EEG and survey data collection into the primary care setting to address these care differences.

Baby Steps is a longitudinal study being conducted in a hospital-based urban primary care clinic serving predominantly low-income families. Infants were recruited prior to their 4-month well-child visits, with EEG and parent surveys collected at 4-, 9-, and 12-month visits. Data collection was integrated into the clinic workflow to minimize disruption. Feasibility was assessed based on the first 250 participants enrolled through metrics of recruitment, retention, and data quality, with bivariate analyses examining predictors of retention.

To reach 250 enrolled participants, 856 eligible families were approached for recruitment. Enrollment reflected clinic demographics (53% Hispanic/Latina/e, 36% Black), and 64% were publicly insured. Around 94% of participants were retained through 12 months. EEG data were collected at 2 or more time points for 87% of participants. Full survey completion ranged from 65% to 78% at each time point. No sociodemographic factors were significantly associated with completion of surveys.

Embedding EEG research in primary care is feasible and facilitates the inclusion of underserved populations. This approach enhances research applicability and may serve as a model for similar efforts in pediatric research.