The RITA-T (Rapid Interactive Screening Test for Autism in Toddlers) Community Model to Improve Access and Early Identification of Autism in Young Children

Overview

Journal Child Neurol Open

Specialty Neurology

Date 2023 Oct 2

PMID 37781220

Authors

Roula Choueiri

William T Garrison

Valerie Tokatli

Naaz Daneshvar

Jillian Belgrad

Guangyu Zhu

Bo Zhang

Affiliations

Soon will be listed here.

Abstract

To evaluate improved identification and the generalization of the RITA-T (Rapid interactive Screening Test for Autism in Toddlers) model through partnerships with Primary Care (PC), Early Intervention (EI), and Autism Diagnosticians. Over 3 years (2018-2021), 15 EI and 9 PC (MD and NP) centers participated in this project. We trained providers on the RITA-T and established screening models. We reviewed charts of all toddlers referred through this model and compared wait times, and diagnoses, to those evaluated through regular referral in a tertiary-based autism clinic. We also examined the RITA-T psychometrics. 377 toddlers met our inclusion criteria. Wait time for diagnosis was an average of 2.8 months and led to further collaboration between community providers. RITA-T cut-off scores stayed consistent. Providers reported improved confidence and easy integration of this model. This model is generalizable and improves the Early Identification of ASD.

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References

Vassar M, Holzmann M . The retrospective chart review: important methodological considerations. J Educ Eval Health Prof. 2013; 10:12. PMC: 3853868. DOI: 10.3352/jeehp.2013.10.12. View

Choueiri R, Lindenbaum A, Ravi M, Robsky W, Flahive J, Garrison W . Improving Early Identification and Access to Diagnosis of Autism Spectrum Disorder in Toddlers in a Culturally Diverse Community with the Rapid Interactive screening Test for Autism in Toddlers. J Autism Dev Disord. 2021; 51(11):3937-3945. PMC: 8510911. DOI: 10.1007/s10803-020-04851-3. View

Robinson L, Gaugh L, Yapo S, Al-Sumairi R, Lorenzo A, Weiss M . Defragmenting the path to diagnosis for underserved youth with Autism Spectrum Disorder in a community-based health system. Healthc (Amst). 2022; 10(1):100597. DOI: 10.1016/j.hjdsi.2021.100597. View

Worster A, Haines T . Advanced statistics: understanding medical record review (MRR) studies. Acad Emerg Med. 2004; 11(2):187-92. View

Marlow M, Servili C, Tomlinson M . A review of screening tools for the identification of autism spectrum disorders and developmental delay in infants and young children: recommendations for use in low- and middle-income countries. Autism Res. 2019; 12(2):176-199. DOI: 10.1002/aur.2033. View

Fluss R, Faraggi D, Reiser B . Estimation of the Youden Index and its associated cutoff point. Biom J. 2005; 47(4):458-72. DOI: 10.1002/bimj.200410135. View

Robins D, Casagrande K, Barton M, Chen C, Dumont-Mathieu T, Fein D . Validation of the modified checklist for Autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics. 2013; 133(1):37-45. PMC: 3876182. DOI: 10.1542/peds.2013-1813. View

Maenner M, Shaw K, Bakian A, Bilder D, Durkin M, Esler A . Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2018. MMWR Surveill Summ. 2021; 70(11):1-16. PMC: 8639024. DOI: 10.15585/mmwr.ss7011a1. View

Hyman S, Levy S, Myers S . Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics. 2019; 145(1). DOI: 10.1542/peds.2019-3447. View

10.

Lemay J, Amin P, Langenberger S, McLeod S . Experience with the Rapid Interactive Test for Autism in Toddlers in an Autism Spectrum Disorder Diagnostic Clinic. J Dev Behav Pediatr. 2019; 41(2):95-103. DOI: 10.1097/DBP.0000000000000730. View

11.

Kaji A, Schriger D, Green S . Looking through the retrospectoscope: reducing bias in emergency medicine chart review studies. Ann Emerg Med. 2014; 64(3):292-8. DOI: 10.1016/j.annemergmed.2014.03.025. View

12.

Lemay J, Yohemas M, Langenberger S . Redesign of the autism spectrum screening and diagnostic process for children aged 12 to 36 months. Paediatr Child Health. 2018; 23(5):308-313. PMC: 6054248. DOI: 10.1093/pch/pxx187. View

13.

Kong X, Sherman H, Tian R, Koh M, Liu S, Li A . Validation of Rapid Interactive Screening Test for Autism in Toddlers Using Autism Diagnostic Observation Schedule™ Second Edition in Children at High-Risk for Autism Spectrum Disorder. Front Psychiatry. 2021; 12:737890. PMC: 8517472. DOI: 10.3389/fpsyt.2021.737890. View

14.

Choueiri R, Wagner S . A New Interactive Screening Test for Autism Spectrum Disorders in Toddlers. J Pediatr. 2015; 167(2):460-6. PMC: 7877705. DOI: 10.1016/j.jpeds.2015.05.029. View

15.

Zwaigenbaum L, Brian J, Ip A . Early detection for autism spectrum disorder in young children. Paediatr Child Health. 2019; 24(7):424-443. PMC: 6812305. DOI: 10.1093/pch/pxz119. View