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

Roula Choueiri,Asher Lindenbaum,William Robsky,William Garrison,Julie Flahive,Manasa Ravi

doi:10.1007/s10803-020-04851-3

Abstract

The objective of this study was to test a screening model that employs the Rapid Interactive Screening Test for Autism in Toddlers (RITA-T), in an underserved community to improve ASD detection. We collaborated with a large Early Intervention (EI) program and trained 4 providers reliably on the RITA-T. Toddlers received the Modified Checklist for Autism in Toddlers (MCHAT-R/F), the RITA-T, developmental and autism testing, and a best-estimate clinical diagnosis. Eighty-One toddlers were enrolled: 57 with ASD and 24 with Developmental Delay (DD) non-ASD. Wait-time for diagnosis was on average 6 weeks. The RITA-T correlated highly with autism measures and EI staff integrated this model easily. The RITA-T significantly improved the identification and wait time for ASD in this underserved community.

Highlights

The Early Identification of Autism Spectrum Disorder (ASD) is an evolving research area
The RITA-T mean scores were significantly higher in the ASD group than in the non-ASD/Developmental Delay (DD) group with a mean score of 20.1 (SD = 3.9) in those diagnosed with ASD and a mean score of 9.7 (SD = 2.9) in those diagnosed as nonASD/DD (p < 0.0001)
The second RITA-T study looked at the psychometrics of the RITA-T in 239 toddlers within a hospital based triaging model including the RITA-T (Lemay et al 2018, 2020)

Summary

Introduction

The Early Identification of Autism Spectrum Disorder (ASD) is an evolving research area. The American Academy of Pediatrics continues to support screening for ASD in primary care (Johnson and Myers 2007). Other programs, such as the Centers for Disease Control (CDC) “ Learn the Signs. Act Early” Campaign, launched in 2004, have developed educational material targeting early childhood providers and parents. These materials are designed to improve developmental monitoring and the detection of early signs of ASD Referrals and wait times are typically further increased among culturally diverse children with limited options through health insurance and other obstacles to their care (Rea et al 2019). Wait lists, for diagnostic evaluations in toddlers with ASD, include other young children who present with developmental delay without the presence

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Conclusion