Duke and NIH develop autism screening tool to improve access to care
Health care providers used the tablet-based application developed by Duke University’s Autism Center of Excellence to screen infants ages 17 months to three years during well-child visits. After toddlers who are candidates for further evaluation for autism spectrum disorder have been identified, they can be connected to appropriate resources.
WHY IT’S IMPORTANT
The app, called SenseToKnow, could also help health care providers ensure children and families get the support they need, according to a recent study funded by the National Institutes of Health.
The U.S. Department of Health and Human Services researchers noted that parent questionnaires typically used in primary care are not as accurate as those used in research settings, particularly among girls and children of color.
The result was greater disparities in early autism diagnoses and interventions.
The application, developed by the Durham, North Carolina Autism Center of Excellence at Duke University, records and analyzes children’s reactions to short films designed to elicit a range of behaviors, according to the NIH.
The researchers say the app can track many early signs of ASD, “including differences in social attention, facial expressions, head movements, response to names, blink rate, and motor skills.”
In the study of 475 young children, the digital screening tool demonstrated an accuracy rate of 87.8% for detecting ASD and a specificity of 80.8% for children without ASD who screened negative.
Fifteen percent of children who screened positive using the standard parent questionnaire were later diagnosed with ASD. Meanwhile, study participants who tested positive for ASD using the digital app had a 40.6 percent chance of subsequently being diagnosed with the condition.
“Combining the app with the standard questionnaire increased the likelihood of a positive screen leading to a subsequent diagnosis to 63.4%,” NIH researchers said.
Following the study, which resulted in 49 of the participating toddlers subsequently being diagnosed with ASD and 98 of them being diagnosed with developmental delays without ASD, the children were connected to appropriate referrals and services.
THE BIGGER TREND
“Children with autism have disproportionately poorer health outcomes than their disabled and non-disabled peers,” states an article on Access to comprehensive healthcare on the nonprofit Autism Speaks website.
“Children with ASD are almost four times more likely to have unmet health care needs compared to children without disabilities, while children with other disabilities are almost twice as likely to have unmet health needs as children with other disabilities without disability.”
Dr. Daniel Turner-Lloveras, co-founder and president of SaludConTech, which supports the Latino community by strengthening digital health, said his organization seeks to eliminate health disparities with digital health.
Using technology and innovation “in an accessible way” can empower people in communities of color who are excluded from health care, he said Healthcare IT News in April at HIMSS23.
Previous studies have compared app-based screening to traditional screening and found digital exams to be superior in detecting conditions such as atrial fibrillation.
The two-stage, 5,000-participant smartphone screening study, the eHealth-based Bavarian Alternative Atrial Fibrillation Detection Study, compared measurements of pulse wave irregularities by smartphone photoplethysmographic sensors of patients with traditional screening and found that digital screening doubled the detection rate.
“Screening with common smartphones significantly increased the detection rate of treatment-relevant atrial fibrillation,” said lead study author Axel Bauer, a professor at the Medical University of Innsbruck, Austria, in announcing the study last year.
ON THE RECORD
“The app’s ability to reliably identify children diagnosed with ASD was consistent across young children of different genders, races, and ethnicities,” NIH officials said of SenseToKnow.
Andrea Fox is managing editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a publication of HIMSS Media.