Overview: Project EARLY is a multisite, randomized comparative effectiveness trial of a lay-delivered Family Navigation (FN) intervention. We aim to assess FN as a means to shorten the time to diagnostic resolution among children with positive ASD screens; shorten the time to deployment of ASD services among those diagnosed; and improve engagement with ASD services. 340 parent-child dyads across 3 stages were randomized to FN or care management, a traditional care model. Families worked with navigators throughout the diagnostic process and for 100 days post-diagnosis. We are in the final stages of data analysis and look forward to disseminating results in the coming months.
Overview: Family Navigation (FN) is an evidence-based care management strategy that is a promising intervention to help low-income, diverse families access timely mental health services. Despite significant evidence supporting the effectiveness of FN, concerns exist about the ability to disseminate FN to a broad population due to inefficiency and cost. This study employs an innovative research methodology, the Multiphase Optimization STrategy (MOST), a framework for developing highly efficacious, efficient, scalable, and cost-effective interventions. We are conducting a randomized experiment to assess the individual components of FN and identify which components and component levels have the greatest effect on access to, and engagement in, diagnostic and treatment services for children with mental health disorders. This information will then guide assembly of an optimized FN model that achieves the primary outcomes with least resource consumption and participant burden.
Overview: Autism Spectrum Disorders (ASDs) are characterized by impairments in communication, reciprocal social interaction, and behaviors that are restricted and repetitive in nature, affecting at least 1.1% of youth ages 3-17 years old in the U.S. Therefore, youth with HF-AS may be at elevated risk for dating violence victimization. This formative research study will serve to develop a new curriculum adapted from the Safe Dates for Families curriculum. The online class will target 12-16-year-old adolescents and foster healthy dating skills through interactive activities. Caregivers and teens will both participate in the research to develop a socio-culturally relevant curriculum for youth with HF-AS.
Autism Adaptive Community-based Treatment to Improve Outcomes Using Navigators (ACTION) Network
Overview: A multi-site NIH-funded project collaborating with Florida State University and University of Miami, this study is open to children ages 12-24 with a positive screen or clinical concern for ASD. All interested families will receive expanded screening while they wait for developmental assessments to help identify high risk for ASD. If they are eligible, study participants are assigned a Family Navigator who will work with families for up to 6 months. Navigators will help families complete the developmental assessment process, connect to community resources and services, and address basic needs and barriers to care. Some families will also receive parent coaching focused on helping improve child social communication skills. All families that complete the screening process will gain access to a suite of online resources related to child development and communication delay.
L2-TIPS: Efficient Strategies for Triage and Preventive Intervention for Children Referred for Diagnostic Autism Evaluations: A Feasibility Study
Overview: Thanks to an internal grant from The Joel and Barbara Alpert Endowment for Children of the City, we are currently investigating the feasibility of the introduction of a second-level screener for Autism Spectrum Disorder in the Boston Medical Center Developmental and Behavioral Pediatrics clinic. The goal of this study is to develop a better understanding of the experiences during the time in which families are going through the diagnostic process in a sample of diverse, low-income, urban families and inform the development of efficient strategies for triage and preventive interventions.
An Ethnographic Study of Emergency Department Encounters for Patients with ASD
Overview: The aim of this study is to identify the specific barriers faced by patients with ASD when accessing urgent healthcare in the pediatric ED and the Pediatric Primary Care Clinic at BMC. We plan to follow a total of 20 patients with ASD during their pediatric ED encounters or urgent care appointments in the Pediatric Primary Care Clinic. We will use ethnographic methods to closely observe each step in the process of obtaining medical care and any challenges or barriers that are experienced throughout these visits.