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      Telehealth Approaches to Care Coordination in Autism Spectrum Disorder

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          Abstract

          This chapter examines the current literature regarding the use of telehealth, and its potential benefits and limitations for diagnosis, treatment, and coordination of care for children diagnosed with Autism Spectrum Disorder (ASD). Barriers to access drive the need to have telehealth as a modality for delivering evidence-based diagnostic and therapeutic processes, which can be impactful in improving developmental trajectories and functional outcomes. The chapter concludes with guidance for clinicians interested in leveraging telehealth, with directions elucidated to further advance the use of telehealth to support families with ASD. More recently, in light of Coronavirus disease 2019 (COVID-19) pandemic and social distancing guidelines and restrictions, this chapter highlights changes in telehealth policy and the use of telehealth for diagnosis and treatment of ASD as well as thoughts about future directions.

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          Most cited references24

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          Identification and evaluation of children with autism spectrum disorders.

          Autism spectrum disorders are not rare; many primary care pediatricians care for several children with autism spectrum disorders. Pediatricians play an important role in early recognition of autism spectrum disorders, because they usually are the first point of contact for parents. Parents are now much more aware of the early signs of autism spectrum disorders because of frequent coverage in the media; if their child demonstrates any of the published signs, they will most likely raise their concerns to their child's pediatrician. It is important that pediatricians be able to recognize the signs and symptoms of autism spectrum disorders and have a strategy for assessing them systematically. Pediatricians also must be aware of local resources that can assist in making a definitive diagnosis of, and in managing, autism spectrum disorders. The pediatrician must be familiar with developmental, educational, and community resources as well as medical subspecialty clinics. This clinical report is 1 of 2 documents that replace the original American Academy of Pediatrics policy statement and technical report published in 2001. This report addresses background information, including definition, history, epidemiology, diagnostic criteria, early signs, neuropathologic aspects, and etiologic possibilities in autism spectrum disorders. In addition, this report provides an algorithm to help the pediatrician develop a strategy for early identification of children with autism spectrum disorders. The accompanying clinical report addresses the management of children with autism spectrum disorders and follows this report on page 1162 [available at www.pediatrics.org/cgi/content/full/120/5/1162]. Both clinical reports are complemented by the toolkit titled "Autism: Caring for Children With Autism Spectrum Disorders: A Resource Toolkit for Clinicians," which contains screening and surveillance tools, practical forms, tables, and parent handouts to assist the pediatrician in the identification, evaluation, and management of autism spectrum disorders in children.
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            A systematic review of early intensive intervention for autism spectrum disorders.

            Early intensive behavioral and developmental interventions for young children with autism spectrum disorders (ASDs) may enhance developmental outcomes. To systematically review evidence regarding such interventions for children aged 12 and younger with ASDs. We searched Medline, PsycINFO, and ERIC (Education Resources Information Center) from 2000 to May 2010. Two reviewers independently assessed studies against predetermined inclusion/exclusion criteria. Two reviewers independently extracted data regarding participant and intervention characteristics, assessment techniques, and outcomes and assigned overall quality and strength-of-evidence ratings using predetermined criteria. Thirty-four unique studies met inclusion criteria. Seventeen studies were case series; 2 were randomized controlled trials. We rated 1 study as good quality, 10 as fair quality, and 23 as poor quality. The strength of the evidence overall ranged from insufficient to low. Studies of University of California Los Angeles/Lovaas-based interventions and variants reported clinically significant gains in language and cognitive skills in some children, as did 1 randomized controlled trial of an early intensive developmental intervention approach (the Early Start Denver Model). Specific parent-training approaches yielded gains in short-term language function and some challenging behaviors. Data suggest that subgroups of children displayed more prominent gains across studies, but participant characteristics associated with greater gains are not well understood. Studies of Lovaas-based approaches and early intensive behavioral intervention variants and the Early Start Denver Model resulted in some improvements in cognitive performance, language skills, and adaptive behavior skills in some young children with ASDs, although the literature is limited by methodologic concerns.
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              Family-Centered Care: Current Applications and Future Directions in Pediatric Health Care

              Family-centered care (FCC) is a partnership approach to health care decision-making between the family and health care provider. FCC is considered the standard of pediatric health care by many clinical practices, hospitals, and health care groups. Despite widespread endorsement, FCC continues to be insufficiently implemented into clinical practice. In this paper we enumerate the core principles of FCC in pediatric health care, describe recent advances applying FCC principles to clinical practice, and propose an agenda for practitioners, hospitals, and health care groups to translate FCC into improved health outcomes, health care delivery, and health care system transformation.
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                Author and article information

                Contributors
                maryellen.mcclainverdoes@usu.edu
                Jeff.Shahidullah@austin.utexas.edu
                krohnkr@miamioh.edu
                neelkamal.soares@med.wmich.edu
                Journal
                978-3-030-46295-6
                10.1007/978-3-030-46295-6
                Interprofessional Care Coordination for Pediatric Autism Spectrum Disorder
                Interprofessional Care Coordination for Pediatric Autism Spectrum Disorder
                Translating Research into Practice
                978-3-030-46294-9
                978-3-030-46295-6
                24 June 2020
                : 289-306
                Affiliations
                [1 ]GRID grid.53857.3c, ISNI 0000 0001 2185 8768, Department of Psychology, , Utah State University, ; Logan, UT USA
                [2 ]GRID grid.89336.37, ISNI 0000 0004 1936 9924, Department of Psychiatry, , University of Texas at Austin Dell Medical School, ; Austin, TX USA
                [3 ]GRID grid.259956.4, ISNI 0000 0001 2195 6763, Department of Educational Psychology, , Miami University, ; Oxford, OH USA
                [4 ]GRID grid.38142.3c, ISNI 000000041936754X, Boston Children’s Hospital, , Harvard Medical School, ; Boston, MA USA
                [5 ]GRID grid.463042.7, ISNI 0000 0004 0629 2075, Pediatric and Adolescent Medicine, , Western Michigan University Homer Stryker M.D. School of Medicine, ; Kalamazoo, MI USA
                Article
                19
                10.1007/978-3-030-46295-6_19
                7310994
                678faf6c-6975-4cf8-a651-c1080bdb5684
                © Springer Nature Switzerland AG 2020

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

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                © Springer Nature Switzerland AG 2020

                pediatrics,autism spectrum disorder,neurodevelopmental,autism,management,treatment,interdisciplinary,telehealth,care coordination,technology

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