Earliest Possible Targeted Red Flags for Autism Spectrum

Autism Spectrum Disorder is a neurodevelopmental disorder that is diagnosed based on clinical features that include social and communication impairments, as well as restrictive, repetitive behaviors. Early intervention is of utmost importance to help lessen and potentially mitigate the negative impacts of this disorder.4-5 Significant efforts to identify children with early signs and symptoms of ASD are needed. Researchers have documented early signs in high-risk populations, such as children with a sibling with ASD6; however, little evidence exists examining the early signs of ASD in a community-based sample. Moreover, researchers know little about the differences in early flags identified by parents in community settings and those identified by clinicians. ASD incidence data is the only type of data that can generate hypothesis on causation, however without a mechanism in place to identify cases at their earliest signs it will be impossible to know what potential factors are influencing causation. The shorter the time between first signs and symptoms of ASD to actual ASD diagnosis improves ones ability to determine factors influencing ASD incidence. The knowledge on what these factors are will improve the time frame. The National ASD Surveillance program first phase is initially the establishment of ASD prevalence rates. The program is also committed to determining possible risk factors for ASD and the best mechanisms for this is the knowledge gained in the collection of information on early flags for ASD, In April 2013, York Region launched the York ASD Partnership, a collaboration between 21 agencies, aimed at providing coordinated access to ASD care.14 Goals of this initiative include coordinated access to ASD diagnosis (any door leads families to the resources they need), improving knowledge and awareness of ASD, providing a continuum of coordinated services, and building infrastructure to improve collaboration and transparency. Improved ASD screening practices must lead to feasible and effective programs of early intervention and therefore the proposed project fits well within the mandate of this initiative. There are approximately 8300 individuals with ASD in York Region of whom 1100 are under the age of 14. The purpose of this project is to collect data regarding early signs of ASD differences detected by parents and primary care clinicians: - Earliest signs of potential ASD, including frequency and intensity (if possible) of these signs, apparent to parents in a typical community setting. - Earliest signs of potential ASD, including frequency and intensity (if possible) of these signs, apparent to clinicians in a typical community setting. - Current tools used by clinicians doing primary health care in York Region in the Greater Toronto Area. - Current tools being used by community clinicians at the secondary screening level for ASD; feasibility and additional information gained by adding standardized ASD screening measures. - Feasibility of training clinicians to use more standardized approaches to developmental surveillance and screening.

Mandatory Technical Criteria Met M1 The Organization must have a team of senior staff with a minimum of 10 (ten) years' experience working with individuals with ASD. M2 The proposed Project Lead must have a minimum of 10 (ten) years' clinical experience in early diagnosing of children at risk for autism. M3 The proposed Project Lead must be a developmental paediatrician or a Clinical psychologist with a licence to practice in their affiliated province or territory. M4 The Organization must have associations with both a University and a local hospital. M5 The organization must assess a minimal of 100 children per year.