# Connecting the Dots: An RCT Integrating Standardized ASD Screening, High-Quality Treatment, and Long-Term Outcomes

> **NIH NIH R01** · DREXEL UNIVERSITY · 2020 · $2,241,105

## Abstract

A growing body of evidence demonstrates that younger age of onset for ASD treatment improves outcomes. Universal toddler
screening for autism spectrum disorder (ASD) has been shown to lower the age of ASD diagnosis by two years compared to
the national median; this in turn lowers the age of access to ASD-specific treatment. Yet on February 17, 2016, the US
Preventive Services Task Force (USPSTF) published a final statement on autism screening in JAMA, in which they found
insufficient evidence to recommend universal ASD screening. One of the primary gaps they identified was a lack of
randomized controlled trials (RCTs) in which children detected through screening received treatment for ASD, with their
outcomes compared to those of children not screened. The current proposal aims to fill this gap, connecting the dots
between the screening and treatment literatures, and demonstrating that standardized, high-fidelity, universal
screening lowers the age of diagnosis and treatment onset, leading to improved short- and long-term outcomes. The
intervention in this RCT is supported deployment of such screening, with immediate evaluation of at-risk children, compared
to a control group receiving usual care approaches to early detection of ASD, namely physician surveillance and/or
unstandardized screening. In a sample of 8,000 toddlers enrolled through participating pediatric practices near Drexel
University, the University of Connecticut, and the University of California Davis MIND Institute, we expect that cognitive
functioning and ASD symptom severity will show greater improvements in the experimental group, in which most children
will be detected at 18 m screening, compared to the control group, in which children are expected to be detected significantly
later. In both groups, missed ASD cases will be detected through screening at 48 m. Across both groups, all children identified
as at risk for ASD will receive a diagnostic evaluation, and all children diagnosed with ASD will be enrolled in one year of
manualized early intensive behavioral treatment (EIBI). In addition to the primary outcome measures of cognition and
symptom severity, exploratory outcomes will include group differences in adaptive functioning, kindergarten readiness, and
social reciprocity as measured by experimental eye tracking and parent-child interaction ratings. We also will examine the
impact of the screening intervention on physician attitudes and on parent empowerment and stress. Finally, we will examine
potential moderators of group differences, to determine whether initial symptom severity, cognitive ability, or SES affects the
expected superior response to treatment in the experimental group. Our Autism Centers of Excellence Network is uniquely
positioned to carry out this study; our prior work demonstrates our extensive experience and productivity in the field of early
screening and treatment in ASD. This study will be the first RCT of toddler ASD screening, and will use rig...

## Key facts

- **NIH application ID:** 9975220
- **Project number:** 5R01MH115715-04
- **Recipient organization:** DREXEL UNIVERSITY
- **Principal Investigator:** Diana L Robins
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $2,241,105
- **Award type:** 5
- **Project period:** 2017-09-07 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9975220

## Citation

> US National Institutes of Health, RePORTER application 9975220, Connecting the Dots: An RCT Integrating Standardized ASD Screening, High-Quality Treatment, and Long-Term Outcomes (5R01MH115715-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9975220. Licensed CC0.

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