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Attention Point: Improving Identification in Rural Communities Using an Interactive Digital Video Library
Children with ASD living in rural communities experience later diagnosis (Mandell, et al., 2005), poor accessibility to specialists (Siller et al., 2013), and limited exposure to evidence-based interventions (Stahmer, 2009). Novel, culturally sensitive techniques must be developed to improve identification in rural settings (Yudell et al., 2012) so that children and families have the same access to quality interventions as children living in urban areas. Video sharing provides a solution for improving early identification in rural communities while also increasing physician knowledge of early red flags using their own patients.
Objectives:
The purpose of this research is 1). To develop and implement an interactive digital video library, Attention Point, in rural medical health clinics; and 2). To establish the feasibility of using Attention Pointso that rural physicians can share video of children at risk for autism with a university-based ASD Clinic and retrieve processed video clips to support early identification.
Methods:
The University of Alabama Autism Spectrum Disorders Clinic, Institute for Rural Health, and the School of Library and Information Studies partnered with 3 rural health clinics to implement this project. Children who failed the M-CHAT (Robins, et al., 1999) participate in 15-minute video-recorded parent-child semi-structured play samples. Video observations are securely shared with the University of Alabama Autism Clinic via Attention Point. Next, the project team scores the CARS-2 (Schopler et al., 2010), which is embedded into the program, and provide detailed feedback to the rural physicians. Annotated comments regarding observed social interaction, nonverbal and verbal language, and repetitive behavior are used to process and segment the videos, which in turn highlight observed red flags. Finally, the project team provides referral suggestions for early intervention, autism-specific testing, and/or other appropriate referrals to the physician. The resulting collection of notable video clips of observed red flags can be used to educate rural physicians and nurses on early signs of autism thereby improving their patient care.
Results:
Preliminary efforts of this project have so far included the development of a prototype video digital library, Attention Point, as one outcome from a resource development project, funded by the National Library of Medicine (HHS-N-276-2011-00004-C). Currently, project investigators are piloting Attention Point with one partnering rural health clinic. Data collection is ongoing. Attention Point will be demonstrated and data will be presented regarding the number of children identified with ASD using Attention Point in our targeted rural health practice as well as qualitative data regarding physician’s experiences using Attention Point.
Conclusions:
The project uses innovative technology to give rural children with ASD access to quality specialized healthcare while also educating rural physicians on early signs of ASD in their own patients. Attention Pointoffers a promising first step to removing the disparity of diagnosis delay in our rural communities, thereby significantly enhancing a child’s potential to have optimal intervention outcomes. Findings can have an immediate benefit on rural areas that experience delays in autism identification and intervention.