Three University of Alabama professors are joining their separate professional forces in an effort to more efficiently detect the early stages of several autism spectrum disorders in rural Alabama.
Autism spectrum disorders are a group of developmental disabilities that can cause significant social, communication and behavioral challenges, according to the Centers for Disease Control and Prevention. These disorders include autism, Asperger syndrome and pervasive developmental disorder.
In a 2008 study, the CDC found that one in 88 children had an autism spectrum disorder, and that same year, the CDC’s Alabama Autism Surveillance Program found that one in 210 children in the state had an autism spectrum disorder.
With this information, Angela Barber, a UA professor and assistant professor of communicative disorders, made a connection.
“Children in rural areas receive a later diagnosis than those in urban areas, which may explain the lower prevalence in Alabama,” Barber said. “Therefore, it is critical to identify children in rural areas who have autism but do not have available resources for diagnosis or intervention services.” Barber teamed up with assistant professor in community and rural medicine Lea Yerby to understand the causes of late identification in rural Alabama.
“Alabama has lower diagnosis rates for autism than the national average, so it is likely that many children are falling through the cracks,” said Yerby, who also works with the Institute of Rural Health Research, removing health disparities for rural children in early childhood. “Transportation to metro centers, lack of access to specialty physicians and clinics and long waiting lists for services are large barriers for rural families.”
Dan Albertson, assistant professor in library and information sciences, joined the team with a plan to divert the problems of rural areas in treating the diseases, which, according to a 2009 report by the CDC, does not happen until children are an average of 51 months (over 4 years) old.
Using Carrollton Primary Care Clinic in Pickens County due to its receptiveness of UA research, Albertson established a method of using video technology in which children who fail a routine autism screening at 18 or 24 months are recorded in a play area. The videos are then sent to Barber and the UA Autism Spectrum Disorders Clinic for analysis.
“Using video technology will allow the ASD to access and revisit patients as a team,” Albertson said. “They will be able to re-review aspects of the video, pausing and rewinding. It tries to speed up the process of getting information from the ASD to patients and helps transport that information for people in rural areas that may have limited access to transportation.”
Upon review, Barber and the ASD will flag the videoed symptoms, give feedback to the doctors at the Carrollton clinic and make referrals to the patients to most effectively treat the condition. “We will provide referral recommendations, such as an autism specific evaluation or early intervention services,” Barber said. “This video library will provide a framework within which physicians can talk about developmental concerns with children’s families and make appropriate referrals for evaluation and intervention services.”
The ASD’s West Alabama Autism Outreach Program is already partnering with doctors in Marengo, Choctaw, Sumter, Hale and Pickens counties to detect the disorders at an earlier age.
Although in its pilot phase, the study using video technology to quicken the detection process is poised to provide children in rural areas the same advantages as those in urban areas.
“We would like to see children in rural areas have the same resources and opportunities for early identification, intervention and successful, meaningful outcomes that children in urban areas have,” Barber said. “We also want to support families and physicians in rural communities who are trying to access important identification and intervention services.”
On the brink of success, Albertson would like to see an expansion of the program to include more areas.
“I’d like to expand to a partnership with other universities and other health clinics,” he said. “I want to see it expanded further into the Southeast and beyond.”
