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FIRST WORDS® Project

The FIRST WORDS® Project is a longitudinal research investigation in the FSU Autism Institute funded by the US Department of Education, National Institutes of Health, and Centers for Disease Control and Prevention. Our major goal is to identify early red flags of communication delays and autism spectrum disorder in children 9 to 18 months of age. Through our research findings, we aim to improve screening tools and early detection of autism spectrum and other communication disorders by maximizing the role of the family in order to help families obtain intervention services sooner.

Infant/Toddler Checklist. To learn more about our evaluation model and to download the CSBS-DP Infant/Toddler Checklist in English and other available languages, click here.

We are conducting studies to achieve the following research aims:

Smart Early Screening for Autism and Communication Disorders in Primary Care. With funding from the Eunice Kennedy Shriver National Institute of Child Health & Human Development, the purpose of this investigation is to validate the effectiveness of a new automated online version of the Early Screening for Autism and Communication Disorders— the “Smart ESAC,” that uses smart technology to seamlessly transition from 10 broadband questions about communication delay to 20 autism-specific questions for children who screen positive on the initial broadband screen. A sample of over 8,000 infants will be recruited at 12 months of age and followed to 30-36 months to study cut-off scores, individual items, and underlying dimensions of the Smart ESAC. It is anticipated that at least 84 toddlers with ASD will be identified from this community sample.

Defining the Social Communication Phenotype in the 2nd Year of Life. With funding from the National Institute on Deafness and Communication Disorders, we are defining the social communication phenotype of ASD in the second year in our sample. The objectives of this longitudinal, prospective research project are to collect precise measures of social communication skills in 100 children with ASD in the second year of life compared to a matched groups of children with developmental delay in which ASD is ruled out and typical children.

Estimating the Prevalence of Autism in Toddlers. We are one of two early surveillance studies in the country funded by the CDC to estimate the prevalence of ASD in toddlers in a population-based study. With funding from the CDC, we are screening 3,000 children per year in 12 counties in the Florida panhandle for communication delay. We are conducting autism-specific screens on children with communicatoin delays and invite families for a diagnostic evaluation to confirm or rule out ASD at 18 months and again at 30 months to estimate the prevalence of ASD. This early surveillance study is a unique resource to identify very young children with ASD in a community-based sample representative of our region.

Improving and Streamlining Screening and Diagnosis of ASD at 18-24 Months of Age. The major aim of this investigation is to streamline the screening, evaluation, and diagnostic process to improve early detection of ASD in children 18-24 months of age funded by National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health & Human Development. We are examining the accuracy of individual items and combination of items on the following measures in 600 children: 1) the Early Screening for Autism and Communication Disorders (ESAC); 2) the Systematic Observation of Red Flags of ASD for a clinical setting (SORF-Clinic), 3) the Systematic Observation of Red Flags of ASD for a home setting (SORF-Home), and the Autism Diagnostic Observation Schedule (ADOS) Toddler Module. The expected outcomes of this study will have significance for the field by documenting the accuracy of a set of promising screening and evaluation measures for toddlers that maximizes the role of families to improve early detection of ASD. The comparison of autism symptoms displayed at home in everyday activities with those displayed in clinical settings will have important implications for building consensus with families of toddlers about early red flags of ASD and the urgency of early diagnosis and for developing more effective screening methods. These findings will advance science by providing researchers methods for identifying and hence studying children with ASD at younger ages, which could impact genetic, biomedical, and intervention research. By improving and streamlining early screening and diagnosis of ASD in 18 to 24 month old children, the findings of this study will have important implications for earlier access to intervention.

Early Social Communication Characteristics of ASD in Diverse Cultures.  This research investigation is a foundational study of early social communication markers of ASD in 18-36 month old children from two diverse cultures in low resource settings from two different countries- Latino immigrants in Southeastern US and the KwaZulu-Natal (KZN) province of South Africa funded by the National Institute on Deafness and Communication Disorders. Social communication markers of ASD will be compared during two different video recorded observation methods—structured observations using systematic sampling procedures and naturalistic observations of everyday activities. Through the FSU College of Medicine, we are working with the early intervention system and a network of physicians in a 5-county region in southwest Florida, including a high-need population of Latino migrant workers in Immokalee. This research study is pivotal to our long term aims of adapting screening and diagnostic tools for epidemiological research and strengthening in-country and global collaboration to build the capacity in low-resource settings for appropriate accessible early intervention.