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The “Prima-Pietra” Project: A Web-Based Platform for Early Autism Risk Assessment

Thursday, 2 May 2013: 09:00-13:00
Banquet Hall (Kursaal Centre)
L. Ruta1,2, R. Siracusano3, G. Tortorella3, M. Boncoddo3, C. Colombi4, G. Crifaci5, L. Billeci6, G. Tartarisco7, M. Ferro8, A. Narzisi9, F. Muratori9 and G. Pioggia10, (1)Institute of clinical physiology, National Research Council, Pisa, Italy, (2)Autism Research Centre, University of Cambridge, Cambridge, United Kingdom, (3)Universita' di Messina, Messina, Italy, (4)National Research Council of Italy, Pisa, Italy, (5)nstitute of clinical physiology, National Research Council, Pisa, Italy, (6)Institute of Clinical Physiology, National Research Council of Italy (CNR), Pisa, Italy, (7)National Council of Research (CNR), Pisa, Italy, (8)“Antonio Zampolli” Institute for Computational Linguistics, Pisa, Italy, (9)University of Pisa – Stella Maris Scientific Institute, Pisa, Italy, (10)Institute of Clinical Physiology, National Research Council (CNR), Pisa, Italy

It is well recognized that the best outcomes in autism spectrum disorders (ASD) are achieved through early diagnosis and early intervention. ASD symptoms may occur as early as 12-18 months and different instruments have been developed for early autism risk assessment under the age of 2 years. The Modified Checklist for Autism in Children (M-CHAT) is a developmental surveillance-screening instrument administered during 18- to 36-month well-child visits that was demonstrated to improve early identification of autism. Novel technologies can substantially contribute to improve early diagnosis in ASD, providing early screening risk assessment platforms, unobtrusive measurements of behaviors and physiological responses, as well as brain structure and connectivity, or other measurable stimulus-event experimental paradigms. The Prima Pietra Project based at the Pervasive Healthcare Center of the Institute of Clinical Physiology of the National Research Council of Italy (Consiglio Nazionale delle Ricerche, C.N.R.) and the AOU Polyclinic “G. Martino” in Messina developed and provided an early autism risk assessment web-based platform for pediatricians and physicians available on the internet. 


The first aim was to exploit the Prima Pietra web-based platform for early remote autism risk assessment with Italian pediatricians in terms of accessibility, usability and acceptance of the system by the users in their clinical routine. The second aim was to enhance the possibility for an early diagnosis in the metropolitan area of Messina applying the screening web-based platform.


The Prima Pietra web-based screening platform is accessible by any web browser. The platform enables the user to add, retrieve, analyze, and mine personal, physiological and behavioral data interacting with a remote secure database management system. The platform allows the child’s information and the M-CHAT scores to be entered by the pediatricians (who also administered the MCHAT to the parents in a face-to-face way) during the routine 18 - 36 months periodic health monitoring controls. If a child fails the checklist, the platform alerts via e-mail the Prima Pietra team and a trained psychologist administers a structured phone interview with the parents in order to verify the risk profile of the child. The platform has been applied for 9 months.


49 out of 108 (45%) pediatricians of the metropolitan area of Messina (Sicily) accepted to take part in the study and were trained to use the Prima Pietra web interface. The participants applied the platform to 483 children during 18- to 36-months well-child visits. 44 children were identified by the platform as failing the MCHAT checklist and were selected for the structured phone interview. An autism risk was assessed for 6 children out of 44 children. 


Our preliminary findings demonstrate that the design and implementation of a web-based surveillance system for early autism screening is well accepted by paediatricians and substantially supports early diagnosis in ASD enabling a promptly early intervention strategy.

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