Autism Navigator®: Using Implementation Science to Improve Global Access to Early Detection and Intervention for ASD

Background: Global prevalence estimates of autism spectrum disorder (ASD), ranging from 0.6%-1.5%, have raised awareness of ASD worldwide (Elsabbagh et al., 2012; Schendel et al., 2012). Research has documented the effectiveness of early intervention, which underscores the need for efficient, effective tools to support healthcare providers in detecting red flags by 18-24 months. There is a research-to-practice gap in high-resource countries that widens in low-resource countries. Implementation science offers a framework and systematic strategies to facilitate the process of adopting evidence-based practice and sustaining with fidelity in everyday settings that can be utilized to reduce the time between scientific advances and widespread implementation. Mobile technology offers one potential solution to bridging the research-to-practice gap. Autism Navigator^®(AN) is a collection of web-based courses and tools with video illustrations that offers the potential for access globally. AN has used an implementation science framework to promote coordinated change for community uptake and sustained utilization in medical, social service, and early intervention systems.

Objectives: This technology demonstration will showcase AN’s web-based collection of courses and tools and report on the process of development, deployment, and utilization of the courses. 

Methods: AN was developed by the FSU Autism Institute. AN for Primary Care is an online course using interactive slides and illustrative video clips of toddlers with ASD. After completing the course, providers can use the online automated Smart ESAC (Early Screening for Autism and Communication) screening tool within an E-Co-System with provider and family portals linking to 5 resources on the FIRST WORDS Project website. The 16-by-16 Lookbooks and Social Communication Growth Charts are for all families. Families of children with a positive autism screen are invited to About Autism in Toddlers, ASD Video Glossary and the How-To Guide for Families. Input from advisory boards and focus groups involving stakeholders informed the development of the E-Co-System. The E-Co-System was built through an iterative process of feedback, review of material for cultural appropriateness, and revolving enhancements to the portal.

Results: We will describe the launch of AN over the past two years beginning with Florida and Georgia and then expanding to other states in the US and other countries including Canada, South Africa, and Brazil. We launched our first free course, About Autism in Toddlers in April 2015 and had 3,643 unique users enrolled from 21 countries in the first 12 months, which increased incrementally to 6,557 unique users from 103 countries after the next 6 months. Autism Navigator for Primary Care has 612 unique users enrolled from 7 countries. The How-to Guide for Families is being piloted with 85 users in 3 countries. Tablet computers will available to experience the screening tool and web-based resources.

Conclusions: Innovative models to increase the number of culturally and ethnically diverse professionals who can deliver evidence-based services are vital to improving global competence in early detection and intervention for ASD (Khan et al., 2012). AN provides a cost-efficient platform, using mobile technology to combine an automated screening tool, parent and provider portals, and links to web-based resources.