Omaha’s Munroe-Meyer Institute is among a handful of centers nationwide that have begun using a new tool to help diagnose autism in some very young children, a move experts say could result in earlier autism diagnosis and intervention for families.
In addition to being the first in Nebraska to use the device clinically, Munroe-Meyer, part of the University of Nebraska Medical Center, also is among about a dozen sites in the United States involved in research testing its effectiveness in slightly older children.
The technology — EarliPoint Evaluation for Autism — was approved by the Food and Drug Administration in 2023 for use with children ages 16 to 30 months.
Alice Shillingsburg, director of Munroe-Meyer’s integrated Center for Autism Spectrum Disorders, said the device — a tablet that shows children short videos depicting social interactions and tracks what they focus on — is based on research that has been conducted over the past several decades.
Studies indicate that children who are 16 to 30 months old and are on the autism spectrum concentrate more on different areas of the videos — objects instead of faces, for example — than children who are developing in a more typical fashion. The device tracks eye movement 120 times a second and can detect with a high degree of accuracy individuals who may be on the autism spectrum.
“We know one of the hallmark features of autism is difficulty with social interactions,” Shillingsburg said. “This is something we do see a difference in with young children, whether they’re attending to social information in the environment or nonsocial information.”
Shillingsburg became a site investigator for the technology last year. Munroe-Meyer since has begun using it as part of the diagnostic process for some younger children.
She and Patricia Zemantic, co-investigator at the institute, stressed that the device does not replace expert clinical involvement in evaluating a child.
The results have to be interpreted along with the child’s developmental history and other pieces of information about the child and the family, typically gathered during an intake visit, said Zemantic, program director of Munroe-Meyer’s Autism Diagnostic Clinic. Children then undergo further evaluation and testing, which typically takes four hours.
But Zemantic said clinicians have been able to reduce that evaluation to about an hour and fifteen minutes using EarliPoint along with other accepted diagnostic tools.
Not only is the shorter evaluation easier for young children to get through and for families to fit into their schedules, she said, the 20-minute video assessment provides a lot of information without sacrificing quality or replacing expert clinical evaluation.
“It does add to the information we get and makes it so much more efficient,” she said.
The device, which its maker says has an accuracy rating of about 80%, is not considered the last word on a diagnosis, however. If clinicians feel at any point that the test wasn’t accurate, she said, they can do more testing.
But Shillingsburg said the time savings could help bring down waitlists not only in Nebraska but also across the country.
Zemantic said Munroe-Meyer typically has a few hundred families on its waitlist at a given time. The time from when a request is made to when an evaluation occurs currently is under a year.
“We’re working to reduce that timeline,” she said. “So I’m really hopeful.”
Reducing the time to evaluation is important, Shillingsburg said, because a diagnosis is the “gatekeeper” for access to care. Clinicians know autism can be reliably diagnosed when a child is 2 years old, if not earlier. But the average age of diagnosis is around 4. One big factor is time that families have to wait for an evaluation. As with many conditions, the earlier interventions can begin, the better the outcomes.
“The sooner you have that information, the sooner you can get started,” Shillingsburg said.
So far, the institute has used the device as part of the diagnostic process for several children in the 16- to 30-month age group. For more information, interested families can visit the appointment page on website at https://www.unmc.edu/mmi/services/resources/appointments.html
The researchers also are participating in ongoing studies to evaluate the device’s effectiveness in children 31 to 84 months, which will compare the gold standard four-hour process to evaluations involving the EarliPoint device. The Munroe-Meyer researchers won’t have access to the results. Instead, they will be reported to the company for evaluation.
“We are excited about it,” Shillingsburg said. “It’s been a long time in the works.”
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EarliPoint™ Evaluation for Autism tracks eye movement 120 times per second and has shown a high degree of accuracy in identifying children on the autism spectrum.