Screening & the Get SET Early Model

What is Screening?

Screening is a way to detect a condition, such as autism, in a population before the onset of full-blown symptoms. There are different types of screening approaches. One approach, universal screening, consists of a whole population receiving screening (e.g., all children that go to their pediatrician for a well-baby check-up) using a validated tool. Sometimes pediatricians engage in universal screening, but sometimes they prefer to screen using their own clinical judgment without the aid of a tool, an approach known as surveillance.

What is the Get SET Early Model?

The Get SET Early Model is based on the idea that the goal of medicine is to diagnose and treat serious conditions as quickly as possible. Because autism spectrum disorder (ASD) begins during gestation --likely as early as the first or second trimesters^1-3-- it is not only present at birth but it is present at early well-baby visits with pediatricians. Despite the fact that ASD is able to be detected, in many cases, by the first birthday⁴, and the diagnosis is stable by 14 months⁵, most toddlers with ASD do not receive a diagnosis and begin treatment until far later at ages 3 to 5 years, a statistic that has remained stable across the past decade^{6, 7}. The considerable time delay between ASD's prenatal onset and eventual detection and treatment could well be a missed opportunity for children and families. Research shows very early treatment (by age ~2 years) increases overall IQ, language abilities, as well as social orienting skills^8-10. Some studies go on to suggest that starting treatment at earlier ages results in better overall outcomes than treatment begun later in life^11-13.

The Get SET Early model, developed by Dr. Pierce and colleagues at UC San Diego, is an exciting, collaborative, approach that is designed to facilitate early ASD diagnosis and treatment engagement by having parents and pediatricians work together. Making use of the 12, 18 and 24 month well-baby check-ups, the Get SET Early model identifies autism through universal screening and immediate referrals for diagnostic evaluations and treatment. The simple 12-steps are illustrated in Figure 1.

This approach expands and improves upon their previous model, the 1-Year Well-Baby Check-Up Approach4. Research on the effectiveness of the new Get SET Early Model is based on the collaborative effort of 203 pediatricians and 57,603 screens administered at well-baby check-ups in the greater San Diego area. Results of this work are currently Under Review in a scholarly journal.

^{Figure 1. Schematic illustrating the key components in the Get SET Early Model}