The PASS+ project will address two major unmet needs of families affected by ASD: the lack of early identification delaying the initiation of treatment; and the lack of access to evidence based treatments due to geographical and human resource barriers. PASS+ will address these by concurrently developing a package aimed at enhancing the early detection of ASD through a population based strategy (the Detection Package); and developing a holistic package of care for families of children with ASD for delivery by lay health workers (the Intervention Package).
The Detection Package aims to increase the coverage of detection of ASD to at least 80% of affected children in the population and reduce the time to detection. The activities will be conducted in a sequential manner as follows: mapping of gate-keepers; developing and implementing a training program for identification and referral of suspected children with ASD; surveillance of gate keepers; and the diagnostic confirmation of ASD using the two stage methodology validated by the INCLEN network (with Sangath).3
The Treatment Package aims to address a range of needs of families affected by ASD. It will comprise a modular parent-mediated, lay health worker delivered intervention built upon PASS, a communication focused intervention based on the PACT, an evidence based intervention evaluated in a large RCT in the UK(8) and adapted for use in South Asia. Additional modules addressing a range of needs of families(4), for e.g. behaviour and sleep management, will be added to this core, to be used according to the specific needs of families. The activities will involve: reviewing practice guidelines used by ASD organisations in the country; conducting selected case studies of services in regional centres; conducting theory of change workshops; synthesizing this information in a intervention development workshop; and piloting the package with a cohort of parents identified through the gate-keepers.