scholarly journals Improving autism and developmental screening and referral in US primary care practices serving Latinos

Autism ◽  
2020 ◽  
pp. 136236132095746
Author(s):  
Katharine E Zuckerman ◽  
Alison E Chavez ◽  
Laura Wilson ◽  
Katie Unger ◽  
Colleen Reuland ◽  
...  
Keyword(s):  
Primary Care ◽  
Autism Spectrum Disorder ◽  
Early Intervention ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Developmental Screening ◽  
Latino Children ◽  
Screening Guidelines ◽  
Primary Care Clinics

Improving autism spectrum disorder screening and referral in primary care may reduce autism spectrum disorder disparities for Latino children. The REAL-START intervention aimed to increase primary care provider adherence to autism spectrum disorder and developmental screening guidelines, and to increase Early Intervention referral for children at developmental risk in primary care clinics serving Latinos. This quasi-experimental study enrolled six Oregon primary care clinics. Clinic staff attended one initial and three follow-up trainings. Trainings addressed screening, billing, referral, and follow-up issues specific to Latinos. Clinic leaders met with a quality improvement facilitator to review performance. Medical record review measured screening and referral at 18- and 24-month well-child visits at baseline and 3, 6, 9, and 12 months. State Early Intervention database queries assessed Early Intervention eligibility. Overall, 2224 well-child visits were assessed (39% Latino). Clinics improved rates of autism spectrum disorder screening from 70% to 94% and general developmental screening from 62% to 95%. Adherence to screening guidelines increased from 46% to 91%. Proportion of children referred to Early Intervention for unchanged, but total referrals increased and age range of referred children broadened. Time to Early Intervention evaluation was slightly shorter among screening-age children. REAL-START may improve screening and referral for autism spectrum disorder and developmental delay in Latino communities. Lay abstract Latino children experience delays in access to diagnosis and treatment of autism spectrum disorder. Primary care–based screening of all children for autism spectrum disorder and referring them for services may reduce racial/ethnic differences and improve care. REAL-START, a yearlong screening intervention, was effective in increasing screening for autism spectrum disorder and general developmental delays, increasing therapy referrals, and shortening time for developmental assessment in primary care clinics with Latino patients.

scholarly journals Need for Pediatric Resident Training in Autism Spectrum Disorder: Preparation for Primary Care

2019 ◽  
pp. 1-5
Author(s):  
Jeffrey F. Hine ◽  
Ashley Dubin ◽  
Amy Swanson ◽  
Jeffrey F. Hine ◽  
Rachel Goode ◽  
...  
Keyword(s):  
Primary Care ◽  
Autism Spectrum Disorder ◽  
Autism Spectrum ◽  
Resident Training ◽  
Spectrum Disorder ◽  
Training Models ◽  
Intensive Intervention ◽  
Follow Up Care ◽  
Specific Practice

Introduction: The increased prevalence of autism spectrum disorder and documented benefits of early intensive intervention have created a need for flexible systems for determining eligibility for autism-specific services, including primary care provider training. Unfortunately, many pediatricians feel uncertain assessing diagnostic risk and facilitating follow-up care for children with autism. Methods: We surveyed current residents regarding their confidence around engaging in specific practice behaviors and providing care for patients presenting with concerns for autism compared to other common concerns seen in primary care. Results: Residents were significantly more confident in their skills with respect to caring for patients with other common concerns than for patients with autism including statistically significant differences in their perceived ability to diagnose, communicate with families about, treat/manage, and facilitate follow-up care. Additionally, nearly all residents with career plans for primary care indicated that autism concerns should fall within their scope of practice and that further training and education about autism is important to their careers. Discussion: These findings underscore that although many current residents feel that being able to recognize and diagnose autism is important, they feel unprepared to do so within current training models and will likely carry this uncertainty forward into future practice. This study reflects clear targets for advancing incorporation of enhanced and active autism-specific training into pediatric residency programs.

Developmental Screening and Referrals: Assessing the Influence of Provider Specialty, Training, and Interagency Communication

2017 ◽  
Vol 56 (11) ◽  
pp. 1040-1047 ◽  
Author(s):  
Christopher Moore ◽  
Irina Zamora ◽  
Mona Patel Gera ◽  
Marian E. Williams
Keyword(s):  
Primary Care ◽  
Early Intervention ◽  
Developmental Screening ◽  
Specialty Training ◽  
Knowledge Gaps ◽  
Screening Process ◽  
Primary Care Clinics ◽  
Communication Problems ◽  
Family Practitioners

Previous studies have shown that different provider approaches, amount of familiarity with the referral and screening process, and level of interagency communication can increase or decrease the likelihood of caregivers completing a recommended referral to early intervention (EI). We surveyed 60 family practitioners and pediatricians at 2 primary care clinics to assess these factors. Pediatricians were more likely than family practitioners to report using, evaluating, and discussing the results of developmental screens. Providers with more experience and recent training expressed more confidence in their ability to describe the EI system to families. Most providers expressed a lack of confidence in their own agency to complete referrals or EI to provide follow-up. The knowledge gaps and communication problems identified in this study could serve as a basis for future interventional work.

scholarly journals The Age at Diagnosis of Autism Spectrum Disorder in Children in Japan

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Shigeki Kurasawa ◽  
Kiyomi Tateyama ◽  
Ryoichiro Iwanaga ◽  
Taro Ohtoshi ◽  
Ken Nakatani ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Sex Differences ◽  
Early Intervention ◽  
Clinical Data ◽  
Large Scale ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Age At Diagnosis ◽  
The Mean

Background. No large-scale study of the timing of autism spectrum disorder (ASD) diagnosis has been performed in Japan to date. The aim of this study was to examine sex differences and annual trends in age at diagnosis of ASD using clinical data. Methods. Clinical data for children aged less than 18 years diagnosed with ASD between January 1, 2009, and December 31, 2013, and in whom follow-up was possible 1 year after diagnosis, were extracted. Results. The mean age at ASD diagnosis was 7.2 ± 4.2 years and the mode age was 3 years. No sex difference was observed for age at diagnosis (p=0.157). An annual trend of earlier diagnosis was observed when fiscal years were compared (p<0.001). Conclusion. This study highlighted the need to develop and provide appropriate early intervention methods and services for ASD children in Japan.

scholarly journals Parents’ Perceptions of Early Interventions and Related Services for Children with Autism Spectrum Disorder in Saudi Arabia

2016 ◽  
Vol 9 (10) ◽  
pp. 128 ◽  
Author(s):  
Faihan Alotaibi ◽  
Nabil Almalki
Keyword(s):  
Autism Spectrum Disorder ◽  
Saudi Arabia ◽  
Early Intervention ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Early Interventions ◽  
Related Services ◽  
Children With Asd ◽  
The Government

<p class="apa">The present study sought to examine parents’ perceptions of early interventions and related services for children with autism spectrum disorder (ASD) in Saudi Arabia. In this study a survey was distributed to a sample of 80 parents with children who have ASD. Parents also were asked open-ended questions to enable them to provide suggestions. The findings indicate that parents have varying perceptions of early interventions and related services. However, they seem to agree that these services are important in assisting their children. Accordingly, parents have suggested that the government needs to increase these services by providing more centers for children with ASD in Saudi Arabia, providing more specialists to deal with children with ASD, promoting inclusion in regular schools and providing more information on early intervention.</p>

Mental health correlates and potential childhood predictors for the wish to be of the opposite sex in young autistic adults

Autism ◽  
2021 ◽  
pp. 136236132110240
Author(s):  
Jung-Chi Chang ◽  
Meng-Chuan Lai ◽  
Yueh-Ming Tai ◽  
Susan Shur-Fen Gau
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Typically Developing ◽  
Item Endorsement ◽  
Opposite Sex ◽  
Autistic Adults

Cross-sectional research has demonstrated the overrepresentation of gender dysphoria in children and adults with autism spectrum disorder. However, the predictors and underlying mechanisms of this co-occurrence remain unclear. This follow-up study aimed to explore baseline (childhood/adolescence) predictors for the follow-up (adulthood) self-reported wish to be of the opposite sex and to investigate its mental health correlates in a sample of 88 autistic individuals as compared with 42 typically developing controls. An item on the Adult Self-Report Inventory-4, “I wish I was the opposite sex,” was used. We compared mental health symptoms between adults with and without this item endorsement. We used prediction models to explore family and autism-related predictors in childhood/adolescence to endorse this item in adulthood. There were more adults endorsing the item in the autism spectrum disorder group compared with the typically developing group. Autistic adults who endorsed the item experienced more mental health challenges, more bullying victimization, more suicidal ideations, and worse quality of life. Lower parent-reported family support and more stereotyped/repetitive behaviors during childhood/adolescence predicted the self-reported wish to be of the opposite sex in adulthood in autistic individuals. It is necessary to raise more attention to gender development and related mental health impact in autistic individuals. Lay abstract Autistic people/people with autism spectrum disorder are more likely to experience gender dysphoria. However, the possible longitudinal predictors and underlying mechanisms of this co-occurrence are unclear. To fill this knowledge gap, we assessed 88 people with autism spectrum disorder and 42 typically developing individuals at their average ages of 13.0 (baseline, childhood/adolescence) and 20.2 years old (follow-up, adulthood). At follow-up, their endorsement on the item “I wish I was the opposite sex” was used to evaluate gender dysphoric symptoms. We compared mental health symptoms between adults with and without this item endorsement at the follow-up assessment. We explored parent-reported family and autism characteristics-related predictors in childhood/adolescence to this item endorsement in adulthood. We found that more autistic adults reported the wish to be of the opposite sex than did typically developing individuals. Autistic adults who endorsed this item experienced more mental health challenges, more school bullying and cyberbullying, more suicidal ideation, and worse quality of life. Moreover, parent-reported lower family support and more stereotyped/repetitive behaviors during childhood/adolescence predicted the self-reported wish to be of the opposite sex in adulthood in autistic individuals. More attention and support should be provided to autistic people regarding gender development and related mental health and quality of life impact, especially during the transition period to young adulthood.

scholarly journals Developing a Culturally Sensitive ICF-Based Tool to Describe Functioning of Children with Autism Spectrum Disorder: TEA-CIFunciona Version 1.0 Pilot Study

2021 ◽  
Vol 18 (7) ◽  
pp. 3720
Author(s):  
Silvana B. Napoli ◽  
María Paula Vitale ◽  
Pablo J. Cafiero ◽  
María Belén Micheletti ◽  
Paula Pedernera Bradichansky ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Latin American ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
International Classification Of Functioning ◽  
Children With Asd ◽  
Practice Methods ◽  
Icf Core Sets ◽  
Family Centered

Background: Autism spectrum disorder (ASD) affects the daily functioning of children and their families; however, in Argentina, there are no standardized tools to guide the description, evaluation, and follow-up of functioning and disability of children with ASD. To fill this gap, the overarching purpose of this study was to create a novel tool guided by the International Classification of Functioning, Disability, and Health (ICF) Core Sets for ASD for clinical practice. Methods: A multistep methodology was used to identify the most relevant ICF categories for an Argentinian clinical setting. The content of this ICF-based shortlist was piloted and revised according to the results. Subsequently, a toolbox of measures was proposed to operationalize each ICF category. Finally, profiles of the functioning of 100 children with ASD were created. Results: An ICF-based tool called TEA-CIFunciona was created, consisting of 32 ICF categories (10 body functions, 15 activities and participation, 7 environmental factors categories). The application of TEA-CIFunciona incorporated a family-centered approach in ASD evaluations and helped identify functional needs. Conclusions: TEA-CIFunciona is the first ICF-based instrument that guides the description of functioning of children with ASD in Argentina. TEA-CIFunciona standardizes collaborative assessments in pediatric ASD populations in Latin American contexts.

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