The Challenges of Autism Diagnosis
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by social communication difficulties and repetitive behaviors or restricted interests.
The American Academy of Pediatrics (AAP) recommends autism-specific screenings at 18 and 24 months. However, actual diagnosis often happens much later, between the ages of 36 to 63 months.
These delays can be attributed to a lack of available developmental-behavioral pediatricians (DBPs).
The Study: A New Approach to Autism Diagnosis
To address this issue, researchers at Boston University Chobanian & Avedisian School of Medicine have proposed a mini-fellowship training program for pediatricians.
The goal is to expedite and facilitate autism diagnoses and connect young children to therapy and resources sooner.
“Pediatric clinicians have an important role to play in the detection and diagnosis of ASD.
Further, pediatric clinicians can recognize signs of ASD, help facilitate diagnosis as well as connect families to available developmental and educational resources in the community,” said corresponding author Mona Doss Roberts, DO, assistant professor of pediatrics.
The Mini Fellowship Program: In-Depth Training for Pediatricians
In a pilot program at Boston Medical Center (BMC), primary care pediatricians received DBP mini-fellowship training for six hours per week for one year.
The training included observing and participating in DBP evaluations and follow-ups for children aged one through 22 years, performing aspects of the Autism Diagnostic Observation Schedule (ADOS-2), Childhood Autism Rating Scale, and various other developmental assessments.
After completing this mini-fellowship training, the pediatricians assessed patients four years of age and younger and referred to DBP for developmental assessment by the primary care clinician.
Findings: A Significant Reduction in Waiting Time
A total of 70 patients, with an average age of 29.5 months, were seen. This streamlined referral process resulted in a decrease in the average waiting time for initial developmental assessment from 135.3 days to 67.9 days.
For those requiring further evaluation by a DBP, the average waiting time dropped from 290.1 days to 120.4 days.
This training led to more patients receiving comparable access and significantly reduced wait times for their initial assessment. The new average wait time was approximately two months.
“Importantly, the faster time to initial assessment corresponded to improved access for developmental assessment by DBP,” added Doss Roberts, who is also a pediatric specialist at BMC.
These findings show the potential impact of specialized training for pediatricians in reducing the wait time for autism diagnosis.
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The study was published in the Journal of Developmental & Behavioral Pediatrics.
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