The diagnosis of autism in community pediatric settings: Does advanced training facilitate practice change?

• Published in: Autism : the international journal of research and practice 2014-07, Vol.18 (5), p.555-561
• Main Authors: Swanson, Amy R, Warren, Zachary E, Stone, Wendy L, Vehorn, Alison C, Dohrmann, Elizabeth, Humberd, Quentin
• Format: Article
• Language: English
• Subjects: Autism; Autism Diagnostic Observation Schedule; Autistic Disorder - diagnosis; Biological and medical sciences; Child clinical studies; Child Development Disorders, Pervasive - diagnosis; Child, Preschool; Clinical Diagnosis; Community Health Services; Developmental disorders; Disability Identification; Humans; Infantile autism; Interviews; Mass Screening; Medical sciences; Mullen Scales of Early Learning; Nurses; Outcomes of Education; Pediatrics; Pediatrics - education; Pervasive Developmental Disorders; Physicians; Practice Patterns, Physicians' - statistics & numerical data; Pretests Posttests; Professional Development; Program Effectiveness; Program Evaluation; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Questionnaires; Screening Tests; Training; Vineland Adaptive Behavior Scales
• ISSN: 1362-3613; 1461-7005
• DOI: 10.1177/1362361313481507

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. This study evaluated the effectiveness of a training program designed to enhance autism spectrum disorder identification and assessment within community pediatric settings across the state. Twenty-seven pediatric providers participated in regional trainings across a 3.5-year period. Trainings provided clinicians with strategies for conducting relatively brief within-practice interactive assessments following positive autism spectrum disorder screenings. Program evaluation was measured approximately 1.5 years following training through (a) clinician self-reports of practice change and (b) blind diagnostic verification of a subset of children assessed. Pediatric providers participating in the training reported significant changes in screening and consultation practices following training, with a reported 85% increase in diagnostic identification of children with autism spectrum disorder within their own practice setting. In addition, substantial agreement (86%–93%) was found between pediatrician diagnostic judgments and independent, comprehensive blinded diagnostic evaluations. Collaborative training methods that allow autism spectrum disorder identification within broader community pediatric settings may help translate enhanced screening initiatives into more effective and efficient diagnosis and treatment.