Initial diagnostic impressions of trainees during autism evaluations: High specificity but low sensitivity
Ashley de Marchena, Andrea Trubanova Wieckowski, Yasemin Algur, Lashae N Williams, Sherira Fernandes, Rebecca P Thomas, Leslie A McClure, Sarah Dufek, Deborah Fein, Aubyn C Stahmer, …
diagnostic confidence toddlers diagnosis early detection initial impression Autism
Reducing the age of first autism diagnosis facilitates access to critical early intervention services. A current "waitlist crisis" for autism diagnostic evaluation thus demands that we consider novel use of available clinical resources. Previous work has found that expert autism clinicians can identify autism in young children with high specificity after only a brief observation; rapid identification by non-experts remains untested. In the current study, 252 children ages 12-53 months presented for a comprehensive autism diagnostic evaluation. We found that junior clinicians in training to become autism specialists (n = 29) accurately determined whether or not a young child would be diagnosed with autism in the first five minutes of the clinic visit in 75% of cases. Specificity of brief observations was high (0.92), suggesting that brief observations may be an effective tool for triaging young children toward autism-specific interventions. In contrast, the lower negative predictive value (0.71) of brief observations, suggest that they should not be used to rule out autism. When trainees expressed more confidence in their initial impression, their impression was more likely to match the final diagnosis. These findings add to a body of literature showing that clinical observations of suspected autism should be taken seriously, but lack of clinician concern should not be used to rule out autism or overrule other indicators of likely autism, such as parent concern or a positive screening result.
Initial diagnostic impressions of trainees during autism evaluations: High specificity but low sensitivity
Creators
Ashley de Marchena - Drexel University
Andrea Trubanova Wieckowski - Drexel University
Yasemin Algur - Drexel University
Lashae N Williams - Drexel University
Sherira Fernandes - Drexel University
Rebecca P Thomas - University of Connecticut
Leslie A McClure - Drexel University
Sarah Dufek - University of California, Davis
Deborah Fein - University of Connecticut
Aubyn C Stahmer - University of California, Davis
Diana L Robins - Drexel University
Publication Details
Autism research
Publisher
Wiley
Number of pages
7
Grant note
R01MH115715 / National Institute Of Mental Health of the National Institutes of Health
R01HD039961 / Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health
Resource Type
Journal article
Language
English
Academic Unit
Epidemiology and Biostatistics; A.J. Drexel Autism Institute
Web of Science ID
WOS:000971555000001
Scopus ID
2-s2.0-85153526558
Other Identifier
991020422331904721
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Collaboration types
Domestic collaboration
Web of Science research areas
Behavioral Sciences
Psychology, Developmental
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