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Role of Primary Care Clinician Concern During Screening for Early Identification of Autism
Journal article   Peer reviewed

Role of Primary Care Clinician Concern During Screening for Early Identification of Autism

Andrea Trubanova Wieckowski, Riane K Ramsey, Kirsty Coulter, Sherief Y Eldeeb, Yasemin Algur, Victoria Ryan, Aubyn C Stahmer and Diana L Robins
Journal of developmental and behavioral pediatrics
02 Apr 2024
PMID: 38564788
url
https://escholarship.org/content/qt4tc4964p/qt4tc4964p.pdfView
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Abstract

The aim of this study was to evaluate the added value of primary care clinician (PCC)-indicated concern during primary care universal standardized screening in early identification of autism. Toddlers were screened for autism during primary care checkups (n = 7,039, aged 14.24-22.43 months) in 2 studies. Parents completed the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up. For each participant, PCCs indicated whether they had autism concerns (optional in 1 study-before or after viewing screening results, required before viewing screen results in the other). Children at high likelihood for autism from screen result and/or PCC concern (n = 615) were invited for a diagnostic evaluation; 283 children attended the evaluation. Rates of PCC-indicated autism concerns were similar whether PCCs were required or encouraged to indicate concerns. High likelihood of autism indication on both screen and PCC concern resulted in the highest positive predictive value for autism and positive predictive value for any developmental disorder, as well as the highest evaluation attendance, with no significant difference between the positive screen-only and PCC concern-only groups. Although the frequency of PCC-indicated autism concern did not differ significantly based on the child's cognitive level, PCCs were more likely to identify children with more obvious autism characteristics compared with more subtle autism characteristics as having autism. The findings support the recommendation of the American Academy of Pediatrics that both screening and surveillance for autism be incorporated into well-child visits. High likelihood of autism on either screen or PCC concern should trigger a referral for an evaluation.

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2 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Behavioral Sciences
Pediatrics
Psychology, Developmental
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