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Role of Primary Care Clinician Concern During Screening for Early Identification of Autism.
Wieckowski, Andrea Trubanova; Ramsey, Riane K; Coulter, Kirsty; Eldeeb, Sherief Y; Algur, Yasemin; Ryan, Victoria; Stahmer, Aubyn C; Robins, Diana L.
Afiliação
  • Wieckowski AT; A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA.
  • Ramsey RK; Nisonger Center, Ohio State University, Columbus, OH.
  • Coulter K; Department of Psychological Sciences, University of Connecticut, Storrs, CT.
  • Eldeeb SY; A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA.
  • Algur Y; Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA; and.
  • Ryan V; Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA; and.
  • Stahmer AC; Department of Psychiatry and Behavioral Sciences, University of California, Davis MIND Institute, Sacramento, CA.
  • Robins DL; A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA.
J Dev Behav Pediatr ; 45(3): e187-e194, 2024.
Article em En | MEDLINE | ID: mdl-38564788
ABSTRACT

OBJECTIVE:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSION:

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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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Atenção Primária à Saúde / Diagnóstico Precoce / Transtorno do Espectro Autista Limite: Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: J Dev Behav Pediatr Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Panamá País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Atenção Primária à Saúde / Diagnóstico Precoce / Transtorno do Espectro Autista Limite: Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: J Dev Behav Pediatr Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Panamá País de publicação: Estados Unidos