title: The diagnosis of autism in community pediatric settings: does advanced training facilitate practice change?
abstract: 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.
authors.affiliation: Vanderbilt University, USA.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Swanson
authors.affiliation: Vanderbilt University, USA zachary.warren@vanderbilt.edu.
authors.forename: Zachary E
authors.initials: ZE
authors.lastname: Warren
authors.affiliation: University of Washington, USA.
authors.forename: Wendy L
authors.initials: WL
authors.lastname: Stone
authors.affiliation: Vanderbilt University, USA.
authors.forename: Alison C
authors.initials: AC
authors.lastname: Vehorn
authors.affiliation: Vanderbilt University, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Dohrmann
authors.affiliation: Blanchfield Army Community Hospital, USA.
authors.forename: Quentin
authors.initials: Q
authors.lastname: Humberd
mesh_terms: D001321:Autistic Disorder / Q000175:diagnosis*; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis; D002675:Child, Preschool; D003153:Community Health Services; D006801:Humans; D008403:Mass Screening; D010372:Pediatrics / Q000193:education*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*
keywords: autism spectrum disorders; diagnosis; screening