title: Factors influencing autism spectrum disorder screening by community paediatricians.
abstract: BACKGROUND
  In most cases, autism spectrum disorders (ASD) can be reliably diagnosed at two to three years of age. However, Canadian data reveal a median age at diagnosis of approximately four years.
  
  
  OBJECTIVE
  To examine general paediatricians' practices regarding ASD screening and identify factors that influence decisions regarding the use of ASD screening tools.
  
  
  METHODS
  Using a qualitative inquiry-based interpretive description approach, 12 paediatricians from four practice groups participated in four focus groups and one individual interview. These were conducted using semistructured interviews, digitally recorded and transcribed verbatim.
  
  
  RESULTS
  Five main domains of themes were identified related to screening tool use: benefits; needs not addressed; elements that limit utility; elements that encourage utility; and implementation challenges. Factors influencing practice included availability of time, comfort with screening tool use, previous use and knowledge about specific tools. Systemic factors included knowledge and access to community resources, as well as the ability to provide support to the child and family.
  
  
  CONCLUSIONS
  The results from the present study identified important factors that influence paediatric practice in ASD screening. As screening tools improve, it will be important to examine the implementation and effectiveness of screening tools and strategies for increased uptake. Future research will also need to attend to the practical needs of physicians and communities in the aim of earlier diagnosis and rapid access to interventional resources.
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta; ; Developmental Paediatrics, University of Toronto, Toronto, Ontario;
authors.forename: Angie
authors.initials: A
authors.lastname: Ws
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta;
authors.forename: Lonnie
authors.initials: L
authors.lastname: Zwaigenbaum
authors.affiliation: Faculty of Social Work, University of Calgary, Edmonton, Alberta.
authors.forename: David
authors.initials: D
authors.lastname: Nicholas
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta;
authors.forename: Raphael
authors.initials: R
authors.lastname: Sharon
keywords: Autism; Autism spectrum disorder; Qualitative research; Screening