Reducing Barriers to Autism Screening in Community Primary Care: A Pragmatic Trial Using Web-Based Screening

Steinman, Kyle J.; Stone, Wendy L.; Ibañez, Lisa V.; Attar, Shana

doi:10.1016/j.acap.2021.04.017

Cited by 10 publications

(4 citation statements)

References 38 publications

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“…In our cohort, 1 out of 6 children was considered "at risk" at the FP assessment (10.1%), the parental M-CHAT-R questionnaire (8.3%), or both. Similar percentages were found in several international studies which used the CDC [30] or the M-CHAT-R questionnaire [31][32][33][34]. The combined risk percentage assessed in this study was higher, speci cally 16%.…”

Section: Discussionsupporting

confidence: 89%

Pediatrician and parental evaluation of child neurodevelopment at 2 years of age

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Clavenna

Roberti

et al. 2023

Preprint

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Purpose: To assess the feasibility of a shared approach combining the clinical expertise of family pediatricians and parents' perspectives in identifying potential disorders in children using standard clinical practice tools. Methods: Within the NASCITA birth cohort, in addition to the family pediatrician’s clinical evaluation, the M-CHAT-R was completed by parents to assess the child’s language, social skills, behavior, and sensory areas. Parents were also asked to complete the PSI-SF to verify the magnitude of stress in the parent-child system. Univariate and multivariate analyses were performed to evaluate the association between child and parental characteristics and the presence of warning signs. Results: The follow-up assessment was completed for 435 infants: 69 (15.8%) presented warning signs: 43 in the pediatrician’s assessment and 36 in the M-CHAT-R (10 in both). A total of 16 children (14 with warning signs) received a diagnosis after a specialist evaluation. Being male (OR=2.42, 95%CI: 1.20-4.86) and having sleep disorders (OR=2.48, 95% CI 1.19-5.71) was associated with a greater likelihood of warning signs in the multivariate analysis, while reading aloud was a protective factor (not exposed versus exposed (OR=3.14; 95% CI 1.60-6.17). For 73 children (18.4%), at least one parent tested positive for PSI-SF. An increased prevalence of parental distress was observed in children with warning signs (OR 2.36, 95% CI 1.27-4.37). Conclusions: Integrating physician and parental perspectives during well-child visits and in clinical practice appears feasible and can improve the identification of children at risk of developmental disorders.

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Section: Discussionsupporting

confidence: 89%

Pediatrician and parental evaluation of child neurodevelopment at 2 years of age

Segre

Clavenna

Roberti

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…In our cohort, 1 out of 6 children was considered "at risk" either at the FP assessment (10.1%), the parental M-CHAT-R questionnaire (8.3%), or both. Similar percentages were found in several international studies which used the CDC 43 or the M-CHAT-R questionnaire [44][45][46][47] . The combined risk percentage assessed in the present study was slightly higher, specifically 16%.…”

Section: Discussionsupporting

confidence: 88%

Pediatrician and parental evaluation of child neurodevelopment at 2 years of age

Segre

Clavenna

Roberti

et al. 2023

Preprint

View full text Add to dashboard Cite

Objective: To assess the feasibility of a shared approach combining the clinical expertise of family pediatricians and parents perspectives in identifying potential disorders in children using standard clinical practice tools. Study design: Within the NASCITA birth cohort, in addition to the family pediatricians clinical evaluation, the M-CHAT-R was completed by parents to assess the childs language, social skills, behavior, and sensory areas. Parents were also asked to complete the PSI-SF to verify the magnitude of stress in the parent-child system. Univariate and multivariate analyses were performed to evaluate the association between child and parental characteristics and the presence of warning signs. Results: The follow-up assessment was completed for 435 infants: 69 (15.8%) presented warning signs: 43 in the pediatricians assessment and 36 in the M-CHAT-R (10 in both). A total of 16 children (14 with warning signs) received a diagnosis after a specialist evaluation. Being male (OR=2.42, 95%CI: 1.20-4.86) and having sleep disorders (OR=2.48, 95% CI 1.19-5.71) was associated with a greater likelihood of warning signs in the multivariate analysis, while reading aloud was a protective factor (not exposed versus exposed (OR=3.14; 95% CI 1.60-6.17). For 73 children (18.4%), at least one parent tested positive for PSI-SF. An increased prevalence of parental distress was observed in children with warning signs (OR 2.36, 95% CI 1.27-4.37). Conclusions: Integrating physician and parental perspectives during well-child visits and in clinical practice appears feasible and can improve the identification of children at risk of developmental disorders.

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“…In practice, system-based programs to improve early detection usually include training sessions for professionals about early signs and existing screening tools (Broder Fingert et al, 2018; Daniels et al, 2014; García-Primo et al, 2014). However, beyond theoretical aspects on early detection, hands-on sessions to discuss and provide guidance about strategies for dealing with parental distress (Daniels et al, 2021), strategies for talking about autism concerns (Steinman et al, 2021), or strategies to foster shared decision-making (van Tongerloo et al, 2015) may ultimately do more to develop a stronger parent–professional partnership and build professionals’ confidence in their ability to support and guide families.…”

Section: Discussionmentioning

confidence: 99%

Determinants of satisfaction with the detection process of autism in Europe: Results from the ASDEU study

Guillon

Baduel

Bejarano‐Martín

et al. 2022

Autism

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Satisfaction with the detection process of autism and its determinants was investigated using data from the Autism Spectrum Disorder in the European Union (2015–2018) network. A total of 1342 family members, including 1278 parents, completed an online survey collecting information about their experience and satisfaction with the early detection of autism in their child. Overall, the level of satisfaction varied considerably from one respondent to another. Difficulty in finding information about detection services, lack of professional guidance and support in response to first concerns, finding a diagnostic service on one’s own, and a delay of more than 4 months between the confirmation of concerns and the first appointment with a specialist were all experiences individually associated with greater odds of being less satisfied. Using a dominance analysis approach, we further identified professional guidance and support in response to first concerns as the most important predictor of the level of satisfaction. These findings highlight the aspects of the process that need to be improved to enhance the experience of the detection process and are therefore relevant to guide health administrations toward actions to be implemented to this effect. Lay abstract Professional guidance and support in response to first concerns appears to be an important predictor of the level of satisfaction with the detection process of autism in young children. In this study, we analyzed the views of 1342 family members, including 1278 parents, who completed an online survey form collecting information about their experience and satisfaction with the early detection of autism in their child. Specifically, we were interested in how specific experiences with the detection process relate to the satisfaction with it and whether we could identify important predictors of satisfaction. The detection process is an emotionally charged period for parents, often described as painful, chaotic, and lengthy. A better understanding of their experiences is important to take appropriate action to improve the detection process. In our sample, the level of satisfaction with the detection process varied greatly from one respondent to another. Among the different experiences we considered, whether or not respondents received professional guidance and support in response to first concerns explained most of this variation. We also found that difficulty finding information about detection services, lack of professional guidance and support in response to first concerns, having to find a diagnostic service on one’s own, and longer delays between confirmation of concerns and first appointment with a specialist were experiences associated with a greater likelihood of being unsatisfied. The findings of this study highlight the importance of the parent–professional relationship in the detection process and have important practical implications for health administrations to improve the detection process.

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Reducing Barriers to Autism Screening in Community Primary Care: A Pragmatic Trial Using Web-Based Screening

Cited by 10 publications

References 38 publications

Pediatrician and parental evaluation of child neurodevelopment at 2 years of age

Pediatrician and parental evaluation of child neurodevelopment at 2 years of age

Pediatrician and parental evaluation of child neurodevelopment at 2 years of age

Determinants of satisfaction with the detection process of autism in Europe: Results from the ASDEU study

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