A diagnostic model used at primary care clinics in rural and underserved communities helped to significantly decrease the time from first concern to a diagnosis of autism spectrum disorder (ASD), thus reducing wait times and potentially directing families to early interventions, according to study results published in the Journal of Developmental & Behavioral Pediatrics.
A team of researchers conducted a study to expand on previous research supporting the use of a diagnostic model in primary care clinics to facilitate the early identification of young pediatric patients with ASD. The investigators collected data before and after the implementation of a streamlined model in primary care clinics providing health care in rural and underserved areas.
The Screening Tool for Autism in Toddlers and Young Children, a play-based standardized assessment to detect early social communication skills, was administered to 80 children (ages 19-47 months) across 5 different clinics to stimulate play, imitation, shared attention, and requesting. Patients were categorized as primary care (40 children) or nonprimary care (40 children); half of each population was seen either before or after the implementation of the streamlined model.
After combining data for primary care and nonprimary care groups, use of the streamlined model resulted in a significant reduction in latency to diagnostic conclusion from an average of 144.7 to 49.9 days. Patients were more likely to experience greater decrease in wait times in primary care than in nonprimary care settings, though these data were not statistically significant.
Limitations to the study include the limited sample size, lack of data on family characteristics, and lack of information regarding increasing access to interventions and support services.
“Despite limitations, the current work suggests that implementation of a streamlined model for early identification of ASD dramatically improves wait times for diagnostic consultation and the capacity of behavioral health providers within underserved and rural [primary care] settings,” the investigators wrote.
Hine JF, Allin J, Allman A, et al. Increasing access to autism spectrum disorder diagnostic consultation in rural and underserved communities: streamlined evaluation within primary care [published online September 4, 2019]. J Dev Behav Pediatr. doi:10.1097/DBP.0000000000000727