Takeaway
- Although most toddlers were screened for autism spectrum disorder (ASD) in primary care, those screening positive seldom received an ASD diagnosis or a referral for specialist evaluation.
Why this matters
- Earlier intervention in ASD may improve developmental outcomes.
Key results
- Rate of ASD screening with Modified Checklist for Autism in Toddlers:
- 93% at 18 months of age.
- 82% at 24 months of age.
- About 4% of toddlers had a positive screening result at either or both ages.
- Of toddlers screening positive (most with follow-up through 4 years of age):
- 18% received an ASD diagnosis.
- 59% received a non-ASD neurodevelopmental disorder diagnosis.
- 31% were referred to a specialist for additional evaluation.
Study design
- Retrospective cohort study of toddlers seen in well-child visits to primary care providers in 54 network pediatric practices during a 2-year period:
- 13,417 at 18 months of age.
- 13,328 at 24 months of age.
- Main outcomes: ASD and other diagnoses, referrals.
- Funding: William Stamps Farish Foundation.
Limitations
- Unclear generalizability.
- Reliance on electronic health records.
- Some toddlers with non-ASD diagnoses may have gone on to receive ASD diagnosis after end of study period.
- M-CHAT follow-up interview to assess positive screenings was not administered.
References
References
