Identifying Children With Autism Early?

Division of General Medicine, University of Rochester, Rochester, New York, United States
PEDIATRICS (Impact Factor: 5.47). 02/2007; 119(1):152-3. DOI: 10.1542/peds.2006-2026
Source: PubMed
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    • "These recommendations encouraged primary care clinicians to provide developmental surveillance at all well child visits and institute developmental screening with validated tools at critical developmental periods in childhood (i.e., at 9, 18, and 30 months of age). An additional recommendation included autism-specific screening at the 18 and 24-month visits [11]. Screening was defined as the use of brief standardized tools that have relatively high sensitivity and specificity for the specific population’s risk status, are reliable, and focus on all developmental domains at specific age intervals to identify developmental delays [10]. "
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    ABSTRACT: Research is needed to identify challenges to developmental screening and strategies for screening in an urban pediatric setting. Parents of young children and clinicians at four urban pediatric practices participated in focus groups prior to implementation of screening. Participants were queried regarding attitudes, social norms, and barriers to developmental screening. Using information from the focus groups, workflow strategies were developed for implementing screening. Referral rates and satisfaction with screening were gathered at the conclusion. Six focus groups of parents and clinicians were conducted. Major themes identified included 1) parents desired greater input on child development and increased time with physicians, 2) physicians did not fully trust parental input, 3) physicians preferred clinical acumen over screening tools, and 4) physicians lacked time and training to conduct screening. For the intervention, developmental screening was implemented at the 9-, 18-, 24-, and 30-month well visits using the Ages & Stages Questionnaire-II and the Modified Checklist for Toddlers. 1397 (98% of eligible) children under 36 months old were enrolled, and 1184 (84%) were screened at least once. 1002 parents (85%) completed a survey at the conclusion of the screening trial. Most parents reported no difficulty completing the screens (99%), felt the screens covered important areas of child development (98%), and felt they learned about their child's strengths and limitations (88%). Developmental screening in urban low-income practices is feasible and acceptable, but requires strategies to capture parental input, provide training, facilitate referrals, and develop workflow procedures and electronic decision support.
    BMC Pediatrics 01/2014; 14(1):16. DOI:10.1186/1471-2431-14-16 · 1.93 Impact Factor
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