Primary Care Autism Screening and Later Autism Diagnosis

• DOI: 10.1542/peds.2019-2314
• Publication Date: 2020-07-06T12:25:11Z
• Authors: Paul S. Carbone; Kathleen Campbell; Jacob Wilkes; Gregory J. Stoddard; Kelly Huynh; Paul C. Young; Terisa P. Gabrielsen
• Keywords: Male; Delayed Diagnosis; Primary Health Care; Autism Spectrum Disorder; 05 social sciences; Infant; Hispanic or Latino; Neuropsychological Tests; Sensitivity and Specificity; Checklist; 3. Good health; Early Diagnosis; Predictive Value of Tests; Child, Preschool; Utah; Humans; Mass Screening; Female; 0501 psychology and cognitive sciences; Healthcare Disparities; Follow-Up Studies

To describe the proportion of children screened by Modified Checklist for Autism in Toddlers (M-CHAT), identify characteristics associated with screen completion, and examine associations between autism spectrum disorder (ASD) screening later ASD diagnosis.We examined data from attending 18- 24-month visits 2013 2016 20 clinics within a health care system evidence M-CHAT subsequent coding diagnosis at age >4.75 years. We interviewed providers information about usual methods scoring referral.Of 36 233 toddlers, 73% were 1.4% diagnosed ASD. Hispanic less likely to be (adjusted prevalence ratio [APR]: 0.95, 95% confidence interval [CI]: 0.92-0.98), family physicians (APR: 0.12, CI: 0.09-0.15). Compared unscreened children, screen-positive more 10.3, 7.6-14.1) younger (38.5 vs 48.5 months, P < .001). The M-CHAT's sensitivity was 33.1%, positive predictive value 17.8%. Providers routinely omitted follow-up interview had uneven referral patterns.A majority ASD, but disparities exist among those screened. Benefits are improved detection diagnosis. Performance can real-world settings administering screens fidelity facilitating timely evaluations children. should continue monitor signs screen-negative