Are you screening for autism when—and as often as—you should?

Primary care providers (PCPs) do not consistently provide developmental and autism spectrum disorder (ASD)–specific screenings recommended by the American Academy of Pediatrics (AAP), according to recent findings. The AAP calls for systematic developmental screening at all 9-, 18-, and 24- or 30-month well-child visits (WCVs) and additional ASD-specific screening at all 18- and 24-month WCVs.

Using self-reported and chart-reviewed data, investigators examined the practices of 94 PCPs from 13 states; 79% of participants were pediatricians, and the remainder included family practice physicians, nurse practitioners, and physician assistants. Just 64% of PCPs administered screening tools at all 9-month WCVs; the rate dropped to 62% for all 18-month WCVs and to 41% for all 24-month WCVs. Over half (51%) of PCPs did ASD-specific screening at all 18-month WCVs, and 41% did so at all 24-month WCVs.

General pediatricians were significantly more likely to follow the AAP guidelines, as were practitioners who were more confident in their ability to screen and identify. PCPs with previous training also demonstrated a significantly higher rate of screening. The years of practitioner experience did not influence screening practices.

Thoughts from Dr. Farber

We clearly need todo a better job here. I know there is a shortage of specialists for specifically diagnosing autism, with long waiting lists, but early intervention if delays are confirmed is the key to treatment. The referral process can be started without a formal diagnosis, but only if we screen for the disorder.

Reference

1. Mazurek MO, Kuhlthau K, Parker RA, Chan J, Sohl K. Autism and general developmental screening practices among primary care providers. J Dev Behav Pediatr. 2021;42(5):355-362. doi:10.1097/DBP.0000000000000909