Improving Access to Diagnostic Assessments for Autism Spectrum Disorder Using an Arena Model

Area of Science:

• Developmental Pediatrics
• Autism Spectrum Disorder Diagnosis
• Healthcare Delivery Models

Background:

• Early diagnosis of autism spectrum disorder (ASD) is crucial for young children.
• Access to timely diagnostic evaluations for toddlers with developmental concerns can be challenging.
• Existing models may not adequately address the demand for pediatric developmental assessments.

Purpose of the Study:

• To enhance access to diagnostic evaluations for children under 3 years old with suspected autism spectrum disorder.
• To implement and evaluate a multidisciplinary 'arena model' for early ASD assessment.
• To reduce delays in initial visits and final diagnoses for young children.

Main Methods:

• Developed and implemented a multidisciplinary 'arena model' involving a developmental behavioral pediatrician, psychologist, and speech language pathologist.
• Utilized quality improvement methods, including Plan-Do-Study-Act cycles and stakeholder feedback, during the design phase.
• Tracked key outcomes such as time to initial visit and time to diagnosis using run charts during implementation.

Main Results:

• Reduced median time to first visit from 122 days to 19 days.
• Decreased median time to final diagnosis from 139 days to 14 days, sustained over two years.
• Lowered the number of required visits from 4-5 to 2, and reduced average assessment costs by $992 per patient.

Conclusions:

• Creative and flexible care delivery models can improve access to developmental assessments for young children.
• Understanding supply and demand dynamics is essential for optimizing pediatric diagnostic services.
• The 'arena model' offers a successful approach to improving early access and efficiency in ASD evaluations.