Multi-stage Screening in Early Intervention: A Critical Strategy for Improving ASD Identification and Addressing...

Area of Science:

• Developmental Pediatrics
• Public Health
• Child Psychology

Background:

• Health disparities in autism spectrum disorder (ASD) detection can delay crucial early interventions for children.
• Early identification of ASD is critical for timely access to support services.

Purpose of the Study:

• To examine potential disparities in the implementation of a multi-stage ASD screening and diagnostic evaluation protocol.
• To assess the effectiveness of the protocol in diverse populations within Part C Early Intervention programs.

Main Methods:

• A cohort of 4943 children aged 14-36 months underwent a multi-stage ASD screening and diagnostic evaluation protocol.
• Logistic regression analyses were used to identify predictors of screening participation and outcomes at each stage.
• Demographic data including race, primary language, and insurance status were collected.

Main Results:

• High participation and follow-through rates were observed across all stages of the screening protocol (64.9% first-stage, 65.3% second-stage, 84.6% diagnostic evaluation).
• Demographic differences in participation were noted only at the first stage, with higher participation among children of color.
• Children with public insurance showed higher positive screening results.

Conclusions:

• The multi-stage ASD screening and diagnostic evaluation protocol demonstrates potential for mitigating disparities in early autism detection.
• The protocol appears effective in engaging diverse populations, including children of color and those with public insurance.
• High participation rates suggest the protocol is feasible and acceptable within early intervention settings.