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General paediatric practice in autism spectrum disorder screening in Ontario, Canada: Opportunities for improvement
Angie Ip1,2, Annie Dupuis3,4, Evdokia Anagnostou1,5
1Bloorview Research Institute, Toronto, Ontario.
Insights
Canadian pediatricians widely use developmental screening tools and most use autism spectrum disorder (ASD) screening tools when concerned. Clearer guidelines and parent-completed forms are needed to improve ASD screening in general practice.
Area of Science:
- Pediatrics
- Developmental Pediatrics
- Child Psychology
Background:
- Early identification of autism spectrum disorder (ASD) is crucial for timely intervention.
- Barriers to early ASD identification exist, with limited data on screening practices in Canadian general pediatrics.
Purpose of the Study:
- To investigate the current practices of general paediatricians regarding ASD screening.
- To examine the utilization of general developmental and specific ASD screening tools by paediatricians.
Main Methods:
- A cross-sectional survey was administered to general paediatricians across Canada.
- Data were collected on the use of developmental and ASD screening tools.
Main Results:
- Of 132 eligible paediatricians, 93% used developmental screening tools and 85% used ASD screening tools for concerned children.
- The Modified Checklist for Autism in Toddlers (M-CHAT) was the most frequently used ASD screening tool.
- Referrals to specialists were common for diagnosis confirmation and resource access.
Conclusions:
- Paediatricians are receptive to using formal ASD screening tools but require clearer guidelines.
- Tool brevity and parent-completed formats are desirable features for supporting ASD screening.
- Enhanced support and resources are necessary to facilitate effective ASD screening and intervention.
Background:
Screening is important for early identification of children with autism spectrum disorder (ASD), potentially leading to earlier intervention. Research has identified some barriers to early identification of ASD, however, information about ASD screening in Canadian general paediatric practice is lacking.
Objectives:
The aim of the study is to better understand ASD screening practice patterns by examining the use of ASD and general developmental screening tools by general paediatricians.
Methods:
The research team conducted a cross-sectional survey of general paediatricians.
Results:
Two-hundred and sixty-seven paediatricians responded and 132 were eligible for the study. Ninety-three per cent of the responders used a developmental screening tool. Eighty-five per cent of the responders used an ASD screening tool when there were concerns for ASD, and 15% never used one. The most commonly used ASD screening tool was the M-CHAT. Children suspected of having ASD were referred to specialists not only to confirm the diagnosis but also to facilitate access to resources. General paediatricians were keen to incorporate formal ASD screening tools in their practice but identified the need for clearer guidelines.
Conclusion:
Previous studies have shown that children at risk of ASD continue to be missed through developmental surveillance and targeted screening. Paediatricians are interested in implementing an ASD screening tool and cite brevity and forms that can be completed by parents as factors that would support the use of a screening tool. Clearer guidelines and tools to support ASD screening and access to resources are needed.
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